Scary..
Monday, January 12, 2004
Pacific Currents: Overuse of antibiotics in China raises
alarm
By JULIE CHAO
COX NEWS SERVICE
BEIJING -- Whenever Ye Zhiming feels a cold coming on and gets that scratchy feeling in his
throat, he goes to a drugstore and buys some antibiotics.
"I used to go to the doctor for a prescription," said Ye, a 37-year-old office clerk. "Now I just buy
it myself. I know what works for me."
It costs him about 60 cents for a box of 24 spiramycin capsules.
Buying any of a range of powerful antibiotics in China is as easy as buying aspirin. Not that a
doctor would have refused him a prescription. As many as 90 percent of people who visit a hospital
in China are given an antibiotic.
The overuse of antibiotics has resulted is a new generation of drug-resistant "supergerms" in the
world's most populous country.
Drug resistance has become an urgent problem in many countries, but the danger has arisen
especially quickly in China, where rapid improvements in living standards have allowed more
people access to better health care. Resistance rates that took the United States decades to reach have
been surpassed by China in just 10 years.
Germ-killing antibiotics have saved millions of lives worldwide in the past half-century. But
because antibiotics have been widely misused and overused, the bacteria they were meant to kill are
able to mutate.
The U.S. Centers for Disease Control and Prevention has called it one of the most pressing global
health problems. With some pathogens becoming more virulent than ever, doctors are running out
of drugs to treat them.
In China, growing global ties mean that public-health problems are no longer just domestic
problems. "The faster we internationalize, the faster the germs will spread," said Xiao Yonghong,
deputy director of the Institute of Clinical Pharmacology at Peking University.
Xiao said the levels of resistance are
alarming. In the United States, 6
percent of cases of infection by E.
coli are resistant to Ciproflaxacin,
recently best known as the antibiotic
used to fight anthrax, but in China,
70 percent of the cases are resistant
to the drug.
Resistance of MRSA, the
Staphylococcus bacteria that is the
main cause of hospital infections, is
also 70 percent, twice the U.S. rate.
Gonorrhea in China is 85 percent
resistant to penicillin, more than
four times the level in Australia.
Tuberculosis had previously been
under control in China, but its
growing resistance to multidrug
treatment is the main reason for the
recent increase of the disease, Xiao
said. "In America, it's simple to get a gun, but at least you need a doctor's prescription to get an
antibiotic," said Xiao, an expert on drug-resistant infections.
The government has issued no guidelines on antibiotic use and no specific policies for combating
drug resistance, Xiao said. Yet the outbreak of SARS last year has heightened awareness.
Aware of the widespread abuse, government authorities have announced that a prescription will be
required starting in July. The media have also started running stories about the issue.
Experts wonder whether the new requirement can be implemented because, in fact, a doctor's
prescription is already required for antibiotics and has been for years. But the law is virtually never
enforced.
Zhang Aiqin, head pharmacist at Beijing's Anzhen Hospital, said the rule won't work in China with
its lax regulations of prescriptions and vast population. "How will each drugstore identify which
doctor and which hospital wrote the prescription?" she said. "It can't be done in China."
Even if prescriptions could be verified, it would not control the ways in which doctors prescribe
antibiotics. "Doctors say they're rushed and don't have time or they just want to be sure or patients
demand them," Zhang said. "They have all sorts of excuses, but in a word, it's just reckless."
Hospitals rely on selling drugs for the bulk of their revenue. Often, doctors even get commissions
from drug companies. Outpatients pay less than $1 to see a doctor, maybe $2 for a specialist, but
might spend $30 or more on drugs. For inpatients, half their hospital bill could be for antibiotics,
according to the Beijing Daily.
"They always ask if we have medical coverage or if we're paying ourselves," Ye said. "If we have
cov- erage, they always prescribe more drugs and more expensive drugs." |
