Urgent call to curb access to antibiotics
Medical community, pharmacists and public should act responsibly to prevent drug resistance in future generations
DUBAI // Tighter regulation and stricter penalties are needed to curb the sale of antibiotics in the UAE, which is putting patients at risk of serious infections.
Doctors blasted pharmacies for continuing to offer prescription-only antibiotics with impunity, after a spot check found half of those inspected dispensed drugs without a medical note.
Despite the criticism, medical professionals accept that many pharmacies and medical centres are under pressure to make profits, and risk losing business to other clinics if they deny a customer’s demand for antibiotics – even if inappropriate.
Dr Ahmed Saleh, a consultant in medicine at Medeor 24x7 Hospital in Dubai, said the medical community regarded it as a major problem.
“If patients have an expectancy and don’t get what they want, they will go to another doctor instead,” Dr Saleh said. “There is pressure to prescribe antibiotics. People used to commonly take them for viral infections, like flu, which is inappropriate.”
Some hospital bugs have become dangerously resistant to common antibiotics, making it harder for doctors to contain infections after even routine operations.
Hand hygiene is a simple but effective method of containing infection in hospitals, but community outbreaks of bugs such as MRSA are increasing.
Most patients stop taking antibiotics as soon as they feel better, often before the course is complete, and worsen the problem by promoting bacterial growth and developing resistance. “We have to work in a medical community that prescribes antibiotics only when it is indicated, and for a particular period of time,” said Dr Saleh, who worked at the infectious disease unit of Rashid Hospital for six years.
“Control needs to be supported by higher authorities with heavy fines.
“We are not just talking about our generation but the future. There is a real risk of running short of vital medicines.
“The bottom line is the patient. If they have resistance to drugs, the result is often mortality.”
Dr Arthur Williams, a family medicine specialist at the American Spine Centre, said tighter regulation would lead to proper use.
“A lot of work is needed here on awareness in the UAE,” Dr Williams said. “Overprescription comes with a price.
“Luckily, the UAE population is generally young and not exposed to certain infections you would find in the Third World. There is a degree of protection here from developing severe disease and infection.”
Surveillance programmes for prescription drugs have been successful in Europe, and have been used in Denmark and Sweden for almost two decades.
The two countries are now the lowest users of antibiotics, and have the lowest rates of antibiotic resistance.
Similar measures have been considered for the UK to try to slow or reverse the amount of antibiotic resistance.
In England, bloodstream infections such as E.coli increased by 15.6 per cent between 2010 and 2014, despite longer courses and higher doses of antibiotics prescribed in general practice.
It is a warning to the UAE, said Dr Jumaa Fairouz, a former director of disease control at the Ministry of Health.
“Everything is about education, but the problem was once worse than it is now,” Dr Fairouz said.
“There is an issue with ethics among pharmacists and most foreign doctors in the UAE come from countries where there is no culture of prescriptions.
“They have easy access to antibiotics in Egypt or Pakistan and most other Arab countries, so they come here and do the same. We need to teach people that this is a big issue.”