Abuse Weakens Antibiotics In Fighting Diseases In Thailand

[webfact]

Abuse weakens antibiotics in fighting disease

By The Nation

Growing resistance of disease strains to antibiotics has become critical in Southeast Asia, including Thailand, prompting health experts from around the world to meet in Bangkok this week to plan how to cope with this threat.

"Thailand is now facing the critical situation of antibiotic drug resistance caused by the irrational use of antibiotic drugs," said Niyada Kiatying-Angsulee of the Thai drug-watch system programme.

"Thailand now has imported and produced antibiotic drugs valued at over Bt20 billion a year," she added.

She said medical personnel were to blame for their irrational prescription and dispensing of drugs to patients.

Also, patients were buying drugs without consultation from physicians or experts, leading to inappropriate drug use. Antibiotic drugs for humans had also had been used in animals and fisheries.

"[As a result] many diseases will not be cured as there are no new drugs available for treatment," she said.

To cope with the rise in drug resistance, the drug-watch system programme will team up with ReAct - a Sweden-based organisation that campaigns for public awareness on drug resistance - to hold a three-day international meeting from tomorrow, bringing together hundreds of health experts worldwide to draw up resolutions to tackle drug resistance in the region.

-- The Nation 2011-05-02

[AsiaCheese]

And they realize that now? Umpteen years into over-prescription of antibiotics for even the slightest cold, by people who should know way better? Amazing...

[asdecas]

I've been reading variations of this same story for at least twenty years. It appears that no amount of publicity, nor any awareness campaigns can stop this abuse of antibiotics, though it's not for want of trying. There will probably never be a solution beyond the formulation of new medications to combat ongoing development of drug resistance.

[moto77]

I've been reading variations of this same story for at least twenty years. It appears that no amount of publicity, nor any awareness campaigns can stop this abuse of antibiotics, though it's not for want of trying. There will probably never be a solution beyond the formulation of new medications to combat ongoing development of drug resistance.

Yes, that's true. And I don't want to belittle the problem, but the fact that you've heard it for 20 years and we haven't had a killer bug tear through the population is telling in and of itself.

Oddly, another solution is to pull out some of the older drugs. It seems that some of the bacteria have lost their resistance to older penicillins that have not been used in years.

[OZEMADE]

And they realize that now? Umpteen years into over-prescription of antibiotics for even the slightest cold, by people who should know way better? Amazing...

With a Pharmacy on every corner and in the middle of the block, why wouldnt the drugs be over perscribed. Most of these people/Pharmacists have a bodgie shingle hanging on the wall anyhow. But most Thai's dont know that.

As far as the drug companies go. They only want Thailand to stop making the drugs for one third of the price, which only takes away their profits. Stuff the other companies and good for you Thailand, keep producing drugs for less.

[AsiaCheese]

@Ozemade:

easily replace "one third" with "a fraction" -- the price I pay for a 20 paracetamol pack (generic) in Switzerland buys 5 plastic screwtop family boxes with 100 pills each... For the hard-of-thinking, that's a 1/25th of the price here!

[OZEMADE]

@Ozemade:

easily replace "one third" with "a fraction" -- the price I pay for a 20 paracetamol pack (generic) in Switzerland buys 5 plastic screwtop family boxes with 100 pills each... For the hard-of-thinking, that's a 1/25th of the price here!

I REST MY CASE.

[anon467367354]

nothing will change. the people here worship doctors like they are gods and for the most part all they do is push drugs. Thailand is a gold mine for the pharmaceutical companies. The doctors will do anything they say, inject anything they want to sell, publish any propaganda they wish and the people here are happy to take kick-backs for a job well done. I've been harping on this for years as well as the consumption of milk, talk about a great source of antibiotics!. It's ridiculous and sad to see the ignorant go down this way at the hands of the profiteers.

[CosmicSurfer]

One major cause being the Hospitals over-prescribing in order to pad their bills.

CS

[mpdkorat]

My mother warned me about this problem about 22 years ago. I'm sure that well informed medics realised this problem even before that.

