Thailand. Highest rate of antibiotic use in the world?

[Sheryl]

Please stay on topic..

[Speedo1968]

On 8/22/2016 at 0:45 PM, PaulusE said:

 

Interesting, may I ask how you were treated?

 

Thank you for your interest "PaulusE".

Unfortunately what I used / use is often deemed as "quackery" ( as it is on this site ) , even though it is a 'thousand' year old remedy and free.

If you wish to know then I can only do it through a private message - I think they have it with this site.

Sorry for this.

[MissAndry]

On 8/21/2016 at 4:19 PM, lostinisaan said:

 

   It's truly amazing how often you'll get Amoxicillin 500 mg capsules for all sorts of illnesses.

The big problem is that you'll need an experienced Micro Biologist to find the right antibiotics for you if you really caught something serious.

 

It's a broad spectrum antibiotic, good for most of the common bugs, from the runs, skin infections to STDs. It's my AB of choice, less side effects than Cipro and  half the price, only 40-50bht fo a course of 10 tablets. 

Edited August 23, 2016 by MissAndry

[lostinisaan]

6 hours ago, MissAndry said:

 

It's a broad spectrum antibiotic, good for most of the common bugs, from the runs, skin infections to STDs. It's my AB of choice, less side effects than Cipro and  half the price, only 40-50bht fo a course of 10 tablets. 

 

 I never had a STD.....

[Sheryl]

Since there are several entirely different pharmacological groups of antibiotics -- chemically unrelated to each other --  it is extremely unlikely you are allergic to all antibiotics. You may have an allergy to a major class of antibiotics and thus all the drugs within that class (which could be a long list), but you cant be allergic to "all" antibiotics.

[JJGreen]

Since there are several entirely different pharmacological groups of antibiotics -- chemically unrelated to each other --  it is extremely unlikely you are allergic to all antibiotics. You may have an allergy to a major class of antibiotics and thus all the drugs within that class (which could be a long list), but you cant be allergic to "all" antibiotics.

I have reactions from one class...so i avoid that class.
Alternatives have worked well

[cumgranosalum]

On August 21, 2016 at 8:08 PM, Scott said:

This link puts Turkey at number 1, followed by Greece, France and Belgium.

 

https://www.weforum.org/agenda/2015/11/which-countries-use-the-most-antibiotics/

 

Thailand doesn't seem to rank on this, so if the intent is to have a Thai bashing thread, I suggest you stop now.  

 

 

 

It is likely that the full uses of antibiotics in Thailand are not actually fully documented.

As mentioned above - This is an OECD report

“Where possible, it also reports data for partner countries (Brazil, China, Colombia, Costa Rica, India, Indonesia, Latvia, Lithuania, Russian Federation and South Africa).”

So it doesn’t include countries like Thailand.

However just shear volume isn’t the key - it is how much is prescribed person and in what circumstances - one doesn’t have to be a survey genius to realise that antibiotics are over prescribed in Thailand and too easily available - to what extent and how this compares to other counties I’m not sure, but regardless of that it is quite clear that Thailand MISUSES (maybe “over” too?) antibiotics.

Remember also that antibiotics are not just used on humans, they are used extensively in agriculture and food production.

State of Antibiotics - worldwide

This 2015 report on the State of world Antibiotics states...

 Antibiotic consumption in humans is increasing globally. The greatest increase between 2000 and 2010 was in low- and middle-income countries (LMICs), but in general, high-income countries still use more antibiotics per capita.

• An estimated 80 percent of all antibiotics are used in the community, where prescribing and purchasing of antibiotics without prescription are common, especially in LMICs. In many countries at all economic levels, clinicians have incentives to overuse antibiotics.
• The confluence of patients with serious medical conditions, interconnectedness of hospitals through mobile patient populations, and high density of antibiotic use make hospital antibiotic use disproportionately important.

 

NB - "An estimated 80 percent of all antibiotics are used in the community, where prescribing and purchasing of antibiotics without prescription are common, especially in LMICs."

 

this map shows Thailand to be in the 2nd highest group as regards consumption - coupled with poor prescription habits that seems to indicate it is quite serious......it is also the lower income countries that have higher antimicrobial resistance too.

 

 

 

 

100 people die a day in Thailand due to antibiotic resistance - this is higher then anywhere in Europe.

