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Buying antibiotics in Southeast Asia

Having easy access to antibiotics may seem like a convenient option when you’re living or travelling abroad, but it can lead to greater health issues further down the line.

While the overuse of this form of medication is a global problem, the practice is particularly concentrated in Southeast Asia, where the popular misconception that antibiotics can cure any illness can make them the ‘go-to’ treatment.

In many countries throughout the region people are able to freely source such medication via the Internet, local pharmacies, general outlets and even market stalls.

The issue is so endemic that even in Hong Kong and Malaysia, where it is illegal to sell antibiotics without a doctor’s prescription or pharmacist’s supervision, the rules are routinely circumvented.

Handling antibiotics with care

While antibiotics can be life-saving drugs, Dr Jace Clarke, Chief Medical Officer at William Russell, says their easy availability gives people a false impression of safety.

“An individual’s use of an antibiotic always needs to be carefully considered and monitored,” he says. “Aside from obvious dangers of buying the wrong drug in the first place – which could include an incorrect diagnosis, allergic reaction or conflict with other medications – it is vital to both the patient and the community that patients finish the complete course of antibiotics.

If they fail to do this, bacteria may develop resistance which would invalidate an individual’s use of the particular antibiotic in the future.”

This ‘spectre of antimicrobial resistance’, as it is known, is directly linked to the rise of superbugs such as E.coli and MRSA (methicillin-resistant Staphylococcus aureus) across Southeast Asia

An Oxford University and Mahidol University study found drug-resistant bacterial infections killed 19,122 people in Thailand in 2010, making the problem more severe than in the US and European Union.

Pharmacy

Identifying the problem

While supervised use may seem to be the answer, doctors themselves are often to blame. Surveys by both the World Health Organisation (WHO) and local sources have found significant numbers of medical professionals in Southeast Asia lacked essential knowledge about what antibiotics should be used for.

For example, in 2016, Indonesia’s Caring Parents Foundation reported that 75% of doctors in an affluent region of Jakarta would always prescribe antibiotics for a common cold.

For its part, the Malaysian government has set up an Antimicrobial Stewardship Programme designed to better educate healthcare professionals about the appropriate use and dangers of over-prescribing antibiotics.

Should you ever self-prescribe antibiotics?

According to Dr Clarke, patients with certain chronic conditions may find easier access to antibiotics a good option as part of a treatment plan agreed with their specialist.

“Some good examples of this would be chronic chest disease and recurrent urinary tract infections,” he explains“My advice would be to make a note of the antibiotic you might need, which includes its local trade name, and then visit a recommended pharmacy to source it.”

Know what you’re buying

According to WHO, sales of Substandard, Spurious, Falsely labelled, Falsified and Counterfeit (SSFFC) medical products are a problem worldwide, with anti-malarials and antibiotics among the most regularly reported.

While it’s always recommended that you buy from a trusted source – such as a hospital pharmacy – the sale of counterfeit and sub-standard medication is common in Southeast Asia, so it’s still a good idea to perform your own checks.

Essential checklist

Counterfeit antibiotics can appear virtually identical to the genuine product and are therefore difficult to detect. Many can be identified by:

  • the condition of packaging, spelling mistakes or grammatical errors
  • checking the manufacturing and expiry dates and ensuring any details on the outer box match the dates shown on the inner packaging
  • making sure the medicine is not discoloured, degraded or has an unusual smell

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