Untitled Document

Excessive usage lowers antibiotics' effectiveness

By Mandy Fu

Mandy Fu

Antibiotics are used to cure pathogenic diseases.

Winney Leung Win Kun, 20, is a Year 1 student at Hong Kong Baptist University. Since her
childhood, she has taken antibiotics whenever she had a sore throat. Her mother is a nurse who can bring drugs home for emergency use.

However, the effectiveness of the antibiotics has been decreasing.

"When I was a kid, I used to feel better shortly after I took the pills. But now I still feel sick even after I have completed all medications," said Miss Leung.

An antibiotic is a kind of drug that kills or inhibits the growth of bacteria. Bacteria, however, have become more resistant to antibiotics today.

At a recent conference on contagious diseases held in Singapore, figures reported a dramatic increase in antibiotic resistance of certain bacteria during the last decade. For example, streptococcus pneumonia was 10 percent resistant to antibiotic penicillin in 1993, but this rose to 65 percent in 1997.

Reports revealed that antibiotic resistance in Asian countries increased more sharply than in the West. Antibiotic resistance has risen to 70 percent in Taiwan and South Korea, but only 30 percent in the United States.

Dr. Henry Yeung Chiu Fat, chairman of Hong Kong Doctors Union, said that the massive use of antibiotics in raising livestock and poultry counted for half of the cause.

"Farmers have used antibiotics indiscriminantly to prevent pathogenic infections. Unfortunatley, the cooking process cannot eliminate the antibiotics. So, we are consuming enormous amounts of them," said Dr. Yeung.

Besides, sometimes patients take antibiotics unnecessarily.

In a normal procedure, doctors need patients' fluid samples for chemical analysis to give appropriate prescriptions. Yet, patients refuse the chemical analyses because they are quite time-consuming.

"What they want is patent medicine so that they can go back to work as soon as possible. Some of them even demand antibiotics from us," said Dr. Yueng.

Consequently, doctors have to give prescriptions by observing the symptoms. Sometimes, if the symptoms are unclear, doctors will prescribe antibiotics for fear of pathogenic infections.

Prof. Margaret Ip of the Department of Microbiology at The Chinese University of Hong Kong urged better surveillance in the sales of antibiotics in order to stop the massive use.

"In Southeast Asia, people can buy antibiotics in easily. Yet, the compositions of the antibiotics are not standardized. This can cause harm to patients," said she.

According to the Antibiotics Ordinance, registered pharmacies can sell antibiotics only with prescriptions given by doctors, dentists or veterinary surgeons. Any offenders under this ordinance are liable to a fine of $30,000 and imprisonment of 12 months. The Department of Health will also cancel the licenses of offending pharmacies.

At present, the department checks twice a year on each pharmacy. It has set up a complaint hotline to receive information on illegal sales of drugs.

Dr. Yeung said that these policies are ineffective, however.

"There should be more frequent inspections. It is also futile that the department always sends the same inspection team to the pharmacies. There are few prosecutions each year because shopkeepers can recognize the inspectors."

In addition, doubling the dosage can keep antibiotics effective. This helps to preserve and extend the life of existing antibiotics.

Another practice is the combination of drugs. For example, tuberculosis requires simultaneous use of five antibiotics. However, there are additive side effects and the cost is much higher.

In Finland and Iceland, microbiologists were able to document methods to lower antibiotic resistance, whereas in Hong Kong, research is proceeding with the quest for new agents. Nevertheless, development of new antibiotics is expensive and often relies on the pursuit of privately funded ventures in pharmaceutical industries.

Prof. Ip said that microbiologists can do research on monitoring the antibiotic resistance at the genetic level - for example, to control the spread of resistant genes would contribute to a drop in antibiotic resistance.

Dr. Yeung said that the Hong Kong Doctors Union is constantly educating its members to prescribe appropriate antibiotics only when necessary and to explain the possible side effects of antibiotics to patients. These include diarrhea, vomiting and difficulty in breathing.

Members of the Union have also put large posters in their clinics to remind themselves and patients to use antibiotics cautiously.

Though antibiotic resistance is persistently high nowadays, it has not changed people's attitude on its use.

Winney Leung said she would continue her usual practice of taking antibiotics without a doctor’s advice.