Edited August 24, 2016 by cumgranosalum

[NativeSon360]

On 8/21/2016 at 4:55 PM, Witblitz said:

If the OP had simply done a simple google search he would find 

that India has the highest rate of use in the world and Thailand doesn't even factor in the stats

 

http://timesofindia.indiatimes.com/india/India-becomes-worlds-largest-consumer-of-antibiotics/articleshow/38251650.cms

 

"India has the highest rate of use in the world and Thailand doesn't even factor in the stats"  http://timesofindia.indiatimes.com/india/India-becomes-worlds-largest-consumer-of-antibiotics/articleshow/38251650.cms

was most sufficient.

 

FYI ~ "If the OP had simply done a simple google search he would find that". etc., is the type of "judgemental" reply comment that creates (unnecessary) hostility between posters. Capisce?

[cumgranosalum]

everybdy is very keen to attribute "top of the list" - but unfortunately they aren't defining what they mean by "antibiotic usage".

 

what is clear is that Thailand overuses, misuses and abuses antibiotics and other medications on humans in a way that is alarmingly high.

 

What isn't clear is what the other posters mean by rate of use - do they mean in general or on humans only?

[cumgranosalum]

1 hour ago, NativeSon360 said:

"India has the highest rate of use in the world and Thailand doesn't even factor in the stats"  http://timesofindia.indiatimes.com/india/India-becomes-worlds-largest-consumer-of-antibiotics/articleshow/38251650.cms

was most sufficient.

 

FYI ~ "If the OP had simply done a simple google search he would find that". etc., is the type of "judgemental" reply comment that creates (unnecessary) hostility between posters. Capisce?

not on my map - I think people should be a bit more critical of their sources......and what they are actually looking at.

[Sheryl]

Please keep it civil.

 

The statistics necessary to compare antibiotic use across countries simply do not exist -- and even if they did, such a comparison would need to control for differing disease patterns or restrict the analysis to inappropriate antibiotic use, for which one would need  to know not only the number of patients given antibiotics but their (reliable) diagnosis.  This would be possible only in countries where virtually all health care is provided through a national health system and antibiotics are not available over the country. In countries with large amount of private medical practice and/or where antibiotics can be dispensed by pharmacies without prescription, virtually impossible to come up with a reliable figure.

 

It is also not really necessary to have hard numbers in the case of Thailand as no-one -- least of all the ministry of Public Health and Thai Medical Council -- disputes that antibiotics are over-prescribed here.

 

The MoPH recently announced an initiative to curb this, at least in public facilities. As it happens, I accompanied a sick child (fever, headache, cough) to a government hospital (a teaching hospital, so more senior doctors review all treatment plans) yesterday and to my amazement, no antibiotics were given..so perhaps something really has been instituted. It is unlikely, however, to stop over-use by private physicians nor self-treatment.

 

 

[limdrew37]

Does it mean antibiotics can be bought in Thailand without any prescription? In most countries you cannot buy any antibiotics without prescription from the doctor. Usually pharmacy look for it and if you cannot provide they won't give you antibiotics.

[Sheryl]

27 minutes ago, limdrew37 said:

Does it mean antibiotics can be bought in Thailand without any prescription? In most countries you cannot buy any antibiotics without prescription from the doctor. Usually pharmacy look for it and if you cannot provide they won't give you antibiotics.

 

Antibiotics can be bought over the counter in many -- probably most -- Asian countries including Thailand. Also true in many South American countries.

 

In such countries it is common for people with non-urgent health problems to go straight to a pharmacy and describe their symptoms to the person behind the counter, and buy what they recommend.  This would not be so bad if that person were always a full-fledged pharmacist  -- in Thailand training for full-fledged pharmacists(as opposed to pharmacy assistants and the like)  is a 5-6 year university program (6 years leading to a Doctor of Pharmacy Degree required since 2014, previously was 5 years leading to a Bachelor degree. Those who graduated pre-2014 are grandfathered in) and geared towards enabling graduates to prescribe for common  conditions and certainly covering issues of antibiotic sensitivity and resistance. HOWEVER, most pharmacies at any given point in time do not have such a person on the premises, let alone behind the counter.  Often these are just pharmacy assistants or even people with no formal related training whatsoever.  Technically that is not legal and only pharmacies with a grade one pharmacist on duty can sell antibiotics, but that law is seldom enforced.

 

 

 

 

[MissAndry]

Just went to a hospital for a nasty cut on my leg, came away with ......

