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Published on April 29, 2008

Pennapa Hongthong

The Nation

Dr Pongpisuth Jong-udom, director of the Health Systems Research Institute (HSRI), said everybody, intentionally or not,

can contribute to the incorrect use

of antibiotics, so they should be aware of the drugs' proper role.

Growing inappropriate use of antibiotics leads to increasing antibiotic resistance as it allows bacteria to adapt and become resistant to the drug.

Pongpisuth said doctors had a role in increasing inappropriate use of antibiotics when they provide inadequate diagnoses.

He said doctors often prescribe broad-spectrum antibiotics because they have not clearly identified the pathogen causing the disease.

"Some doctors prescribe antibiotics because patients request it," he said, adding that some patients have the misunderstanding that they must get medicine whenever they visit the doctor.

The truth is, Pongpisuth said,  those who have viral infections can recover by taking good care of their health. There is no need to take medicines, particularly antibiotics, which treat bacterial infections and have no effect against viruses.

The inadequate  diagnoses do not happen only in Thailand, but also in many developed countries.

Last year, research found that in the United States 82 per cent of patients with acute sinus infections and nearly 70 per cent of those with chronic sinus infections were prescribed antibiotics.

The data was surprising, because most sinus infections are caused by viruses.

An article in the March edition of Lancet, the world's leading independent general medical journal, confirmed that antibiotics could not help sinus infections.   

Another contribution to the alarmingly high rate of  antibiotics use, Pongpisuth said, came from pharmacies where all kinds of antibiotics are sold freely, as prescriptions are not required by law.

Dr Pisonthi Chongtrakul, director of the Antibiotic Smart Use Project, which aims to reduce the use of antibiotics, agreed with Pongpisuth.

He said the use of some antibiotics, particularly the strong ones  are listed by the Public Health Ministry as third and fourth-line drugs, must be regulated.

"Strong and broad-spectrum antibiotics such as Ciprofloxacin, and Levofloxacin should not be sold over the counter. They should only be available by prescription," he said.

Pisonthi said he was afraid that if strong antibiotics are used widely, the drugs would lose the ability to effectively kill target bacteria and Thais would require stronger and more expensive antibiotics.

"If, one day, we find there are no stronger antibiotics available, we will all die as the existing antibiotics can no longer treat us," he said.