[edwinchester]

I've been reading variations of this same story for at least twenty years. It appears that no amount of publicity, nor any awareness campaigns can stop this abuse of antibiotics, though it's not for want of trying. There will probably never be a solution beyond the formulation of new medications to combat ongoing development of drug resistance.

Yes, that's true. And I don't want to belittle the problem, but the fact that you've heard it for 20 years and we haven't had a killer bug tear through the population is telling in and of itself.

Oddly, another solution is to pull out some of the older drugs. It seems that some of the bacteria have lost their resistance to older penicillins that have not been used in years.

Right now there are antibiotic resistant strains that are causing many deaths. My own Thai sister in law is seriously ill in hospital as I type this with a post operation infection that is not responding to treatment.

[OZEMADE]

If a well know hospital in Pattaya perscribes expensive medication for you, say around 3000B. You take the perscription across to the BIG pharmacy in North Pattaya road and if you dont want a receipt they give it to you for 1000B, a saving of 2000 Baht.

You see they supply the hospital with most of their drugs.

[Crushdepth]

It's not just pharmacies that are the problem - doctor in Thailand *routinely* over prescribe, because the hospital makes $$$ selling drugs.

[VBF]

@Ozemade:

easily replace "one third" with "a fraction" -- the price I pay for a 20 paracetamol pack (generic) in Switzerland buys 5 plastic screwtop family boxes with 100 pills each... For the hard-of-thinking, that's a 1/25th of the price here!

Oddly enough, SOME drugs are no longer cheaper in Thailand. Neurofen is about 60Baht (£1.22) for 12 in Pattaya but in UK it's £1 for 12 (Wilkinsons). I emailed a friend in UK only yesterday to enquire so that information is current. Of course, that's only one example and it's NOT an anti-biotic.

I rather think that it's the Thai people who are taken in by the "must use an antibiotic" line. We Farang are lucky enough to be slightly better informed!

Edited May 2, 2011 by VBF

[OZEMADE]

It's not just pharmacies that are the problem - doctor in Thailand *routinely* over prescribe, because the hospital makes $$ selling drugs.

Well they have to pay for the Hellipad on the roof for the chopper that was to be used in traffic accidents, that only gets used for transporting people around the country.

[exbelg]

in thailand and US : medicine is big business... hopitals and doctors only think about making more money...

every time my children where in the hospital for small or less small thing: first thing they to is prescribe antibiotics without any reason or testing the germs ...

[SanukJoeII]

Oddly enough, SOME drugs are no longer cheaper in Thailand. Neurofen is about 60Baht (£1.22) for 12 in Pattaya but in UK it's £1 for 12 (Wilkinsons). I emailed a friend in UK only yesterday to enquire so that information is current. Of course, that's only one example and it's NOT an anti-biotic.

I rather think that it's the Thai people who are taken in by the "must use an antibiotic" line. We Farang are lucky enough to be slightly better informed!

Careful with comparing. As you already misspell the name (Neurofen instead of Nurofen) you might not have noticed that Nurofen contains either 200, 400 or 800 mg of Ibuprofen, the active ingredient. So comparing e.g. 200 mg Nurofen with 400 mg Nurofen makes no sense.

Even if it would be same price, it is a western company getting the profit: made in Thailand by or on behalf of Reckitt Benckiser!

The whole problem imo is the availability of antibiotics in pharmacies, over the counter, where as far as I can remember in the west you need a prescription.

Thais are grown up with that, as I keep (behind closed doors) the family pharmacy I remember MIL came to me with an infected cut in her leg, asking for antibiotic.

I gave her Betadine and a plaster and two days later the problem was solved. They are used to getting antibiotics, paracetamol and vitamins, loads of vitamins.

Doctors and hospitals are part of it, although not the largest part, they earn money with medicines but not a lot, depending on the hospital. Government hospitals are way cheaper than private or so called international hospitals, and you get the same brands of medicines....

