Most private doctors prescribing antibiotics too easily: expert

November 03, 2016 14:46
Frequent use of antibiotics has contributed to the problem of antimicrobial resistance in many patients. Photos: HKEJ

Unnecessary prescription of antibiotics is a cause for serious concern in Hong Kong's healthcare sector, a top microbiologist said on Wednesday, warning that bad practices by doctors have worsened the problem of antimicrobial resistance.

According to Yuen Kwok-yung, a University of Hong Kong microbiologist professor who heads an expert panel on antimicrobial resistance, seven in ten private doctors in the city prescribe antibiotics too easily. 

The prescription abuse is serious, he said, noting that one in every two public hospital patients with Staphylococcus aureus infection was found to be drug resistant.

It marks a higher ratio compared to other advanced countries, Yeun said at a seminar, the Hong Kong Economic Journal reports.

Yeun heads high-level committee set up by the government to examine issues related to antibiotic resistance, a move that came in the wake of a global increase in antibiotic resistant bacteria.

The microbiologist said it is wrong to assume that patients need to be put through an entire course of antibiotics treatment when a problem is detected.

Some patients recover after just a few days of taking the drugs, he pointed out.

Given the wrong practices of many doctors, the Yuen committee plans to come up with new regulations governing the use of antibiotics.

The Department of Health hosted a seminar on Wednesday on anti-microbial drug resistance, bringing together 200 experts from Hong Kong and overseas to discuss ways to alleviate the problem of antibiotic resistance.

A day earlier the Yuen committee held its first meeting to discuss the resistance of bacteria at various levels, including farms, food, communities, and medical facilities.

Panel members also discussed how to conduct better surveillance, health promotion, education and assessments throughout the territory.

Yuen said the problem of antibiotic resistance in Hong Kong is "quite serious".

According to a survey conducted by the health department in 2012, 70 percent of private doctors in the city regularly prescribe antibiotics for minor illnesses such as cold and sore throat.

The survey also found that 35 percent of the public had taken antibiotics at least once in the past year.

Of those people, up to 2.3 percent were said to have taken the drugs without prescriptions. They managed to buy the drugs from pharmacies despite getting no authorization from doctors.

According to Yuen's estimates, that would be 60,000 people purchasing antibiotics over the counter.

Yuen added that about half of the patients at local public hospitals suffering from Staphylococcus aureus were drug-resistant. In comparison, the rates in the UK and Sweden were below five percent and two percent, respectively.

"It's totally unacceptable, and very frightening," Yuen sighed.

"Something must be done" as 30 percent of hospital patients were found to have drug-resistant E-coli, while 80 percent were found to have the Erythromycin-resistant Streptococcus pneumoniae, he said.

"Unfortunately 70 percent of the doctors prescribe antibiotics regardless of the seriousness of the illness, most tackling only sore throats, cold, or even coughs. They would prescribe antibiotics without conducting any microbial tests for up to seven or ten days.

"The public thinking that we should take antibiotics for at least seven to ten days is a completely mistaken idea," the expert said.

Yuen notes that studies in other countries have pointed out that taking three to five days of antibiotics doesn't amount to much of a difference from taking seven to ten-day treatments.

He reminded people to always have proper medical consultations before taking antibiotics.

Yuen said that in two to three months, his panel will start mapping out practical recommendations that will help develop strategies to deal with the issue of drug resistance.

Other initiatives being considered include doing research on private medicinal data, such as the number of days patients should be advised to take antibiotics.

Local doctors can take a lesson from medical practitioners in the Netherlands who perform protein tests to confirm bacterial infection before prescribing antibiotics, Yuen said.

The test would take only a minute or so and cost just around HK$40 to HK$50, he pointed out.

According to Cheng Chi-man, a general practitioner in Hong Kong, the newer breed of doctors is generally more cautions in using antibiotics, compared to the earlier generation.

But he pointed out that some illnesses do require long treatments in antibiotics that cannot be shortened, such as pneumonia that requires one to two weeks of treatment or prostatitis that needs several weeks of treatment.

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