6 stitches, bag of NORGESIC, bag of DICLOXACILLIN, bag of NIDOL.

took the NORGESIC for a slightly bad back (but they didn't know I had that)

took the NIDOL because the leg hurt a bit.

not sure if I will take the DICOXACILLIN ....... no infection risk as far as I can see.

 

No need to visit a pharmacy, the hospitals hand them out like sweeties.

[MissAndry]

45 minutes ago, limdrew37 said:

Does it mean antibiotics can be bought in Thailand without any prescription? In most countries you cannot buy any antibiotics without prescription from the doctor. Usually pharmacy look for it and if you cannot provide they won't give you antibiotics.

 

You can buy almost any drug you can name in a Thai pharmacy, or a generic version.

Whatever rules there are, most don't care.

[Sheryl]

4 minutes ago, MissAndry said:

 

You can buy almost any drug you can name in a Thai pharmacy, or a generic version.

Whatever rules there are, most don't care.

 

 

True of antibiotics but most definitely not true for "almost any drug". There are drugs that are by law limited not only to prescription but to hospital pharmacies only, e.g. narcotics.

 

 

[NativeSon360]

6 hours ago, cumgranosalum said:

not on my map - I think people should be a bit more critical of their sources......and what they are actually looking at.

You think! Oops! I keep forgetting about all the perfect  know-it-all "winners", who post on TVF.

 

I was not disputing your academic position. In that regard,  you are 100% correct. However, your readily sarcastic manner towards another poster, was my point of contention.. Obviously, that simple point of view was much too high of a reach, for your peculiar level of English comprehension, eh? It costs you nothing to be polite to people, on this very casual discussion platform.

 

I thank God,  to have been blessed with not having the likes of "your" map , to guide me through life. Hallelujah! Now, back to the topic thread, and cheers

Edited August 24, 2016 by NativeSon360

[NativeSon360]

6 hours ago, cumgranosalum said:

everybdy is very keen to attribute "top of the list" - but unfortunately they aren't defining what they mean by "antibiotic usage".

 

what is clear is that Thailand overuses, misuses and abuses antibiotics and other medications on humans in a way that is alarmingly high.

 

What isn't clear is what the other posters mean by rate of use - do they mean in general or on humans only?

The powers that be, in the US, do the exact same thing as the Thai medical profession tycoons do. This discussion topic is beginning to evolve into absurdity. I'm out of here! Adios, 

[cumgranosalum]

13 hours ago, NativeSon360 said:

The powers that be, in the US, do the exact same thing as the Thai medical profession tycoons do. This discussion topic is beginning to evolve into absurdity. I'm out of here! Adios, 

You appear not to understand the basic problems facing the Thai medical industry that whilst sharing the same pressures from Big opharms etc are compounded considerably by the nature of the home market

 

You are comparing apples and lemons- the US has a dreadful nationwide healthcare system - the worst in the western world. 

However that is in no way comparable to the systemic problems that pervade the Thai system - which extends from the all-pervasive presence of corruption which in turn leads to unqualified and poorly trained practitioners which in turn leads to the mis-prescribing and g=ross over-use of antibiotics....especially broad spectrum - as they are often used as a substitute for proper diagnosis.

[ClutchClark]

On August 21, 2016 at 10:59 PM, Speedo1968 said:

For some reason I became allergic to all antibiotics before or during July 2012.  

 

I don't see how this is possible. 

 

Are you allergic to other types of medication?

[Bonobojt]

I can see why people become Monks these days, no sex with woman so no risk of getting sexual infections, good Buddhist reasons to go vegan or vegetarian so no consumption of antibiotics in meat. Healthy vegetarian diet means good immune system which means less chance of getting sick and needing to go to the doctor. No alcohol, no stress, nice life in the temple.

 

There are fat a lot of overweight Monks though, but I'm talking about the slim vegan ones.

 

[ClutchClark]

On August 21, 2016 at 10:12 PM, AlQaholic said:

Meanwhile studies has shown repeatedly that taking antibiotics compared to not taking antibiotics does not shorten the length of the convalescence.

 

 

I had a lingering C-MRSA infection. 

 

US physicians refused to prescribe a sufficient dose of antibiotics and kept insisting I return fo follow-up office visits at $150/each in the event the infection did not clear up. 

 

I went to Thailand and while there I purchased the dosage I needed based on thorough online research. I did not require a prescription and the medication itself was 1/15th what it would have cost in the USA.  (And I filled it at Boots pharmacy in BKK).

 

Only after I was on this increased dosage of CLINDAMYCIN did the MRSA finally go away and my open wounds heal. 

