VietNamNet Bridge – Vietnamese health officials are encouraging local patients to use antibiotics only when prescribed by a doctor but a survey by the Health Ministry reveals that 76 per cent of doctors prescribe medicines unreasonably, causing antibiotic resistance to about 33 per cent of patients.

The rate is making the public more skeptical when using antibiotics. Should they continue taking the doctors' advice or buy medicines with their own experience? Should they keep away from using antibiotics?

Nguyen Khanh Chi, a mother of two sons in Ha Noi's Hoan Kiem District said that she used to take her children to the hospital so regularly that she became familiar with different kinds of medicines including antibiotics.

However, she was upset to know that many of the antibiotics that the children were prescribed earlier were not necessary to treat the children's health problems or too strong for them.

"A retired doctor who is a friend of my family told me about unnecessary antibiotics when he saw the prescriptions," Chi said.

She also said that the medicines that the retired doctor prescribed to her children were much simpler and cheaper than those prescribed by doctors at hospitals. More importantly, the medicine worked and her children got better soon.

Another young mother Nguyen Phuong Loan said she was struggling and asking for advice from many people when selecting doctors for her baby.

"Being a mother for the first time is accompanied by difficulties including those related to health treatment and using medicines," she said.

"I learned a big lesson after using antibiotics for my daughter when she had a cough and running nose at her sixth month. After taking antibiotics, she had to defecate a dozen times a day.

At that time, because of being inexperienced, she just thought of how to ease her baby's health problem and relieved her pain as soon as possible, Loan said, "So, I was hasty using antibiotics for my baby."

Vice head of Health Ministry's Medical Examination and Treatment Department, Cao Huy Thai, said that misusing medicines, particularly antibiotics that caused drug resistance was popular in hospitals.

He said that many hospitals across the country did not have a laboratory system that helped doctors test, identify and prescribe exactly the kind of antibiotic each patient needs.

As a result, doctors prescribed antibiotics for patients mostly based on their experience, Thai said.

A survey by the ministry on drug sales at stores in northern provinces showed poor understanding over antibiotic use as 88 per cent of examined drug stores in urban areas and 91 per cent of those in rural areas sold antibiotics without requiring prescription.

Revenue from antibiotics sale accounted up to 18 per cent of the stores' total revenue. Expense for antibiotics made up 17 per cent of total medical examination and treatment of patients.

Thai said that almost all hospitals in Viet Nam faced the increase of bacteria resistant to antibiotics.

The World Health Organization puts Viet Nam among the countries with the highest rate of antibiotic-resistant infections in the world, pointing to the indiscriminate use of such drugs among local patients, as well as the growing practice of using antibiotics in animal feed.

Resistance to carbapenems, for instance – the strongest form of antibiotics – has risen to 50 per cent in Viet Nam, while another family of powerful drugs, third-generation cephalosporins, now bears a resistance of over 60 per cent.

Head of Clinical Pharmacodogy Department in Ha Noi University of Pharmacy, Nguyen Thi Lien Huong said that in Viet Nam, antibiotics were sold so easily, anyone could buy them and used them without doctors' prescription.

"Patients are over-using antibiotics and doctors are over-prescribing antibiotics," Huong said.

She said that it was difficult for people to evaluate if a prescription by a doctor was right or not.

However, she said that to curb the antibiotic resistance, patients should first take antibiotics as prescribed.

More measures were also needed to better control and improve drug prescription quality in hospitals and healthcare centres, she said.

Health Minister Nguyen Thi Kim Tien said at a meeting on fighting against antibiotic resistance in Viet Nam last Saturday that health workers, patients and pharmacists played key roles in the fight.

Communication was needed to provide them more understanding about antibiotic use and resistance, she said.

Viet Nam's current Law on Pharmacy had regulations on drug prescriptions and banned over-prescription, Tien said, adding that there was no sanction for uncontrolled drug sales between patients and pharmacists at drug stores.

A revised Pharmacy Law, expected to be in the National Assembly's next meeting, added a ban on drug sales without a doctors' prescription, she said.

"The inappropriate use of antimicrobial drugs threatens the capacity of the health system to prevent, control and treat common infectious diseases, resulting in higher mortality, prolonged treatments and catastrophic expenditures for the patients," said Dr Lokky Wai, the World Health Organisation (WHO) Representative to Viet Nam.

Dr Wai stressed that antimicrobial resistance was a multidimensional problem that not only affected public health, but also the economy and the sustainable development of the nation, Viet Nam News reported early this week.

"As a society we must take decisive actions to preserve the effectiveness of antimicrobials before it is too late," said Dr Wai.