Battle Against Antibiotics

In spite of tough measures, the overuse of antibiotics in China is still rampant By Yuan Yuan

Battle Against Antibiotics

In spite of tough measures, the overuse of antibiotics in China is still rampant By Yuan Yuan

DRUG ABUSE: The overuse of antibiotic drugs is rife in China

Since penicillin was invented in 1928,antibiotics have spread rapidly around the world. In China, antibiotics are commonly referred to by another name—medicine to diminish inflammation.

“This name has contributed a lot to the spread of antibiotics in China,” said Song Hongbin, a professor at the Institute of Disease Control and Prevention of the Academy of Military Medical Sciences.“People use antibiotics for almost everything as patients often have different sorts of in fl ammation, and do not understand side effects of antibiotics.”

Huang Yiwen, a 32-year-old Beijing resident, said that since he was a child, doctors used antibiotics on him whenever he had a cold. “It has been common for children with colds to receive antibiotics,” Huang said.

“China is de fi nitely overusing antibiotics,and such abuse has destroyed the health of an entire generation of Chinese people,” said Yao Jianhong, an of fi cial from the Ministry of Health (MOH) .

On April 18, 2011, the MOH initiated a nationwide campaign to regulate the clinical usage of antibiotic medicines.

According to regulations issued by the MOH last April, antibiotics used by hospitals are limited to 50 types for third-grade hospitals (the highest rank under China’s hospital classi fi cation system) and 35 for second-grade hospitals. Before the implementation of the regulations, almost every hospital stocked and used more than 100 types of antibiotics. The MOH also requires that the precautionary use of antibiotics should be limited to 30 percent of all patients undergoing surgery.

Zhao Minggang, Deputy Director of the Medical Administration Department under the MOH, said at a press conference on November 10, 2011 that the MOH will take two more years to regulate the usage of antibiotics with further measures.

Rampant use

In China the most common method of administering antibiotics is by intravenous (IV) drip.In hospitals and clinics across China, patients often sit in rows of chairs or on gurneys in“infusion rooms,” where antibiotics are injected directly into a vein via a drip attached to an overhanging bottle or bag.

Among China’s 15 best-selling medicines, 10 are antibiotics

Statistics from the MOH last year show that 70 out of 100 Chinese inpatients were using antibiotics, while actually only around 20 percent of them really needed antibiotic drugs. Vice Minister of Health Ma Xiaowei attributed the abuse to slack supervision, the incompetence of some health workers, poor public awareness and some doctors’ desires to pro fi t by prescribing more antibiotic drugs than necessary.

“Doctors often prescribe these medicines because their income is connected to the amount of drugs they prescribe,” said Zhong Nanshan, Director of Guangzhou’s Institute of Respiratory Diseases and a member of the Chinese Academy of Sciences. According to Zhong, antibiotic drugs account for about one quarter of drug sales in hospitals. “Hospitals will suffer significant economic losses if they are unable to sell their current antibiotic stocks before their expiry dates,” Zhong said.

The overuse of antibiotics isn’t simply a matter of doctors’ prescriptions. Many patients also prefer to use antibiotics even when they are only slightly ill.

According to He Ping, a physician at Beijing’s Haidian Hospital, more than 80 percent of his patients said they store antibiotics at home in case of different kinds of infections. Among China’s 15 best-selling medicines, 10 are antibiotics.

“People believe the myth that antibiotics can diminish in fl ammation, so they use them to treat everything from toothaches to fever.Some patients even demand that doctors use expensive antibiotics on them even though we explain to them it is not necessary,” He said.

But very few people are aware of the side effects of the overuse of antibiotics. Even if they know, they often chose to ignore the danger,although antibiotics can damage organs, cause disorders in the body’s normal bacteria and increase the resistance of disease causing germs.

“Actually all these side effects are stated clearly in the description of the medicine, but Chinese people believe that medicines are poisonous anyway, so they ignore the side effects most of the time,” Zhong said.

The use of antibiotics was “inappropriate” in 58 percent of cases, according to a review of 1,000 patient records at 10 hospitals in Beijing and four provinces from 2005 to 2010.

In October 2010, NDM-1, a multi-drugresistant strain of bacteria, was detected in a sample taken from an 83-year-old cancer patient in Fujian Province. This bacterium is resistant to all antibiotic drugs and is referred to as a “superbug.”

“The cause of superbugs is the abuse of antibiotics,” said Yang Li, an associate professor at Peking University’s School of Public Health. “It takes about 10 years to develop a new antibiotic but bacterial resistance emerges within only two years. There may come a time when there are no effective antibiotics left. The emergence of superbugs sounds a warning to many Chinese who have the misconception that antibiotics are a cure-all.”

Contaminated food

On December 21, 2011, a woman named Gong Xiaoming posted a message on her Twitter-like micro-blog on Weibo.com saying that she was experiencing itchy rashes all over her body, and suspected it was the lamb she’d eaten for dinner that caused it. “I think the lamb contained excessive antibiotics,” said Gong.

Immediately, Liao Xinbo, Deputy Director of the Guangdong Provincial Department of Health, responded that Gong’s suspicions were not unfounded. “Antibiotics can accumulate in the bodies of humans who frequently eat contaminated meat,” Liao said.“It is widely known that antibiotics have already become a panacea in China’s animal husbandry industry. Whenever a peak season arrives for epidemic diseases, farmers always use large doses of antibiotics in animal diets to help keep them healthy.”

According to Xiao Yonghong, a professor at the Institute of Clinical Pharmacology at Peking University, 46.1 percent of the antibiotics—or about 96,800 out of the 210,000 tons produced in China—are currently used in livestock.

Nanfang Dailyin Guangzhou, capital of south China’s Guangdong Province, quoted an anonymous person who owns a large pig farm as saying that without antibiotics many of the pigs would not survive long enough to be sold. “Antibiotic residues left in animal products are invisible time bombs that enter the human body,” Xiao said. “When they accumulate to a certain level they can cause pathological changes in the body, resulting in alarming symptoms from allergies to serious intoxication.”

Since 2002, the MOH, along with the Ministry of Agriculture and the State Food and Drug Administration, have released lists of medications that are banned for use in animal husbandry. In 2005, a total of 29 antibiotics were prohibited for use in animal husbandry in a file directory released by the Ministry of Agriculture.

However, the illicit use of antibiotics has continued.

“This is largely because the current food safety inspection process does not target antibiotic residues,” Xiao said. “A lack of veterinary knowledge is also behind some of the abuse. As a result, there is a need to better educate farmers in the advanced practices of animal husbandry,and make them more aware of the risks of the overuse of antibiotics.”