Joe

[Deeral]

THe Thai medical industry - like everything else in Thailand - has corruption and nepotism running through it - the result is poorly trained staff who paid for their qualifications and have scant regard for ethics or appropriate treatments. so long as they got a quick result etc or the patient went away they considered it a "success".

The problem with this is the indiscriminate used of antibiotics, frequently when they are completely unnecessary. The result - is that Thailand is head and shoulders above other countries in contributing to the obsolescence of antibiotics throughout the world.

[Deeral]

It would also be useful when comparing Thai medical care to other countries to bear in mind that in Thailand regardless of initial cost, efficacy or mistakes made, there is virtually NO comeback for the patient whatsoever.

[jomtienbob]

The problem is not just in the obvious medical fields by greedy doctors and health professionals, its also in the animal feeds. Antibiotics used sub-therapeutically in all forms of animal feed have bred methicillin resistant microbes for decades and the problem continues to escalate. EU regulators have set limits on traces of antibiotics found in meat however this has only just slowed the habit. Antibiotics are indeed the greatest enabling invention of mankind in millennia and we are rapidly diminishing its benefits by allowing myopic greed and abuse of the drugs in non therapeutic uses to take over from the sensible and IMHO obvious long term benefits. This is not just a local phenomena nor is it only found in Asia, it's just short sighted greed and constant confirmation that 'cash is king' everywhere in our societies. The only real long term answer of course is what is so seldom found here, good education and awareness...

[Soboringtochooseaname]

More bullshxt...

Stop feedings pigs and other animals with antibiotics and then someone could start to open his mouth...

I used to tell Thai that they shouldn't eat antibiotics so easily, but i now perfectly understand them and take antibiotics whenever i need them without asking a doctor: who wants to miss 1 or 2 days at work because not taking antibiotics at the first symptoms (to take them later after having missed work already!), and anyway, it happens so many times that doctors do not know if your condition is due to bacteria or virus, so why stupidly waiting to take antibiotics ?

But of course you can believe the "experts" in cheating the world...

[Soboringtochooseaname]

And to those who do not understand why doctors so easily prescribe antibiotics:

when you pay 800 thb in private hospital to meet a doctor, i guess you want him to cure you, and as he doesn't have more clue than yourself about your disease better give you antibiotics that might be useful !

They would loose customers if not giving antibiotics, because in many cases these antibiotics are useful, and anyway nobody wants to pay 800 thb again the second time when you have to meet a doctor again because the first one didn't give you antibiotics...

[weary]

nothing will change. the people here worship doctors like they are gods and for the most part all they do is push drugs. Thailand is a gold mine for the pharmaceutical companies. The doctors will do anything they say, inject anything they want to sell, publish any propaganda they wish and the people here are happy to take kick-backs for a job well done. I've been harping on this for years as well as the consumption of milk, talk about a great source of antibiotics!. It's ridiculous and sad to see the ignorant go down this way at the hands of the profiteers.

I know all about the antibiotics abuse. Interested to hear what you have learned on milk consumption, please PM me.

[goatfarmer]

"The whole problem imo is the availability of antibiotics in pharmacies, over the counter, where as far as I can remember in the west you need a prescription."

This claim could easily be tested by comparing resistance in over the counter countries with resistance in prescription countries. On the other hand, international travel being what it is might erase any differences.

In any event, the whole issue is overblown for two reasons:

1. Despite claims of resistance ancient antibiotics such as penicillin and its variants dicloxacillin and amoxycillin, are still being prescribed as the first line of defense for wound and respiratory infection after decades use. Why might that be? Perhaps because they still work.

2. New antibiotics are being created all the time.

http://www.sciencedaily.com/releases/2011/04/110408075152.htm

http://www.swissinfo.ch/eng/science_technology/New_antibiotic_offers_hope_against_superbug.html?cid=8474318

http://news.nationalgeographic.com/news/2010/09/100909-cockroach-brains-mrsa-ecoli-antibiotics-science-health/

As one poster said, we haven't been wiped out despite 20 years of this claim. Let's find something else to fret about.

