Acute Shortage Of Penicillin In Thailand!

[Jaivin2011]

I do not want to put this into the Health Forum but rather the main Thailand News forum but could not do so as I think that its very important for all foreigners residing in Thailand to know this.

Took my friend who has secondary Syphllis to A Private Hospital here this morning and was told that he needed injectable Penicillin 1.2 million units per ampoule for six doses sbut the Doctor said that she did not have any stocks at the moment and that you cannot order it as there is an acute shortage for the last 6 months! Checked with Samitivej, BNH and Paolo and found out that all hospitals under the Dusit Medical Group does not have it. Bamrungrad, Bangkok Christian , St Louis , Sririraj , Chulalongkorn Hospital all said the same and so did bangrak Hospital and also a few that we check in Pattaya, Phuket and Chaingmai via phone. My staff when down to check the clinics at Silom near Patpong and also a lot of pharmacies and none carried stocks. Found out that the GPO (Government Pharmaceutical Organisation had none).

Whats going on, Penicillin is critical for many diseases and secondary options can cause drug resistant and super bugs.Please help if anyone knows where to get injectable peenicillin at 1.2 million units per ampoule.

Thanks.

PS: Its not trivail when a country is does not have stocks of a major medication.And they are trying to be a Medical Hub? One underground dealer at Sukhumvit was asking for Bt 25,000 per ampoule! which was outrageous.

[smokie36]

You mean 1.2g ampoules Its not a worldwide issue, there is plenty at my hospital here in the UK.

Good luck with your search.

[smokie36]

I would add you will get better info from the mods on the health forum on this....more local and accurate advice.

[Jdietz]

As long as it's still attached it is not usually referred to as 'my friend'

Good luck finding it, but instead of paying 25K why not take a 90 Baht OTC strip of Cypro instead. The bug you want to treat is more than likely quite resistant to penicillin already anyways.

[farang000999]

i assume there is an alternative?

[smokie36]

Alternative is Doxycycline 100mg twice daily.

Still recommend this be moved to the health Forum.

[geriatrickid]

As long as it's still attached it is not usually referred to as 'my friend'

Good luck finding it, but instead of paying 25K why not take a 90 Baht OTC strip of Cypro instead. The bug you want to treat is more than likely quite resistant to penicillin already anyways.

And you know this because you identified the variant?

Ciprofloxacin is an inappropriate drug and won't work.

A very irresponsible statement and one that hopefully will be ignored.

Please shush.

Edited June 23, 2012 by geriatrickid

[Jaivin2011]

Hi, its not for "my friend" but really for a friend and its 1.2 million units per ampoule and not a 1.2 g ampoule and also for secondary syphllis, intravenous high dose of penicillin is a guaranteed cure as long as you are not allergic to it. Many people develop resistant to other types of antibiotics and the doxycyline 100mg twice daily protocol is good for stage one syphillis and even then in some cases might still fail to sure syphillis and in secondary syphillis, two 1.2 million units injections at one time and the similar injections evry other week for a total of three weeks is a guranteed protol according to the doctor here and also in the US CDC Circulars and also the Harvard Medical Journals. The point is that Penicillin is also important for amny other diseases and yet there is none in Thailand at the moment. Is this not serious?

[smokie36]

Hi, its not for "my friend" but really for a friend and its 1.2 million units per ampoule and not a 1.2 g ampoule and also for secondary syphllis, intravenous high dose of penicillin is a guaranteed cure as long as you are not allergic to it. Many people develop resistant to other types of antibiotics and the doxycyline 100mg twice daily protocol is good for stage one syphillis and even then in some cases might still fail to sure syphillis and in secondary syphillis, two 1.2 million units injections at one time and the similar injections evry other week for a total of three weeks is a guranteed protol according to the doctor here and also in the US CDC Circulars and also the Harvard Medical Journals. The point is that Penicillin is also important for amny other diseases and yet there is none in Thailand at the moment. Is this not serious?

