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Editorial: National addiction?
The new report from the World Health Organization (WHO) reveals the “global problem” of the irrational use of antibiotics, leading to the resistance of some bacteria to the drugs
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he new report from the World Health Organization (WHO) reveals the “global problem” of the irrational use of antibiotics, leading to the resistance of some bacteria to the drugs. Countries, the WHO says, should reinforce a national policy to ensure prudent use of antibiotics to reduce antibiotics resistance to bacteria. It recommends, among others, that the government introduce legislation to stop the sale of antibiotics without prescriptions.
Here lies the problem.
True, the sale of antibiotics without a prescription is an issue. Many people come to the pharmacy demanding antibiotics, saying “I’m used to these”; most pharmacies, fearing the revocation of their licence, will refuse, and the consumer hops to the nearest medicine shop or street stall, easily buying “amoxylin” – at least that’s what the label says.
However, ensuring patients get antibiotics only through prescriptions is problematic, as the problem seems to lie in the prescriptions itself.
The common experience here is to visit the doctor, report your symptoms and get a big bunch of medication, including antibiotics, for all kinds of complaints including the common flu. Doctors prescribe, and patients hardly ask let alone challenge. The doctors are our modern healers; we trust them with our life – most of the time. Even given reports of the pharmacy industry, in which doctors stand to gain by prescribing costly medication while cheaper options exist.
Then when such patients happen to be mildly sick overseas it becomes a hot conversation topic among family and friends on how the strange doctors in advanced countries tend to prescribe much less. The WHO report on the antibiotic resistant bacteria makes Indonesians wonder about their bodies and the trap we’re in: We practically grew up on antibiotics, largely gained from prescriptions, and feel we need them to cure our coughs and colds.
When told that antibiotics are not the best prescription for such viral infections, even if they could be lifesavers, the unlikely option for people expecting to get back on their feet during their busy week would be to patiently sit out minor ailments, insisting only on basic medication with sufficient rest. Their conclusion after three days might be: I need those antibiotics. Reports of too much antibiotics prescribed to patients here are far from new. The government reaction has been insignificant, if any, with people feeling none the worse, though ignorant of our possible developing resistance to “prudent” medication.
The average person cannot wait for the government – assuming it pays attention to the WHO recommendations – to figure out how to ensure “rational antibiotic use”, including the education of health workers and the public on the issue. The reason why Indonesians flood hospitals in Malaysia and Singapore is precisely because sick people with some disposable income hear from others who speak about a haven where physicians explain your condition, the necessary procedures and medication, and the options, without patients having to beg them.
If people are educated on the prudent use of antibiotics, while physicians retain their image here as those who know all, and cannot be questioned, the national addiction to antibiotics may still be with us for a long time. Despite our laws on health, doctors and hospitals, the Indonesian patient, when possible, would prefer to fly overseas rather than wait for everyone in the health industry to live up to their ethics and show they understand a patient’s rights.
