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some common sense for antibiotics
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These days, I was always asked a question by my patients: Why dont you use antibiotics for me ? How could the wound recover without antibiotics?
Every time I would spent time explaining to patients with my patience. I tried my best to change the deep notion in their mind, although most of the time useless.
Most Chinese ordinary people think after operation, they must be given antibiotics, without that their wound couldnt heal by itself. And even, when they catch a cough, get a fever,or a diarrhea and so on ,they must be given antibiotics, then they could recover.
Is antibiotics really so useful and powerful? And is antibiotics truly safe for everybody' body?
The answer is absolutely no.
First, let me talk about my patients. Most of them got a thyroid operation, which is a clear operation, called "type I " cut. In medicine, cut is classified into three type,I ,II and III.Type I means absolutely clear.Type II means probablely being polluted, like operations for gastrointestinal duct(There are plenty bacteria in your gastrointestinal duct). Type III means wound has been infected, like suppurative appendicitis. For Type I ,our country has very strict provision to ban to use antibiotics unless there is apparent infection of the wound. For Type II, we will use some basic antibiotics to prevent infection. Only for Type III operation, we could use some strong antibiotics.
Actually, no matter what type of antibiotics, it has so many side effect to our body, especially for liver and kidney.The worst thing is that, antibiotics abuse could lead a very serious social problem. As we know, according to Darwinian' evolution, every species will suvive to live, including bacteria. Once we use antibiotics too much, there must be more and more bacteria they wont be sensitive to these antibiotics and tolerant to it. Resulting that antibiotics are more and more useless to patients. There was even a thing happened in our hospital' ICU, a patient infected a kind bacterium, but test showed the bacterium was insensitive to all the current antibiotics. Which means the patient' only result was waiting to die, no helps we doctors could gave. And this was a very terrible horror for other patients in the ICU, once they got it ,they also would die. So our hospital had to close the ICU temporarily.
Next time I would talk about antibiotics contituously..............
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Post comment Comment (5 replies)
- Reply sunnyv
- Education and informtion about antibiotics should be given in school and we should not burden doctors to dispense such information to patients. Even in an advanced city like Hong Kong, we are having similar problems. Sometime ago, I overheard a housewife recommending a certain private doctor to another housewife saying that the doctor is very good. The reason she cited was that that doctor gave a lot of different medicines resulting in quick cure of illness. Actually, what the doctor prescribed could be vitamin and mineral pills. No wonder, doctors are sometimes frustrated by queries from patients. Anyhow, doctors still need to inform them, otherwise they could go to other sources to get medicine, including antibiotics. Antibiotics abuse is dangerous. An average Chinese person consumes 138 g of antibiotics per year — 10 times the amount consumed per capita in the U.S. Something has to be done about it before things get out of control.
Here is a news article in the TIME magazine on this subject;
http://content.time.com/time/world/article/0,8599,2103733,00.html
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The article is reproduced here just in case it is censored in China:
Every year when the wet winter weather sweeps through southern Anhui province, Ling Cheng gets a niggling cough that she just can't shake. But instead of heading to the medicine cabinet, Ling, like millions of other Chinese, heads instead to her local hospital for a dose of IV antibiotics. "When the coughing gets annoying, I just go to the clinic two or three days in a row and take a drip, she says. After that it usually clears up straight away — it's much more effective than taking pills;
Last month, the country's Ministry of Health revealed that on average each Chinese person consumes 138 g of antibiotics per year — 10 times the amount consumed per capita in the U.S. Meanwhile, three times as many Chinese people are prescribed penicillin compared with the international standard. The Ministry also pointed out that 70% of inpatients at Chinese hospitals received antibiotics; the World Health Organization (WHO) recommends a maximum of 30%. (Read about China's plan to reform its health care.)
China's thirst for antibiotics has serious consequences. The WHO says the effectiveness of antibiotics is under threat from overuse in China, as diseases mutate to develop immunity. It estimates that 6.8% of tuberculosis cases in China are multidrug resistant, compared just 2% in developed countries. Experts believe that diseases as diverse as syphilis and the hospital superbug MRSA are thriving as they adapt to China's antibiotic-heavy environment. "We are now on the brink of losing this precious arsenal of medicines, ''Dr. Michael O'Leary, the WHO's China representative, said in a 2011 statement, calling for more responsible use of antibiotics. "The speed with which these drugs are being lost far outpaces the development of replacement drugs''
Despite the best efforts of health care officials, it is not clear just why the problem has grown so severe — or exactly what the solution might be. For many years, researchers believed the expectations of patients themselves were to blame: a patient didn't get an injection or a drip would feel that they weren't getting a good standard of care. But research by the WHO suggests that medical practitioners in China will often prescribe antibiotics "to be on the safe side," reasoning that at the very least the drugs won't harm their patients. (''In Some Chinese Hospitals, Violence Is Out of Control and It's Doctors Who Are at Risk.'')
Financial motivations may also play a role. By some estimates the government subsidies cover just 8% of the running costs of hospitals, leaving the institutions to cover the other 92% by charging for care. At study called ''Patient Knowledge and Antibiotic Abuse,'' published earlier this year by a team from China Europe International Business School, Princeton and Peking University, showed that drug sales now account for over 50% of all hospital revenues and antibiotics account for 47% of all drug sales — and that hospitals were allowed to charge a 15% markup on drug sales. They also found that doctors' incomes were also closely linked to their prescription of certain pharmaceuticals, with both bonuses from their hospitals and kickbacks from companies augmenting their salaries.
Across the country, local administrators are starting to take steps to tackle the problem. In Beijing, the municipal health bureau is currently undertaking a survey of antibiotics usage at 165 hospitals across the city. Those found to be overusing the drugs will have their rankings downgraded — a move that will directly affect the fees they can charge. Shanghai has rolled out a similar scheme that limits the variety of antibiotics each hospital can prescribe. (Read about China's growing medical boom.)
On the national level, a plan to curtail the use antibiotics through tighter regulation is also in the works. The Ministry of Health said last spring that it was drafting new laws, although the details have not been released. It is therefore unclear what effect, if any, the regulations will have, particularly because what seems to be similar measures have been in place for several years.
The team behind the antibiotic study argues that the simplest solution to the problem is patient education about the use and misuse of antibiotics. Their research showed that patients who displayed some knowledge of antibiotics were far less likely to be prescribed the drugs by their physician. ''A simple intervention in which patient's display of knowledge about appropriate antibiotic use can dramatically reduce the abuse of antibiotics,'' the report said. However, it also noted that patients who broached the subject with their doctors faced ''a deterioration in the quality of their interactions with the physician.''; And, really, who wants a grumpy doctor during flu season?
Next ''The Desperate Need for New Antibiotics.''
- Reply moli
- In fact, most of the Chinese people know something about antibiotics, however, they still choose to use antibiotics just hope to get better soon, by the way, the don't think antibiotics does bad to their health.
- Reply Chuckheng
- The article you reproduce is a big warn to Chinese, we should value this problem soon.
sunnyv: Education and informtion about antibiotics should be given in school and we should not burden doctors to dispense such information to patients. Even i ...
- Reply sunnyv
Chuckheng: The article you reproduce is a big warn to Chinese, we should value this problem soon.
Everyone should do their part to educate the public and avoid the terrifying disaster of drug resistant diseases.
