Overprescribing antibiotics

[Admin_2]

In Thailand and probably many other countries, I believe that antibiotics are given out way too freely. This leads to the drugs having no effect later on when they are actually needed.

When I get a common cold, pharmacists want to give antibiotics. If the flu is going around, hospitals hand out antibiotics. Antibiotics are for bacteria, and there is no cure for the common cold.

Because of the lack of controls and/or knowledge regarding when to use antibiotics, many bacteria now resist common antibiotics. This is very serious, and will only get worse unless the public and the "authorities" learn more about when to dish out such powerful medicines. I typically refuse antibiotics unless I'm coughing up green crap.

This case of the Boy Who Cried Wolf hit my home recently. My daughter had a cough towards the end of last week. It was a productive cough, but what was coming up was clear (it had no color). I had my wife bring her to the hospital. As she is only 2 months old, I asked asked her to refuse antibiotics as I assumed it was just a regular cold that needed symptom treatments. Because of my lack of knowledge and my distrust of the Thai medical system, I probably made a grave error as 2 days later my daughter was back in the hospital with a vacuum shoved down her throat.

It's reached a point where I don't know what to do. I'm not a doctor, and the worst part is that I don't trust any Thai doctor 100%. I don't trust any US doctor 100% either, but at least I have enough faith to listen to them more often than I listen to myself when it comes to health treatment. This time my lack of knowledge and/or trust bit me on my ass hard...real hard.

Where was I going with this? An article I just came across on CNN that made me want to get this off my chest and see what others think about how antibiotics are given out here.

http://edition.cnn.com/2010/WORLD/asiapcf/09/09/china.lookout.for.superbugs/index.html?hpt=T1#fbid=VW-BBxa59gV&wom=false

"Beijing, China (CNN) -- China's capital will step up surveillance of antibiotic-resistant bacteria in response to a superbug that first emerged in South Asia and is spreading globally, state media said.

The Beijing Municipal Health Bureau will create a network to monitor major medical institutions by year's end, the China Daily newspaper reported.

Cases of the NDM-1 superbug, as it's commonly known, have been reported in countries such as Australia, Britain, Canada, Japan, the Netherlands, Sweden and the United States. China has not detected the bacteria, but is at risk of an outbreak because of geography, global travel and the overuse of antibiotics.

The improper use of antibiotics has led to one of the world's most pressing public health problems, according to the U.S. Centers for Disease Control and Prevention. Antibiotics cure bacterial infections, not viral infections such as colds and flu.

Many bacteria have become resistant to commonly prescribed antibiotics, leading to longer illnesses, more doctor visits or longer hospital stays, and the need for more expensive and toxic treatment, the CDC says. Some resistant infections can lead to death.

The New Delhi metallo-lactamase-1 (NDM-1) gene is thought to have emerged in India or Pakistan. But India has rejected British scientists' findings that travelers picked up the bacteria when they went to India for inexpensive medical treatment, including cosmetic surgery. The Indian health ministry says such organisms are present universally."

[funky_house]

Its not just dishing them out freely, that reduces their effect, but also the fact that patients tend not to finish the course.

As soon as they feel better, they stop taking them, whereas they should continue until the total amount prescribed has been taken, in the doses prescribed by the doctor.

[English_Bob]

Someone more widely travelled than I, told me that it's a SE Asian thing.

Unless the patient leaves with 4-5 different medicines, they don't feel they have been treated.

I also notice that my Thai friends go to hospital for trivial reasons... food poisoning, headaches, tiredness.

As for trusting Thai doctors, a friend of mine had a slight motorbike accident and injured his hand. He went to Bumrungrad and had an X-ray. The doc told him it was soft tissue damage and gave him pain killers and anti inflammatories.

I asked him about a bold white line on the X-ray and he explained it was part of the bones in the hand.

Later it transpired that it was a fracture and needed strapping up for over a week.

[CiaranM]

it's a tough call Rob in Ireland/UK u can't get antibiotics without a doctor's script and unless i'm really ill i won't take them. here however, they seem to dish them out like smarties and ppl go running for them if they have a runny nose or cough. this obviously weakens ppl's immune systems while also enabling the bacteria to build up a resistance to antibiotics.

because they r given out so freely here u r obviously dubious as to if they r genuinely required when prescribed .... anyway hope u all get well soon.

take care and see u soon.

