The dangers of over-prescription of antibiotics in Thailand

[Jingthing]

As most are aware, in Thai medical culture, if the doctor doesn't give you multiple bags of pills for ANY visit, you aren't getting "quality" medical care. I guess another example of "Thainess" that might just be very dangerous to the public.

While this link is about this problem in the U.S. I think it's fair to assume the problem is at least as bad or probably worse in Thailand because of the pill pushing medical culture.

I guess all we can do as individuals is to question it every time a doc here gives us antibiotics. But I'm afraid that's just a drop in the bucket ...

The use of antibiotics is the single most important factor leading to antibiotic resistance around the world. Antibiotics are among the most commonly prescribed drugs used in human medicine. However, up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. Antibiotics are also commonly used in food animals to prevent, control, and treat disease, and to promote the growth of food-producing animals. The use of antibiotics for promoting growth is not necessary, and the practice should be phased out.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/09/16/taking-antibiotics-you-dont-really-need-might-kill-you/

Please note: I intentionally posted this in the general forum as it is against health forum rules to post such general health related news items there. Cheers.

Edited September 18, 2013 by Jingthing

[cpofc]

During the VN War there was an 'urban myth' that scared the living bejesus out of many.

It was called 'Saigon Rose'. Saigon Rose put the same fear into the military population of the day as what aids did to the world at large in the mid 80s'

Saigon Rose was an incurable form of VD. It was even said that should you get it you would be sent to some mysterious island in the South China Sea to see out the remainder of your life. Much like a 'Leper Colony'.

Like most urban myths there was some truth in he rumour.

In fact 'Saigon Rose' was a severely resistant strain of NSU - Non Specific Urethritis

Brought about by servicemen in SEA self medicating and taking antibiotics as preventative medicine before even hitting the bars.

A very good mate of mine took 8 months to clear up after getting a dose in Subic Bay.

Back in Aust at Balmoral Naval Hospital, HMAS PENGUIN, they kept numerous samples of his in incubators whilst they tried out different concoctions to kill it.

[jocko]

Google Dame Sally Davies (Professor).

Resistance to antibiotics.

Not good reading for mankind it's a worldwide problem

[Jingthing]

Yes of course it's a global problem, but Thailand is on the globe ...

http://www.independent.co.uk/news/science/chief-medical-officer-dame-sally-davies-resistance-to-antibiotics-risks-health-catastrophe-to-rank-with-terrorism-and-climate-change-8528442.html

"Antimicrobial resistance is a ticking time-bomb not only for the UK but also for the world. We need to work with everyone to ensure the apocalyptic scenario of widespread antimicrobial resistance does not become a reality. This threat is arguably as important as climate change."

Edited September 18, 2013 by Jingthing

[ToddWeston]

It's not exclusive to Thailand or the medical profession handing these out as candy, it's also the idiots who self diagnose and self prescribe.

Keep a record of use - trust me you'll need it someday.

[jocko]

It's not exclusive to Thailand or the medical profession handing these out as candy, it's also the idiots who self diagnose and self prescribe.

Keep a record of use - trust me you'll need it someday.

There are ex pats in Thailand who are happy to go to the Chemists and buy what they need over the counter it's almost a plus point.

Yipeeeee

[lujanit]

With regards to Thailand a very real problem is that you can walk into most pharmacies and purchase antibiotics OTC. No doctor's script required. Many people here, my wife included race off to the pharmacy to get Amoxicillin or similar at the slightest hint of the sniffles.

The real problem is lack of education. Try telling a Thai, for that matter most asians and probably most people on the planet that the common cold is 99.9% viral in origin and that taking an antibiotic (antibiotics are for bacterial diseases) is useless. The other problem is that Thai's will not question what their doctor is prescribing or why he is prescribing it. They are too scared. Loss of face issue?

Resistance to antibiotics is a global problem. MRSA is particularly worrisome due to the difficulty of treating it with penicillin type antibiotics. MRSA is a direct result of the bacteria evolving to no longer be able to be killed by these types of antibiotics. We are going to be in deep shit when Staph becomes resistant to vancomycin.

[Sheryl]

Thailand does have a particular problem with regard to drug resistant STIs, worse than in mopst countries.

Thai doctors when treating other illnesses not only overuse antibiotics (pretty much a universal issue) but also tend to prescribe them for an insufficient time period which is not so universal and definitely adds to the risk of resistance. It also means that in cases where the antibiotic really was (a) necessary and ( the right drug, the desired cure may not be achieved. (And, the same abx may not work against same bug next time).

[lujanit]

Thailand does have a particular problem with regard to drug resistant STIs, worse than in mopst countries.

Thai doctors when treating other illnesses not only overuse antibiotics (pretty much a universal issue) but also tend to prescribe them for an insufficient time period which is not so universal and definitely adds to the risk of resistance. It also means that in cases where the antibiotic really was (a) necessary and ( the right drug, the desired cure may not be achieved. (And, the same abx may not work against same bug next time).

What Sheryl says is quite correct, however there is one more aspect that compounds the issue. Many people correctly prescribed the right antibiotic and course for a particular situation stop taking the antibiotics before they complete the full course due to the fact that they feel better. You should always complete the entire course regardless of whether you feel okay or not.

[Sheryl]

Indeed yes. In fact the point at which you feel better is earlier than the point at which all bacteris will have been eliminated and stopping then is a sure path to resistance and, often, a relapse.

[Baloo22]

With regards to Thailand a very real problem is that you can walk into most pharmacies and purchase antibiotics OTC. No doctor's script required. Many people here, my wife included race off to the pharmacy to get Amoxicillin or similar at the slightest hint of the sniffles.

The real problem is lack of education. Try telling a Thai, for that matter most asians and probably most people on the planet that the common cold is 99.9% viral in origin and that taking an antibiotic (antibiotics are for bacterial diseases) is useless. The other problem is that Thai's will not question what their doctor is prescribing or why he is prescribing it. They are too scared. Loss of face issue?

Resistance to antibiotics is a global problem. MRSA is particularly worrisome due to the difficulty of treating it with penicillin type antibiotics. MRSA is a direct result of the bacteria evolving to no longer be able to be killed by these types of antibiotics. We are going to be in deep shit when Staph becomes resistant to vancomycin.

I ran into the same thing. Every time I go to a pharmacy here in Thailand telling them I have a cold ("pen watt") they try to give me some antibiotics. I tell them "No, I just need some Tylenol and something for the stuffy nose". They still try to give me antibiotics. I've tried telling them that it won't do any good for a cold, but it's a waste of time.

This leads me to wonder what are they teaching these pharmacists in the schools here. I've walked past the School of Pharmacy at Chiang Mai University several times, so I know they have them here. I also wonder how many of these pharmacies actually have a trained/qualified pharmacist running the show.