A recent study in Singapore has unearthed a troubling trend in the misuse of antibiotics, with younger Singaporeans seeking these powerful drugs against medical advice.Â
The misuse of antibiotics can have severe consequences, including an increased risk of antibiotic resistance, a global health concern that threatens the efficacy of treatments for various infections.
Unwarranted Antibiotic Prescriptions: A Closer Look
Over four years, about 12 per cent of oral antibiotics were prescribed in polyclinics without an infection diagnosis. This is contrary to guidelines cautioning against inappropriate antibiotic consumption. Alarmingly, younger patients, primarily between 21 and 44 years old, are the ones frequently requesting antibiotics contrary to the advice of their family physicians.
Inappropriate Demands and Expectations
Healthcare professionals face mounting pressure from patients who are insistent on obtaining antibiotic prescriptions. “We have patients who are pushy, requesting for antibiotics, pressuring us for antibiotics,” said Dr Chua Guan Kiat, director of Chua Medical Clinic & Surgery. This indicates a lack of knowledge among younger patients about the differences between viral and bacterial infections, as antibiotics are ineffective against viruses.
The Consequences of Antibiotic Misuse
Misuse of antibiotics can lead to antimicrobial resistance, where bacteria evolve after exposure to antibiotics, rendering these drugs ineffective. Symptoms like fever, cough, and flu may persist in patients whose bacteria have developed resistance to antibiotics despite them taking the medication.
Furthermore, resistant cases will require more expensive, newer-generation drugs with potentially more side effects. Misuse could also lead to antibiotic resistance within the community, thus exacerbating the situation.
Increased Antimicrobial Resistance
Antimicrobial resistance (AMR) is a growing concern where microorganisms, including bacteria, viruses, parasites, and fungi, develop resistance against medicines meant to eliminate them. This issue affects people, animals, and even our environment, leading to ineffective treatment of infections.
The progression of AMR can start when a patient consumes antibiotics and cultivates drug-resistant bacteria in their gut. In healthcare settings, these resistant bacteria can transfer to others through contaminated facilities and inadequate hygiene. Similarly, animals fed with antibiotics may also harbour these resistant bacteria. When food, direct animal contact, or the environment introduce drug-resistant bacteria to the human population, a wider spread of AMR troublingly ensues.
Consequently, antibiotic misuse can lead to bacterial resistance, rendering the antibiotics useless. Additionally, this problem intensifies when symptoms like fever, cough, and flu persist due to antibiotic-resistant bacteria. Subsequently, it results in the need for more costly, next-generation drugs that may carry more side effects.
Improving Antibiotic Literacy
To tackle this, education and communication are paramount in ensuring the correct prescription and usage of antibiotics. We urge doctors to explain to their patients why they are prescribing or not prescribing antibiotics. Moreover, we should encourage patients to complete their entire course of prescribed antibiotics, advising against saving them for future use.
The study’s lead author, Dr Sky Koh, suggested that medication should be dispensed appropriately and that diagnosis and prescriptions should be properly documented. This is vital in ensuring that prescriptions are attuned to antibiotic guidelines. Therefore, it should be appropriately directed at eradicating the bacteria causing the infection.
Future Steps
The National University Polyclinics (NUP) is now considering the creation of its guidelines on the proper prescription of antibiotics. We will achieve this by studying current hospital and international guidelines, examining local resistance patterns, and analysing antibiograms.
Finally, as we witness an alarming rise in antibiotic misuse in Asia, a focused effort in creating awareness, promoting understanding, and improving patient-doctor communication becomes increasingly critical. Ultimately, the health of individuals and the wider community may depend on it.