[English_Bob]

A proper press industry would investigate the commissions and incentives paid to doctors by drug companies.

[CiaranM]

A proper press industry would investigate the commissions and incentives paid to doctors by drug companies.

in fairness the same could be said about how drugs r selected in the UK/EU/USA .... IMO the situation is made much worse here by pharamcies dishing out antibiotics willy nilly without any requirement for a doctors script !!

[kaunitz]

A proper press industry would investigate the commissions and incentives paid to doctors by drug companies.

Not only to doctors! Unfortunately, I tend to get ear inflammations quite easily here in Thailand. Everytime I go to a pharmacy for eardrops (34 Baht), they also try to sell at least one kind of antibiotics plus painkillers (200+ Baht) with that and they are visibly not happy when I decline.

[koolbreez]

One of the main problems in Thailand is the practice of pharmacists acting as doctors. They are not trained to diagnose medical conditions, yet it happens all over Thailand, to save the client money.

My friend is a pharmacist, and she is constantly acting as a doctor, and prescribing medication that would require a doctor's prescription in any developed country. She does this to save the patient money, and to make a sale.

Another area that has the CDC very worried is the misuse of malarial drugs. In the Trat area, and along the Cambodian border there, there is a form of malaria that has become resistant to the drug combination used to treat it. They blame this on backpackers, and the faulty information they get off the internet on how to prepare for going into a malaria risk area. They simply buy the drugs in Bangkok, and follow what they've been told on the internet on how to use them, by other backpackers. Read Loneplanet's Thorn Tree Forums, and you constantly run into this faulty misinformation.

This happens all the time, at some point a bacteria will become resistant to the drug used to treat it, but from the misuse, and over prescribing of a drug, the same bacteria becomes resistant allot faster, as is happening in Thailand.

With the 30 baht medical scheme, there should never be a case where a pharmacist is making a medical decision concerning someones health, and then prescribing medication that in any developed country could only be prescribed by a doctor. It just speeds up the time frame when the bacteria finally becomes drug resistant.

[eagle]

A proper press industry would investigate the commissions and incentives paid to doctors by drug companies.

word

[SoBeIt]

In my opinion,

I actually agree about how easy to get all the antibiotics in Thailand.

Maybe that is the reason why the life expectancy of ppl in Asia isnt so high like in western world.

But, what Ive learned here is that, even though it is not easy to get antibiotics her in Europe.

The doctors here seem like, they just want to perscirbe everything, even it is not really needed.

At least in Sweden anyway, it is like, they just havet to give you the medicine, otherwise if somthing happenes they would f**ked.

And this is also with the "giving vaccine issue" it seems to me like people in western world is weaker than people in Asia.

They might live longer but they actually get many sickness and all the allergy, diabetic type 1 (which is 1/100,00 in China)

I do believe that western is overprotected more than in Thailand when it is concerned about "Mecdical Stuff"

And it is so sick when they have to give all the kiddy vaccine for all the new born children even though all thoese diesease that body can actually deal it by itself. And that makes many western kids become weak coz all thoese vaccines just go in and destroy the immune system which is not really ready yet in the early stage of life.

I saw a reseacrh from the German hospital about giving some serious vaccine to the children and then it actually effect them later on in life..

It is all about "Fear"

anyway, plz all the English teachers here.. dont be so fussy with my English..

Im just a Thai person who trys to write something long in English..

okiedokie?

[PeeMarc]

I've been banging on about this subject for years. I believe that the overuse of antibiotics in Thailand is precisely why people here seem to get so sick so often. I just cannot understand why so many people here are so weak, and seem to go to the hospital for even the slightest of things like a cold or common flu.

I'm not a doctor, but I know that antibiotics essentially take over where the bodies natural immune systems should be at work. In many ordinary cases one can be back at work in 1 day where in the old days one would need 3-4 days in bed to recover. And in a world that is ever increasingly impatient, it makes sense to just take the antibiotics. But the problem is, I believe, the body just gets weaker and weaker because it hasn't had to deal with anything by itself. And so, it becomes a false economy to take antibiotics because one just gets sick more often anyway. And worse, the body will get sicker each time because it hasn't build much immunity for itself.

Personally, I have only ever taken antibiotics 2 times in my entire life and only for serious problems. Any other time i have refused, and preferred to just go to be and sweat it out. In my life I only get sick once a year and I've never once been admitted to hospital.

