Indonesian Doctors Criticized for ‘Alarming’ Use of Antibiotics

April 16, 2011

The use of antibiotics has reached an alarming level in Indonesia, fueled by poor diagnosis, ignorance and poor regulation of drugs, experts say.

“Irrational use of drugs, including antibiotics, is a global problem, but sporadic surveys show that the use of antibiotics in Indonesia has reached an excessive level,” said Purnamawati, a pediatrician and founder of the Foundation for Concerned Parents.

The most recent survey, conducted by Purnamawati’s foundation in 17 Indonesian cities, revealed that antibiotics were prescribed in 78.4 percent of cases of respiratory and stomach illnesses in children in 2008 — against 54.5 percent in 2006.

Such conditions are generally caused by viruses that are not treated by antibiotics, Purnamawati said.

The survey also showed that on average five different brands of drugs, including antibiotics and antihistamines, were prescribed for every case of respiratory infection, with generic drugs accounting for less than a quarter of drugs prescribed.

“Polypharmacy [the use of more drugs than necessary] is rampant not only in Jakarta, but also in other cities,” Purnamawati told IRIN. “Apart from the financial cost, there’s an intangible cost when we are prescribed antibiotics when we don’t need them. It’s a very high price to pay.”

Misuse of medicines, particularly antibiotics, leaves patients with fewer options for treatment when bacteria become resistant, said the World Health Organization’s representative in Indonesia, Khanchit Limpakarnjanarat, at a recent seminar.

In Southeast Asia, misuse and poor access to other drugs continue to be major components of the widespread inappropriate use of antibiotics, according to WHO. A comprehensive study led by the WHO and government is under way.

Patients too often demand that doctors prescribe antibiotics because they believe the drugs will speed up recovery, said Hari Paraton, chairman of the Antimicrobial Resistance Control Programme at Dr Soetomo Hospital in Surabaya.

“The situation is the same across Indonesia,” he said. “Doctors, pharmacists and the public contribute to the problems.”


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