Misuse of antibiotics a common problem: Experts

Singapore is developing a nationwide plan to tackle antimicrobial resistance - a result of inappropriate or misuse of antibiotics.

It is a very common problem, said infectious diseases specialist Leong Hoe Nam.

Sometimes, patients ask for antibiotics - regardless of the nature of their infections - because of the placebo effect.

A study by the Yong Loo Lin School of Medicine at the National University of Singapore with public health experts from the National University Health System published last month found that a third of more than 900 patients with upper respiratory tract infections surveyed expected antibiotics to be prescribed.

Of the third, almost half would ask their general practitioners for antibiotics, or visit a second doctor for it.

Dr Leong said patients are not the only ones at fault. Doctors are also partly responsible for the rise of deadly superbugs, a strain of bacteria that has become resistant to antibiotic drugs.

"Many of us use antibiotics in the wrong setting. Even in the best case scenario, antibiotics are used inappropriately 15 to 20 per cent of the time," said Dr Leong.

Wrong prescriptions can happen as it is difficult to tell a bacterial infection from a viral one initially.

He said: "You need time for a disease to manifest to differentiate between the two types.

"It is difficult because everyone wants to get well quickly and go back to (work). You don't have the luxury of time any more."

Animal husbandry plays a part too. Giving antibiotics to animals will help them grow bigger faster, but the animals will also carry antibiotic-resistant genes.

These genes are passed to us when we eat them, Dr Leong said.

The fact that Singapore is "porous" to other neighbouring countries with high antimicrobial resistance is also a problem, he said.

"Looking at our own backyard is great, but we must also remember that we can bring germs back unknowingly," said Dr Leong.

He added: "It is a whole ecosystem, from the medical industry to government policies, and to other countries as well.

"We need a multi-disciplinary approach to solve this problem."

The New Paper finds out when antibiotics are the cure.

Antibiotics should be taken only when prescribed.

The basic guideline is when there is a high likelihood of bacterial infection, said general practitioner Ng Siau Peng.

Very mild bacterial infections may go away by themselves if the immune system is strong enough, but usually, antibiotics are required to help the patient recover faster, he said.

Bacterial infections range from strep throat to tuberculosis.

"Some patients think antibiotics can help with faster recovery, so as doctors, we have to explain why we are not giving them any," said Dr Ng.

Should I ask for antibiotics if I am not prescribed any?

Doctors are trained to identify which types of antibiotics are suitable for which groups of bacteria.

Dr Ng said patients should clarify their doubts with doctors if they are unsure about the prescription.

Rather than taking the initiative to ask for antibiotics, Dr Leong suggested that patients request for diagnostic tests instead.

This will give doctors a clearer idea of whether an ailment is caused by a bacterium or virus, he said.

Is it okay to take leftover antibiotics from a family member?

No. It is unsafe to do so, said Dr Ng.

Some types of bacterial infections require specific types of antibiotics.

Taking the wrong antibiotic may actually cause a delay in proper treatment, which can worsen the infection, he said.

You can also have allergies to certain antibiotics that you may not be aware of.

fjieying@sph.com.sg

This article was first published on December 28, 2016.
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