My other theory, while not being any sort of conspiracy idea, is that it makes sense for doctors to give antibiotics as often as possible. The reason is that they will get more visits, and thereby make more money.

[SoBeIt]

I'm not a doctor, but I know that antibiotics essentially take over where the bodies natural immune systems should be at work. In many ordinary cases one can be back at work in 1 day where in the old days one would need 3-4 days in bed to recover. And in a world that is ever increasingly impatient, it makes sense to just take the antibiotics. But the problem is, I believe, the body just gets weaker and weaker because it hasn't had to deal with anything by itself. And so, it becomes a false economy to take antibiotics because one just gets sick more often anyway. And worse, the body will get sicker each time because it hasn't build much immunity for itself.

.

Indeed, we get fewer coz the body fight hard to try to get all the **** out.

If we are really really sick.. then we need the medicine for that.,,

That is "NEW" for me and I just knew about it maybe just 3 years ago.

What we do in Thailand is..

"Oh, I got a cold, snotty, couging for a day or two, we need to buy "Tiffy" or whatever they called nowadays"

I think it is also because Thai people lack of the knowledge about this.

And that is a good chance for all thoes sneaky medicine companies can make money from..

Sometime we take the medicine, we dont even know waht the **** is inside

and how it will effect the body, we just "TAKE" coz the doctors "GIVE" it to us..

I think seriously, we need more info about these things..

[Crustyjuggler]

In my opinion,

I actually agree about how easy to get all the antibiotics in Thailand.

Maybe that is the reason why the life expectancy of ppl in Asia isnt so high like in western world.

But, what Ive learned here is that, even though it is not easy to get antibiotics her in Europe.

The doctors here seem like, they just want to perscirbe everything, even it is not really needed.

At least in Sweden anyway, it is like, they just havet to give you the medicine, otherwise if somthing happenes they would f*cked.

And this is also with the "giving vaccine issue" it seems to me like people in western world is weaker than people in Asia.

They might live longer but they actually get many sickness and all the allergy, diabetic type 1 (which is 1/100,00 in China)

I do believe that western is overprotected more than in Thailand when it is concerned about "Mecdical Stuff"

And it is so sick when they have to give all the kiddy vaccine for all the new born children even though all thoese diesease that body can actually deal it by itself. And that makes many western kids become weak coz all thoese vaccines just go in and destroy the immune system which is not really ready yet in the early stage of life.

I saw a reseacrh from the German hospital about giving some serious vaccine to the children and then it actually effect them later on in life..

It is all about "Fear"

anyway, plz all the English teachers here.. dont be so fussy with my English..

Im just a Thai person who trys to write something long in English..

okiedokie?

Infant mortality rate per 1000

Thailand 18.23 per 1000 births.

UK 4.93

Maybe they should vaccinate better here, better to be weak than dead.

Diabetes is more about lifestyle and poor diet.. Sure it's low in China, you can't really have a sugar problem if you can only afford to eat rice.

[CiaranM]

anyway, plz all the English teachers here.. dont be so fussy with my English..

Im just a Thai person who trys to write something long in English..

okiedokie?

i'm not a teacher of any kind but i still believe u need a damm good spanking young lady !!! :twisted: :twisted:

and i'm not fussy at all about ur english !!

[SoBeIt]

Infant mortality rate per 1000

Thailand 18.23 per 1000 births.

UK 4.93

Maybe they should vaccinate better here, better to be weak than dead.

Thailand is developing country

and i actually think that it's not just about "vaccine" though

Prematue babies which are born in week 22 have a chance to survie 25%

but im not talking about that complications that will follow after in their life.

Western has more money to effort all thoes machines and also the social wellfares that help you to survive coz the tax money.

If you are a farmer in the country side in thailand,

the hospital that you can go is maybe just the little health care center.

Which is lack of all the good doctors, and good euipments.

Not so often we'll see the pregnant women come to Bkk with the helicopters coz the have to do emergency operation, right?

But it happenes time to time here in Sweden and it is super normal.

So, if we talk about the bith rate..

it is not just the vaccine issue we have to look at .. but also other factors too..

i dont think that it is so fair if we compare UK and Thailand in that issue.

Coz the structure of the country is different.

