Antibiotics Resistance

1:17 AM


I was doing locum one day and saw a young lady. She came to the clinic with her father, She had sore throat and runny nose for the past 4 days. She had preceding fever which has since resolved. Clinical examination revealed nothing much. She was afebrile and her throat wasn't even injected. There was NO EVIDENCE OF INFECTION.

I told them that it might possibly be a resolving viral URTI. The father wasn't convinced.

Bagi la antibiotik doktor. Doktor lain bagi je....

It was still rather early and I still had some juice left. So I explained to them regarding antibiotics.



Tak boleh pakcik nanti ada resistance....bla bla bla....nanti makan ubat tak jalan dah...bla bla bla...tak elok untuk masa depan...bla bla bla.....nanti bakteria tu lawan balik.....bla bla


The father didn't look convinced. It was almost a muka sekupang.....dua kupang perhaps.

Bagi saya beli antibiotik pastu saya simpan buat SPARE je

Breathe in......Breathe out.....Breathe in......big fake smile......and I said NO...politely.

Maaf encik, saya tak buat kerja macam tu. Jika perlu baru saya bagi.

Deep inside I wanted to say "Here's a spare MBBS for you"

I don't blame the patients for their ignorance. Getting antibiotics from GPs is a norm.

Anak kamu tu demam dah sehari, pegi le jumpe doktor seberang jalan tu....suruh deme bagi antiobiotik. Baru sihat sikit.

There aren't any concerted efforts by medical staff to stop antibiotic resistance from getting out of control. There are instances where doctors themselves take pride in giving the newest generations of antibiotics to patients, claiming that it makes good business. One example is giving 3rd generation cephalosporins to patients with one day history of URTI with other symptoms suggestive of viral cause. The last time I checked, the most common cause for URTI was viral....which is NOT an indication to start antibiotics. What happens next? What happens if a bacteria species develops a resistant strain? Are we expecting more Multi Drug Resistant Organisms? The fact that patients can say

Saya nak beli buat spare and doktor lain bagi je shows how rampant it is.

Some will say that it is the customer's right to demand for their medications....CUSTOMER IS ALWAYS RIGHT. But that shouldn't apply here. Call me old school but it is MY DUTY to do what is right. I might be MOfrust but I WAS a medical student and my lecturers taught me well. Rampant, unnecessary use of antibiotics is WRONG.

Methicillin Resistant Staphylococcus Aureus (MRSA) and Multi Drug Resistant Tuberculosis (MDR TB) are just a few organisms that has wreaked havoc in hospitals. It is scary. A child who sustained a minor laceration wound  on the knee while visiting a relative at the hospital almost lost a limb after it turned to be MRSA. Another patient almost died of MDR PTB after all other drugs did not work. It is a really worrying trend. 

It is time to change. And this time it starts with DOCTORS.

BETUL kan yang biasa, BIASA kan yang betul.

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  2. I had a PHARMACIST come in the other demanding for azithromycin for better compliance apparently and she too had ZERO signs of infection. When I told her her infection is viral she made a face. Just continuously insisted that she be given azithromycin. then when I told her about the antibiotic resistance she went "How getting antibiotic resistance? I no sick since last year and I rarely take antibiotics so I getting resistance?". So I just decided that she was probably one of the most not-so-bright and dangerous pharmacist ever not knowing her job. And she's probably going to kill someone doing her job ever so well with the glorious knowledge that she has and just documented that I had counselled her elaboratedly and that she insisted on antibiotics. And there was another lady who had a fall and had a small tiny abrasion and wanted antibiotics for that. When I told her antibiotics was not needed, she too went crazy and asked me "You mean people who fall down and have injuries don't need antibiotics?" I guess we all should have died of septic shock from all the falls we had as children and we had NO antibiotics (HOWEVER DID WE SURVIVE??)

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