 

It does no good for the US to severely limit access to sufficient quantity of Antibiotics when Asian and Latin American countries hand it out "like M&M's". The only way superbugs don't get created is if every country participates. 

 

 

[craigt3365]

5 hours ago, ClutchClark said:

 

I had a lingering C-MRSA infection. 

 

US physicians refused to prescribe a sufficient dose of antibiotics and kept insisting I return fo follow-up office visits at $150/each in the event the infection did not clear up. 

 

I went to Thailand and while there I purchased the dosage I needed based on thorough online research. I did not require a prescription and the medication itself was 1/15th what it would have cost in the USA.  (And I filled it at Boots pharmacy in BKK).

 

Only after I was on this increased dosage of CLINDAMYCIN did the MRSA finally go away and my open wounds heal. 

 

It does no good for the US to severely limit access to sufficient quantity of Antibiotics when Asian and Latin American countries hand it out "like M&M's". The only way superbugs don't get created is if every country participates.

My father had MRSA.  He was treated by a specialist that dealt with this.  An ordinary doc could not prescribe the meds needed to get rid of it.  And for good reason.  What he was given was the last line of defense for this super bug.  If handed out by every doc in the US, and not taken as required by the patients, it would be rendered ineffective quickly.  And we'd be in big trouble.

 

The problem isn't with the US, it's with places like here and others that hand out these meds like candy.  If that was stopped, it would help immensely.  You are misinformed.

[impulse]

1 hour ago, craigt3365 said:

The problem isn't with the US, it's with places like here and others that hand out these meds like candy.  If that was stopped, it would help immensely.  You are misinformed.

 

There are multiple sides of the problem, and you're right that the USA is pretty good on one side.   but that's only part of a complex issue.

 

The flipside is the people who can't afford $100-150 to go to the doctor to get a script for the same meds they've been treated with every time they go in and spend $150 for the script that allows them to buy the $3 meds.  I wonder how many US people die because they put off going to the doctor until the infection gets out of control- for economic reasons?  Probably more than die of antibiotic resistance in Thailand. 

 

Another side where the USA fails is where the doctors can't treat appropriately without risking their license for getting on a DEA list for over-prescribing perfectly appropriate meds.  Being from Texas and living in China, I had to go to Colorado to get enough of an appropriate drug to last through my 6 month average stay in China.  No Texas doctors would prescribe more than 30 days, and they had to use a DEA 3 part script that put them on the list- and most of my Texas doctors refused to do anything that would put them on the list.  My doctor in Denver would give me a script for 6 months.  But it cost me a thousand $$$ to make the trip to Colorado every time.

 

I love the Asian (Thailand and China, at least) system where I can walk in to a pharmacy, ask for what I need and spend $3 instead of waiting for an appointment, spending $150 for 3 minutes with the Doc, then spending the $3.  I don't abuse it, but I can see where that can happen.

[craigt3365]

Agree.  But if Asia was allowed to dispense the drug my father used, it would have been ineffective and he would have died.  Cuts both ways.  You say you love Asia, but couldn't get your meds in China?  As for the drug, was it invented by a company in the US? 

 

The US heath care system needs repairs, but that's another topic!

[impulse]

6 minutes ago, craigt3365 said:

Agree.  But if Asia was allowed to dispense the drug my father used, it would have been ineffective and he would have died.  Cuts both ways.  You say you love Asia, but couldn't get your meds in China?  As for the drug, was it invented by a company in the US? 

 

That particular drug (not an antibiotic) was only available through western clinics, the closest of which was 100 miles away, charged out the wazoo for the appointment and the drugs and they could only prescribe 14 days by law.    When I did get it in China, I got a Chinese made generic.  Here in Thailand, I get a generic from France- for 10x what it costs in the USA- and only through hospitals.  It's an anomaly, and I don't judge the system based on that 1 outlier.   But I digress.

 

To your point about "ineffective", given that 80% of antibiotics are fed to livestock, I wonder how much of the resistance we're discussing is from over-prescribing it to people?  That's a real question of curiosity, not trying to make a point.  I don't know.

[craigt3365]

2 minutes ago, impulse said:

 

That particular drug (not an antibiotic) was only available through western clinics, the closest of which was 100 miles away, charged out the wazoo for the appointment and the drugs and they could only prescribe 14 days by law.    When I did get it in China, I got a Chinese made generic.  Here in Thailand, I get a generic from France- for 10x what it costs in the USA- and only through hospitals.  It's an anomaly, and I don't judge the system based on that 1 outlier.   But I digress.