[SoBeIt]

errr.. i was typing so fast..

and many places which are miss-typing (whatever it called)

i noticed it.. but not time for that now..

Need to get my ass off from the computer now..

Love, Pissa and Understanding!

[SoBeIt]

they should vaccinate better here, better to be weak than dead.

Diabetes is more about lifestyle and poor diet.. Sure it's low in China, you can't really have a sugar problem if you can only afford to eat rice.

Im talking about Diabetic Type 1 here

[Crustyjuggler]

i dont think that it is so fair if we compare UK and Thailand in that issue.

Coz the structure of the country is different.

Your right and actually i agree with many of your points.. I guess i'm lightly implying there is more than enough money in Thailand to accommodate a better structure for all its people.. Unfortunately we all know that money will never make it to a worthwhile destination.

[Crustyjuggler]

Im talking about Diabetic Type 1 here

So you did, my bad..

[English_Bob]

Someone more widely travelled than I, told me that it's a SE Asian thing.

Unless the patient leaves with 4-5 different medicines, they don't feel they have been treated.

I also notice that my Thai friends go to hospital for trivial reasons... food poisoning, headaches, tiredness.

As for trusting Thai doctors, a friend of mine had a slight motorbike accident and injured his hand. He went to Bumrungrad and had an X-ray. The doc told him it was soft tissue damage and gave him pain killers and anti inflammatories.

I asked him about a bold white line on the X-ray and he explained it was part of the bones in the hand.

Later it transpired that it was a fracture and needed strapping up for over a week.

I've been contacted by someone at Bumrungrad who is aware of this case. They asked me to point out that it was another doctor at Bumrungrad who noticed the first misdiagnosis and called my friend to come back for extra treatment.

Having said that, my friend is a commerical pilot and was told by the first doctor there was no reason for him not to fly. It's quite conceivable that he would have gone to work before the second doctor called him back... My trust is not restored.

[SoBeIt]

Your right and actually i agree with many of your points.. I guess i'm lightly implying there is more than enough money in Thailand to accommodate a better structure for all its people.. Unfortunately we all know that money will never make it to a worthwhile destination.

Yep , sad but true..

That's why Thailand is classified as a developing country.

[DANNO]

I share many of your concerns Rob... it is not a SEA issue...at least I have seen it in the the US all of my so called adult life.....People get sick --> go to the Doc ---> and expect an instant cure ! Common cold seems to necessitate Antibiotics and Docs that I know says Some of their patients virtually demand them, even if they are not going to be effective.

I have heard about the over use of the risking their future effectiveness over time as bacteria mutates into more resistive forms (which has begun according to some evidence).

..as described here the first time I used any (twice not in my lifetime), I stopped taking them when I felt better (as I do not like taking drugs) and the buggers returned (duh!)

so if they are prescribed (and in the US only a Doc can issue script) take them all.

I too listen to MDs with a bit of scepticism ....remember you are buying a service ---the customer --- they might cure you but they aren't Gods and make mistake too. An MD friend said to me she was certain a surgeon was perplexed by me...because I was intelligent to ask questions and not just go along with everything they said.

( got hit by a bus once while riding a bike...my entire right side hurt and mildly concussed---released after x-rays were negative( right hip to ankle...) only to find out three days later the right foot was broken. :x

But at some point you have to"put your money down and take your chances"

develop relationship with your Doc so you DO have confidence in them --and they in you too! They get jerked around by patients too, giving them half-ass information.

Good luck and I hope y'all are feeling Great soon!

anyway, plz all the English teachers here.. dont be so fussy with my English..

Im just a Thai person who trys to write something long in English..

okiedokie?

i'm not a teacher of any kind but i still believe u need a damm good spanking young lady !!! :twisted: :twisted:

and i'm not fussy at all about ur english !!

no but I am concerned about her French :twisted:

[eagle]

Antibiotics are in the animals from the factory they came from. We make food faster but lose the race with pathogens.

[Bruce551]

Antibiotics are in the animals from the factory they came from. We make food faster but lose the race with pathogens.

Thai shrimp farms-loaded with antibiotics.

[eagle]

Antibiotics are in the animals from the factory they came from. We make food faster but lose the race with pathogens.

Thai shrimp farms-loaded with antibiotics.

Its common in animal food farms and in the end it all ends up in the rivers thru waste system.