[AgentSmith]

No shit! Antibiotics are available without prescription which is just plain stupid. Even worse is that local clinics without true medical personnel prescribe antibiotics but often deny someone to finish the full period of treatment. I once had to resolve to self medication because they refused to give more tablets after 4 days because as they stated the symptoms had subsided... I told them I wanted to finish the typical 7 to 10 days treatment but they kept refusing having no idea what I was talking about. Luckily the drug store in the next town sells them over the counter. So no this whole story about resistance against antibiotics is not surprising at all. But it's too late anyway. It's 5 minutes past 12. Time to look for alternatives!

Edited May 2, 2011 by AgentSmith

[skinnymilinky]

I've been reading variations of this same story for at least twenty years. It appears that no amount of publicity, nor any awareness campaigns can stop this abuse of antibiotics, though it's not for want of trying. There will probably never be a solution beyond the formulation of new medications to combat ongoing development of drug resistance.

Yes, that's true. And I don't want to belittle the problem, but the fact that you've heard it for 20 years and we haven't had a killer bug tear through the population is telling in and of itself.

Oddly, another solution is to pull out some of the older drugs. It seems that some of the bacteria have lost their resistance to older penicillins that have not been used in years.

Well here in the UK there is a massive problem with MRSA and C-Diff due to the overuse of antibiotics. A great number of people in the UK die every year after contracting these diseases and they spread quickly through hospitals. Just because it hasn't happened yet doesn't mean it won't. Remember that healthcare in the UK has only just been facing these new antibotic-resistant strains over the past couple of years and the healthcare system has been around for much longer.

The number of times I have had to say to my husband, no don't take those antibiotics, you only have a cold!! The pharmacists are so quick to give them out and there is no understanding about what they should be used for. (and that includes my husband!)

[bumpkin]

There is another aspect, besides over prescription.

It is important that patients taking a course of antibiotic should complete the prescribed course of medication.

Stopping taking the antibiotic part way through the prescribed course of treatment, for whatever reason ( - cost, feeling better, forgetfulness, laziness, etc...) is also a contributory factor to reducing the longterm effectiveness of anitibiotics.

Doctors prescribing such medication should seek to assure themselves that the patient is likely to and/or is capable of completing a prescribed course of treatment.

[happysanook]

No shit! Antibiotics are available without prescription which is just plain stupid. Even worse is that local clinics without true medical personnel prescribe antibiotics but often deny someone to finish the full period of treatment. I once had to resolve to self medication because they refused to give more tablets after 4 days because as they stated the symptoms had subsided... I told them I wanted to finish the typical 7 to 10 days treatment but they kept refusing having no idea what I was talking about. Luckily the drug store in the next town sells them over the counter. So no this whole story about resistance against antibiotics is not surprising at all. But it's too late anyway. It's 5 minutes past 12. Time to look for alternatives!

what's even more stupid is having to pay $100 to talk to a Dr. at a clinic to get antibiotics prescribed when they're needed...as in most of the US. most european/uk countries have the right of it.

[VBF]

Oddly enough, SOME drugs are no longer cheaper in Thailand. Neurofen is about 60Baht (£1.22) for 12 in Pattaya but in UK it's £1 for 12 (Wilkinsons). I emailed a friend in UK only yesterday to enquire so that information is current. Of course, that's only one example and it's NOT an anti-biotic.

I rather think that it's the Thai people who are taken in by the "must use an antibiotic" line. We Farang are lucky enough to be slightly better informed!

Careful with comparing. As you already misspell the name (Neurofen instead of Nurofen) you might not have noticed that Nurofen contains either 200, 400 or 800 mg of Ibuprofen, the active ingredient. So comparing e.g. 200 mg Nurofen with 400 mg Nurofen makes no sense.

Even if it would be same price, it is a western company getting the profit: made in Thailand by or on behalf of Reckitt Benckiser!

Good point Joe - I shall check on that!

As for the spelling, that MIGHT be another example of UK/US English spelling - I have seen it spelt (spelled) both ways in various places. Just Google either spelling and you'll see the same.

Edited May 2, 2011 by VBF