Focus

Addicted to antibiotics

By Li Li (China Daily)
Updated: 2010-11-09 07:46

Cure on demand

But how did China develop this addiction to antibiotics?

To some extent, patients must share the blame. Doctors at several hospitals told China Daily they are often put under extreme pressure by people demanding "the quickest cure".

"Today, patients are impatient," said Wu Shuai, an outpatient doctor at a hospital run by the Red Cross Society of China in Zhaoqing, Guangdong. "Many of them come and request antibiotics straight away. They expect to see an immediate effect."

Facing such opposition, many medics cave in and prescribe unnecessarily strong antibiotics, he said.

Zhaoqing is just two hours' drive from Hong Kong and Wu explained that many of his patients are businessmen and women from the mainland who return for treatment as antibiotics are tightly controlled in the special administrative region.

Sacrificing safety for speed can result in dire consequences, though. Liu Jianmin, for example, had never visited a hospital before he was diagnosed with lung cancer.

"Whenever I was sick, I just went to a drug store and bought whatever antibiotics the salesperson recommended," said the 58-year-old.

The farmer from Luobei county in Northeast China's Heilongjiang province is now in Beijing receiving treatment, which doctors say is being hampered as drug sensitivity tests have shown he is antimicrobial-resistant.

However, patients are not professionals and many health experts insist doctors must shoulder the responsibility for the overuse of antibiotics.

"One more treatment is one more way of making money for the medical department and one more bonus," said Wan Ruijie, a doctor at Chongqing No 1 People's Hospital, explaining why antibiotics are prescribed so often.

But money is not the only problem; there is also a shortfall in applied knowledge.

"In China, as long as you are a doctor you can prescribe antibiotics," said Tang at Jinan University's No 1 Hospital, "but not many (doctors) really understand how to use antibiotics correctly and are indifferent to learn."

The only official regulation on antibiotic use is the 2004 Guiding Principles for Clinical Application of Antibacterials issued by the Ministry of Health. Yet, Tang argued that the guide is too rough.

"A more detailed guideline with enforcement mechanisms is needed," he said. "The power to prescribe antibiotics should be clearly laid out."

As farmer Liu can testify to, the easy access to antibiotics through drug stores and private health centers is also a major contributing factor. Although the government forbids the sale of the medicine without a prescription, the rule is generally ignored.

The difference in antibiotic use between Chinese hospitals and the country's international clinics is also stark.

At Beijing United Family Hospital and Clinics, a joint China-US venture mainly serving the capital's expatriate community, the use of antibiotics has been kept at 12 to 15 percent.

"We don't prescribe antibiotics of the common cold," said Andy Wang, a Chinese American physician at the hospital who worked in Seattle for five years before practicing in China. "We only use it when we find evidence of an increase in white blood cells."