"Although it takes a longer time to recover with antibiotics, I think they are still effective,"she said.

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	Mandy Fu

	Antibiotics are used to cure pathogenic diseases.
Winney Leung Win Kun, 20, is a Year 1 student at Hong Kong Baptist University. Since her childhood, she has taken antibiotics whenever she had a sore throat. Her mother is a nurse who can bring drugs home for emergency use. However, the effectiveness of the antibiotics has been decreasing. "When I was a kid, I used to feel better shortly after I took the pills. But now I still feel sick even after I have completed all medications," said Miss Leung. An antibiotic is a kind of drug that kills or inhibits the growth of bacteria. Bacteria, however, have become more resistant to antibiotics today. At a recent conference on contagious diseases held in Singapore, figures reported a dramatic increase in antibiotic resistance of certain bacteria during the last decade. For example, streptococcus pneumonia was 10 percent resistant to antibiotic penicillin in 1993, but this rose to 65 percent in 1997. Reports revealed that antibiotic resistance in Asian countries increased more sharply than in the West. Antibiotic resistance has risen to 70 percent in Taiwan and South Korea, but only 30 percent in the United States. Dr. Henry Yeung Chiu Fat, chairman of Hong Kong Doctors Union, said that the massive use of antibiotics in raising livestock and poultry counted for half of the cause. "Farmers have used antibiotics indiscriminantly to prevent pathogenic infections. Unfortunatley, the cooking process cannot eliminate the antibiotics. So, we are consuming enormous amounts of them," said Dr. Yeung. Besides, sometimes patients take antibiotics unnecessarily. In a normal procedure, doctors need patients' fluid samples for chemical analysis to give appropriate prescriptions. Yet, patients refuse the chemical analyses because they are quite time-consuming. "What they want is patent medicine so that they can go back to work as soon as possible. Some of them even demand antibiotics from us," said Dr. Yueng. Consequently, doctors have to give prescriptions by observing the symptoms. Sometimes, if the symptoms are unclear, doctors will prescribe antibiotics for fear of pathogenic infections. Prof. Margaret Ip of the Department of Microbiology at The Chinese University of Hong Kong urged better surveillance in the sales of antibiotics in order to stop the massive use. "In Southeast Asia, people can buy antibiotics in easily. Yet, the compositions of the antibiotics are not standardized. This can cause harm to patients," said she. According to the Antibiotics Ordinance, registered pharmacies can sell antibiotics only with prescriptions given by doctors, dentists or veterinary surgeons. Any offenders under this ordinance are liable to a fine of $30,000 and imprisonment of 12 months. The Department of Health will also cancel the licenses of offending pharmacies. At present, the department checks twice a year on each pharmacy. It has set up a complaint hotline to receive information on illegal sales of drugs. Dr. Yeung said that these policies are ineffective, however. "There should be more frequent inspections. It is also futile that the department always sends the same inspection team to the pharmacies. There are few prosecutions each year because shopkeepers can recognize the inspectors." In addition, doubling the dosage can keep antibiotics effective. This helps to preserve and extend the life of existing antibiotics. Another practice is the combination of drugs. For example, tuberculosis requires simultaneous use of five antibiotics. However, there are additive side effects and the cost is much higher. In Finland and Iceland, microbiologists were able to document methods to lower antibiotic resistance, whereas in Hong Kong, research is proceeding with the quest for new agents. Nevertheless, development of new antibiotics is expensive and often relies on the pursuit of privately funded ventures in pharmaceutical industries. Prof. Ip said that microbiologists can do research on monitoring the antibiotic resistance at the genetic level - for example, to control the spread of resistant genes would contribute to a drop in antibiotic resistance. Dr. Yeung said that the Hong Kong Doctors Union is constantly educating its members to prescribe appropriate antibiotics only when necessary and to explain the possible side effects of antibiotics to patients. These include diarrhea, vomiting and difficulty in breathing. Members of the Union have also put large posters in their clinics to remind themselves and patients to use antibiotics cautiously. Though antibiotic resistance is persistently high nowadays, it has not changed people's attitude on its use. Winney Leung said she would continue her usual practice of taking antibiotics without a doctor’s advice. "Although it takes a longer time to recover with antibiotics, I think they are still effective,"she said.