 

To your point about "ineffective", given that 80% of antibiotics are fed to livestock, I wonder how much of the resistance we're discussing is from over-prescribing it to people?  That's a real question of curiosity, not trying to make a point.  I don't know.

My father use to get a drug via IV, cost $10k USD!  Thank goodness he had full insurance.  Insane.

[ClutchClark]

1 hour ago, impulse said:

Another side where the USA fails is where the doctors can't treat appropriately without risking their license for getting on a DEA list for over-prescribing perfectly appropriate meds.  Being from Texas and living in China, I had to go to Colorado to get enough of an appropriate drug to last through my 6 month average stay in China.  No Texas doctors would prescribe more than 30 days, and they had to use a DEA 3 part script that put them on the list- and most of my Texas doctors refused to do anything that would put them on the list.  My doctor in Denver would give me a script for 6 months.  But it cost me a thousand $$$ to make the trip to Colorado every time.

 

This is spot on. 

[Speedo1968]

On 8/22/2016 at 0:45 PM, PaulusE said:

 

 

To Clutch Clark

Sorry when I clicked on Quote another message came up and I can't delete it or start a clean reply page to you.

 

Yes - a long long list, including as an example, all uk brands of Aspirin but not to Thai Aspent ( not avail in UK ), also max dosage I can take is one tablet.

 

I carry a list with me at all times outside the house, a list is posted clearly in my house and with any hospital / clinic I attend.    Some medications are obviously life threatening or can do damage.

 

My body has always been highly responsive to any external or internal input, a big advantage in my occupation.   The antibiotic issue arose when admitted to hospital in KK in 2012..     Also noticeable,  is that I now seem to have become hyper-responsive.

 

In 2013 I was bitten by a spider whilst at an international farming exhibition in Bangkok.  Taken to hospital I was offered treatment which I advised the doctor I had had some slight side effects to before.    Rushed off his feet to tend an injured child he gave the nurse instructions and, after a jab I was left unattended; no one came when I called for help as a severe allergic response took place.   It has permanently affected the nerves in my feet and to doctors that know it is called "curled toe".

 

It's possible that working in farming all my life ( since 1961 when I was 15 ), in many different countries and, the flagrant use / miss-use of antibiotics with livestock could be a reason but, I don't know for sure why.    I could certainly tell you stories ...........

 

Fortunately I have a very understanding doctor in KK ( the same who treated me in 2012 ) and, he is always willing to discuss alternatives to so called "conventional" treatment.

 

 

 

[ClutchClark]

11 minutes ago, Speedo1968 said:

 

To Clutch Clark

Sorry when I clicked on Quote another message came up and I can't delete it or start a clean reply page to you.

 

Yes - a long long list, including as an example, all uk brands of Aspirin but not to Thai Aspent ( not avail in UK ), also max dosage I can take is one tablet.

 

I carry a list with me at all times outside the house, a list is posted clearly in my house and with any hospital / clinic I attend.    Some medications are obviously life threatening or can do damage.

 

My body has always been highly responsive to any external or internal input, a big advantage in my occupation.   The antibiotic issue arose when admitted to hospital in KK in 2012..     Also noticeable,  is that I now seem to have become hyper-responsive.

 

In 2013 I was bitten by a spider whilst at an international farming exhibition in Bangkok.  Taken to hospital I was offered treatment which I advised the doctor I had had some slight side effects to before.    Rushed off his feet to tend an injured child he gave the nurse instructions and, after a jab I was left unattended; no one came when I called for help as a severe allergic response took place.   It has permanently affected the nerves in my feet and to doctors that know it is called "curled toe".

 

It's possible that working in farming all my life ( since 1961 when I was 15 ), in many different countries and, the flagrant use / miss-use of antibiotics with livestock could be a reason but, I don't know for sure why.    I could certainly tell you stories ...........

 

Fortunately I have a very understanding doctor in KK ( the same who treated me in 2012 ) and, he is always willing to discuss alternatives to so called "conventional" treatment.

 

 

 

 

Yes, your decades of exposure to agricultural poisons could easily explain your condition. I am not a doctor but I have seen this type of response in farmers and blue-collar workers from industrial environments.

 

I do hope you carry an EPI pen...assuming you are first tested to make sure you have no reaction ;-(

 

No doubt you are now motivated to live a very chemical free life as much as possible.