Sorry for confusion OP....but if you read this from BNH you will understand why I posted.

http://www.bnhhospital.com/en/pharmacy_library/detail/Augmentin-1-2g-intravenous

Maybe its a language barrier....I can't believe there is no Penicillin in Thailand.

[tinfoilhat]

Hi, its not for "my friend" but really for a friend and its 1.2 million units per ampoule and not a 1.2 g ampoule and also for secondary syphllis, intravenous high dose of penicillin is a guaranteed cure as long as you are not allergic to it. Many people develop resistant to other types of antibiotics and the doxycyline 100mg twice daily protocol is good for stage one syphillis and even then in some cases might still fail to sure syphillis and in secondary syphillis, two 1.2 million units injections at one time and the similar injections evry other week for a total of three weeks is a guranteed protol according to the doctor here and also in the US CDC Circulars and also the Harvard Medical Journals. The point is that Penicillin is also important for amny other diseases and yet there is none in Thailand at the moment. Is this not serious?

your friend is lucky you are so clued up on his condition. Perhaps you can order online

[Time Traveller]

Try Singapore or India. Situations like you mentioned are not uncommon in Thailand, even if it likes to say it is a "Medical tourism hub"

[Jingthing]

There seem to be multiple issues blamed on the floods and manufacturing being crippled.

[Mobi]

This topic really belongs in the health forum where more informed advice from Sheryl and others will be available.

[Jaivin2011]

Found out this morning that the situation about Penicillin is really serious as Hospitals upcountry in places like Chiangrai and Chiangmai are claiming that they have not been having penicillin supplies for the last 6 months and worst there are also other antibiotics like Minicin etc which is not available. Tried Singapore and apparently they too have a shortage but have sufficient stocks for emergency cases and all Hospitals have to keep strict records hence no way of buying from there.

I really hope that the Moderators of this great forum will somehow help to get this news to the media as an explanation from The Ministry Of Public health is really needed and all Thai Citizens and Foreigners need to be aware of the situation. If you check up, penicillin is really needed as the first line of defense for numerous diseases and second line antibiotics can actually cause resistance (hence a person is actually not properly cured and can die if that disease progresses.)

Anslo, if any TV member has any suggestions where to get real penicilling for IM purpose (Ie Intramuscular Injection) please advise. Really need help. Thanks.

[Pseudolus]

No idea where to get it - I had a similar issue with gout pills a while ago where the ones I needed were out of stock everywhere. Eventually the GF found some tucked out of the way. The media are no use in Thailand. It would be reported as "Penicillin is useful for treating some diseases and Thailand is doing their best to make sure this is available to patients". No reporting at all, just a ball of arse.

http://www.mnh.co.th/

Try calling them - they manufacture the stuff based in Sukhumvit so no flood there. Just a thought; isnt' it used for first line treatment for meningistus? Making the demand post flood from the numerous waterborne ailments far outstrip the supply ability.

[GreenSnapper]

Call first and check availability in Malaysia. Then Air Asia to KL.

[naboo]

For the OP's friend, ask your doctor whether the following will work.

250mg intramuscular injection of cetriaxone and simultaneously 1000mg of azythromycin orally (once), then follow up with 100mg doxycycline daily for 10 days (take after food).

I'm no doctor but I believe that it'll rid him of syphilis.

[Forethat]

Many people develop resistant to other types of antibiotics

Antibiotic resistance is developed in, or acquired by, the microorganism, not the host.

[Sheryl]

First of all, it is not penicillin per se that is in short supply it is a specific long-acting intramuscular (IM) injection form.

