19 October 2005

On Antibiotic Prescriptions

I was still in College when I learned that not all infections need to be treated with antibiotics. Our professors warned us that, if ever we became doctors, they hoped that we would not overprescribe antibiotics for complaints as mild as colds, coughs, and sore throat. Colds are caused by viruses and antibiotics are of no use in the treatment process.

In the Philippines, another problem is self-medication. A mere prescription advice from a friend is taken as gospel-truth as the sick person heads to a drugstore to buy the "advised antibiotic," which is usually taken in less than 7 days, and further adds to the growing problem of bacterial resistance.

Most antibiotics here are supposed to be acquired by prescription only, but no regulating agency is seriously enforcing it. Hah! I often overhear sick people doing "quick-consults" with drug employees: "Ano ba ang magaling sa ubo at sipon?" [What's good for cough and colds?] Said drug-employees suddenly become "doctor-experts", and prescribe a medicine, usually an antibiotic, which more often than not, is incorrect medicine.

A recent study published in the October 2005 issue of Pediatrics, explored the hypothesis of whether children of medical professionals were getting less antibiotic prescriptions than that of the general population:
Comparison of children of physicians, pharmacists, nurses and non-health personnel showed that those of physicians were 50 percent less likely than others to receive an antibiotic prescription. Children of pharmacists were 69 percent less likely to be prescribed these drugs. However, for nurses, the likelihood was similar to that of the general population.

Children of parents in low-income groups were also significantly more likely to receive antibiotics than those with higher incomes.

The findings, say the researchers, "support our hypothesis that better parental education does help to reduce the frequency of injudicious antibiotic prescribing." [Reuters Health, Oct 18 2005]

I agree with the researchers. It is the parents who need to be informed and educated about the proper use of antibiotics.

I was particularly concerned with a line in the news item that said that much of the erroneous antibiotic prescription can be attributed as a "response to parental demands."

Are you a parent? Do you usually demand your doctor to prescribe some heavyweight antibiotic for your sick kid? Do you think your doctor is not good enough when he says that all your sick kid needs is plenty of water and bed rest?

Are you a medical professional? Do you let yourself be intimidated by a parent who wants an antibiotic prescription (even when its not necessary) for his/her sick child?

Use of strong antibiotics spawn more bacterial mutations that lead to resistance later on. The infection problem becomes worse when your antibiotics no longer work. We can only curb this growing bacterial resistance to antibiotics by learning to use antibiotics judiciously.

11 reactions:

Rygel said...

*sigh* and even if they do need antibiotics, they often fail to complete the 1 week usual treatment. When they feel better, they stop taking the medications.

duke said...

This is such a timely post to read for me. My husband just got sick last week . He was insisting on taking an antiobiotic without consulting a doctor. I stood firm and told him we should consult a doctor before taking any prescribed meds. True enough, when we checked with the doctor, he advised him to drinks lots of water and get some rest. No antibiotics!

bayi said...

Not only do some doctors prescribe antibiotics once too often, some are said to administer steriods for pains that do not need them. The older patients think the world of these doctors, telling each other how good these doctors are!

ruth said...

i had the advantage of having learned about antibiotic resistance at the university, so i am extremely wary of using antibiotics. if i do, then i make sure i complete the 7-day prescription. i try to keep my son as drug-free as possible, even for fevers, i do not immediately give paracetamol at the first sign of fever.

one more weird thing in the philippines is the sale of antibiotics in "tingi". pa-isa isa. that only exacerbate the problem of bacterial resistance.

Alice H said...

Even though I know that antibiotics are not necessary for most childhood ailments, I admit I feel a little sheepish and disappointed when I take my son in for something and we don't end up with a prescription. I'm not one to ask for antibiotics when the illness is viral, though.

Dr E said...

Rygel, that has been the perennial problem.

Good coincidence, Duke. Bed rest and drinking lots of water as a treatment option has been underestimated by many for such a long time.

Steroids, Bayi. That's even more dangerous.

I agree with you, Ruth. I think antibiotics should be sold as a package treatment to ensure the minimum 7-day compliance.

That's good to hear, Alice H. I know how you feel. I've long seen the disappointed faces of my patients when I tell them they don't need any prescription but bed rest.

eye said...

ako po ay isang batang lumaki sa antibiotic (ganun ako kalala hehe!), kaya nga napagsasabihan ko minsan ang mga kakilalang kong hindi tinatapos yung dosage kapag magaling na daw sila, at yung iba naman hindi sinusunod yung eksaktong oras na dapat nilang inumin yung gamot. di naman sila nakikinig :( sadya ata talagang matitigas ang ulo ng mga pinoy... bukod pa sa problemang self-medication na nabanggit mo.

Dr E said...

Good example nyan, Eye, eh yung smoking. Almost everyone knows it causes lung cancer. Do they quit knowing it does?

BabyPink said...

buti na lang hindi talaga ako laking gamot. sa bahay namin, my mom would usually say "lots of water and rest does the trick" and that really worked for us. hindi nga naman kami sakitin. minsan nga natatakot ako sa mga gamot eh.:)

beajerry said...

It's sad that the data shows nurses suck at antibiotic savvy.

Dr E said...

Good for you, Baby Pink. Natural immunity is still our best defense against infections.

I read that too, Beajerry. :(