Doctors handing out antibiotics on demand

Doctors handing out antibiotics on demand

PETALING JAYA - Patients demand, doctors oblige. That's why we have become a nation of antibiotic pill poppers.

More than half of patients in private clinic are given antibiotics for common ailments, even where bacteria are the unlikely cause.

Most upper respiratory tract infections (URTI) leading to sore throat, fever, flu and cough are caused by viruses but in almost 60 per cent of the cases, antibiotics are prescribed.

Health Ministry's infectious disease national head Datuk Dr Christopher Lee said the sole reason for prescribing antibiotics must be clinical.

Warning general practitioners against giving in to economic pressure from patients and drug companies, he said: "Business can't go on as usual."

Quoting the National Medical Care Survey 2014 (see info-graphics) which covered 27,587 patients of 545 public and private clinics nationwide, he said in government clinics, only 17 per cent of URTI patients were given antibiotics.

For gastroenteritis cases, 23 per cent of private clinic patients were given antibiotics compared with 9 per cent in Government hospitals.

Dr Lee said rising resistant rates of common infections were worrying.

In the last decade, resistance to common first line antibiotics used to treat gonorrhea, lung, ear, blood, brain, spinal cord and urinary tract infections and bloody diarrhoea, rose between 15 per cent and 50 per cent.

Dr Lee said doctors who turned their patients into antibiotic-poppers were "carpet bombing" bacteria.

"If your sore throat is caused by a virus, an antibiotic will not cure the infection.

"Instead, it will kill all the other harmless bacteria which help keep bad bacteria from taking over your body," he added.

Last month, Sunday Star highlighted how Malaysians very likely rank among the world's highest antibiotic users with 90 per cent of doctors surveyed in Selangor saying patients expected antibiotics.

Dr Lee said there were ongoing campaigns to counsel doctors on how to deal with patients insisting on antibiotics.

He said those who were prescribed with antibiotics should always ask the doctor if they were really necessary.

"Questioning the doctor forces him to self-audit," he said.

According to a recent review on anti-microbial resistance, related deaths were expected to be the highest in Asia at 4,730,000 by 2050.

"Antibiotic usage is very high here. It's our common resource and it should also be our common responsibility.

"If we don't do something now, it'll reach an alarming stage very soon," Dr Lee said, adding that the ministry was closely monitoring government clinics and hospitals.

He said sudden prescription spikes or questionable antibiotic usage should be quickly addressed.

"Recently, the use of expensive antibiotics rose suddenly in a small rural hospital so we investigated it.

"In the public sector, we have a surveillance system but we cannot compel the private sector to send its data to us for monitoring," he said.

Sungai Buloh Hospital senior consultant physician (infectious disease) Dr Benedict Sim said superbugs were already present in hospitals, adding that community clinics would also face the same problem if the rampant use of antibiotics was unchecked.

"Gastroenteritis, even if caused by bacteria, doesn't usually require antibiotics but they are being dished out so frequently.

"If we're not careful, treating common infections and diarrhoeal diseases will become much costlier and more difficult," he added.

Health Minister Datuk Seri Dr S. Subramaniam said the recently launched national antibiotic guideline and the reintroduction of the anti-microbial stewardship programme protocol was a step forward to streamline anti-microbial use and promote good prescribing practice.

He said all stakeholders, including healthcare administrators, practitioners and pharmacists. had a responsibility to "preserve the miracle of antibiotics", adding that immediate and coordinated measures must be taken.

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