Penicillin comes in many forms: oral, short-acting intravenous, and several different IM injection peparations with differing lengths of action. Rest assurred that the most widely used forms of it (oral and short0acting IV) are still available everywhere, in multiple brands. What the OP is looking for is specifically procaine penicillin, a long-acting intramuscular injection for which there is only one manufacturer in Thailand. You could contact the manufacturer directly to see what the story is:

M & H Manufacturing Co Ltd

Factory:

41 Sukhumvit Rd Samutprakarn 10270

Tel: 0 2753 8730, 0 2394 2141, 0 2753 8730 ext 700 (Customer Service)

Fax: 0 2384 3602, 0 2753 7979 (Customer Service)

Website: http://www.mnh.co.th

If procaine penicillin cannot be obtained there are certainly alternatives...usually a long (e.g. 20 days) regimen of doxycycline, which is what is done for people who are allergic to penicillin. Azithromycin can also be used in some cases depending on how advanced it is. It should also be possible to treat with repeated IV doses although that would entail hospitalization. (Benzathine penicillin is also often used but is not registered for use in Thailand)

What I find very odd about this story is the initial doctor not having advised an alternate course of treatment given that the first drug of choice was unavailable. It often occurs that for one reason or another a first line drug cannot be used (unavailable, patient allergic, patient has contraindications to it etc) and one then turns to alternative lines of therapy.

I suggest the OP bring his friend to the Thai Red Cross Anonymous clinic, they see probably more syphilis than anyplace in the country and will be able to advise on treatment.

.

[Jaivin2011]

Hi, Been outthe whole day checking out various pharmacies, clinics and hospitals in Bangkok , and its the same no benzathine penicillin for Intramuscular injection use. My firends and staff have also been checking around and there is none around in the upcountry hospitals and Malaysia and Singapore has also proven to be futile.

Please if anyone knows where to procur it, please let me know urgently as my friend really needs it. Thank You in Advance.

[Jaivin2011]

Hi Khun Sheryl,

Thanks a lot about the manaufacturer, will try tomorrow. The reason we have to use it and not doxycyline is because he is already developed resistant to doxycycline and also azithromycin and also tetracycline according to the Doctor and that he needs it fast. The red cross clinic also does not have stocks of benzathine penicillin.

Thanks.

[bina]

if i remember correctly, we use procaine penicillin shots on animals,some sub cutaneous, some IM long lasting, so u dont have to give an injection every day to a horse for instance but rather every 48 hours... usually animal antibiotics are the same as human antibiotics, just the amounts /percentages may be different...its called LA PEN G or something to that sort... a very long shot..like for emergency use..

bina.

[Sheryl]

It is PROCAINE PENICILLIN you need to ask about, not BENZATHINE. Both are long acting and both are used to treat syphilis. But there is no licensed brand of benzathine Pcn in Thailand. So if you have been asking places about benzathine naturally all will say no. Need to ask specifically about procaine. the manufacturer is your best shot as they would know if they have supplied it anywhere recently.

If all else fails you can readily get it in Cambodia. But needs a trip to at least Batatmabang, don't trust the small pharmacies close to the border.

[Jaivin2011]

Ok Update for everyone here:

a) There is no Procaine Penicillin (for intramuscular injections) and even Penicillin G that is used for IV injections in Thailand at the moment! Almosts all the private and government hospitals do not have it and according to the GPO, the problem has ben ongoing for about 8 months and expected to prolong as they are only expecting new stocks in December. None of the local thai companies are making it anymore also.Oral Penicillin is available but cannot be used in cases where the IM or IV forms are needed.

The problem is similar in Malaysia , Singapore, Cambodia,and even Australia. (You can goggle and see the news on penicillin shortages).

Managed to get some via courrier from India but shits I never knew that Penicillin can be that expensive.

Thanks to all the posters for their help and useful comments.

[wpcoe]

Sheryl, I am currently being treated with "Benzathine penicillin G2.4 munit" at Bangkok Hospital-Hua Hin. Initially they only had in stock enough for one dose, but called me back when they got enough for three doses (three weekly injections), so somehow they got their hands on Benzathine penicillin. God that stuff hurts!