Correct perception to act together

While many countries still use first-generation antibiotics effectively, Vietnam has had to use third and fourth-generation antibiotics. The reason is that the indiscriminate purchase and use of antibiotics in treatment has made the situation of drug resistance increasingly alarming.

Health care worker cares for a patient with drug resistance

Critical because of arbitrary use of antibiotics

Ho Chi Minh City University of Medicine and Pharmacy Hospital has just received and treated a patient named D.VN (70 years old, residing in Ben Tre province) who was admitted to a local hospital due to difficulty breathing for 2 weeks. Previously, he bought antibiotics to take but did not improve, so his family transferred him to Ho Chi Minh City University of Medicine and Pharmacy Hospital in a state of being on a ventilator, had to be intubated and was diagnosed with pneumonia caused by Klebsiella pneumoniae (one of the gram-negative bacteria with the highest antibiotic resistance rate).

Mr. N. was treated with colistin (the last-line antibiotic for treating multi-resistant gram-negative bacteria). Subsequent sputum culture results showed that multi-resistant Klebsiella pneumoniae bacteria still existed (only sensitive to a group of aminoglycoside antibiotics - a group of strong antibiotics but toxic to the kidneys and cochlear vestibule, with a narrow therapeutic range, requiring monitoring of drug concentrations in the blood). The doctors consulted with the clinical pharmacist at the department, decided to use a combination of piperacillin/tazobactam and amikacin (an aminoglycoside group), and monitored kidney function and measured drug concentrations in the blood to optimize treatment. As a result, Mr. N. improved positively, his fever subsided, and he was able to stop using the ventilator.

As someone who regularly uses antibiotics for his children when the weather changes, Nguyen Minh Tien (living in District 8, Ho Chi Minh City) said that in his family's medicine cabinet, there may be any medicine missing, but antibiotics such as amoxicillin, penicillin... are indispensable in case the children get the flu when the weather changes. Mr. Tien said that his children often cough, he is afraid of going to crowded hospitals and his children's mild illness is not serious enough to require hospitalization, so he takes antibiotics for convenience.

As easy as buying antibiotics in Vietnam

According to Associate Professor, Dr. Luong Ngoc Khue, Director of the Department of Medical Examination and Treatment Management (Ministry of Health), the invention of antibiotics is a miracle in modern medicine. The invention of antibiotics has greatly changed the treatment process, helping to destroy dangerous bacteria, thereby controlling many diseases.

However, reality over the years has shown that the unreasonable abuse of antibiotics by humans has created conditions for bacteria to build resistance to antibiotics, making them almost ineffective. It must be admitted that: nowhere is it easier to buy antibiotics than in Vietnam - this is a big challenge for the community.

According to Professor Ngo Quy Chau, Chairman of the Vietnam Respiratory Society and Professional Director of Tam Anh General Hospital in Hanoi, the cause is the unreasonable use of antibiotics at all levels of the health care system, such as unreasonable prescriptions, poor control of hospital infections, use of antibiotics in aquaculture, animal husbandry and in the community... In particular, people using antibiotics on their own, arbitrarily increasing or decreasing doses or skipping doses also increases the risk of antibiotic resistance.

Statistics at Bach Mai Hospital (Hanoi) show that the situation of antibiotic resistance is increasing alarmingly every year. In previous years, the rate of antibiotic-resistant patients from lower-level hospitals was only a few cases, but up to now, many cases transferred from lower-level hospitals to Bach Mai Hospital were found to have antibiotic-resistant bacteria when they were cultured upon admission. Many patients were admitted to the hospital for another disease but the infection increased rapidly, encountering antibiotic-resistant bacteria, causing the patient to become critically ill and die from the infection, not from the disease when the patient was admitted.

Risk of serious drug resistance

According to Dr. Le Quoc Hung, Head of the Department of Tropical Diseases, Cho Ray Hospital (HCMC), the current use of antibiotics in our country is quite indiscriminate. People can easily buy antibiotics at pharmacies, completely different from the world where they must have a doctor's prescription. In addition, in the hospital environment, the rate of doctors using antibiotics is still very high, nearly half of the prescriptions for antibiotics are not reasonable in terms of type, dosage, time...

There are even many indications for "treating" antibiotics that are "surrounding" in nature, not to mention that judging the type of bacteria using antibiotics can sometimes lead to drug resistance. "Many patients with drug-resistant infections are very difficult to treat, the hospital stay is very long, the cost of using antibiotics is high, especially having to use many types of antibiotics at the same time to be able to treat drug-resistant bacteria", Dr. Le Quoc Hung informed.

The doctor is advising the patient on how to use the medicine safely.

Commenting on the increasingly serious level of antibiotic resistance in Vietnam and its great pressure on public health, Mr. Cao Hung Thai, Deputy Director of the Department of Medical Examination and Treatment Management (Ministry of Health), said that in addition to the financial burden caused by prolonged treatment, we also face the possibility of a future without effective antibiotics to treat some infectious diseases, especially for surgeries and treatments such as cancer chemotherapy and tissue transplants.

According to a survey by the health sector, most antibiotics are sold without a doctor's prescription, 88% in urban areas and 91% in rural areas. The problem of antibiotic resistance is becoming increasingly serious as many bacteria are resistant to many types of antibiotics, the main cause of which is antibiotic abuse. Most of the current first and second generation antibiotics do not have specific effects. Most hospitals have to use new generation antibiotics in treatment.

Strive to basically control drug resistance by 2045

Deputy Prime Minister Tran Hong Ha has just signed a decision approving the National Strategy on Antimicrobial Resistance Prevention in Vietnam for the 2023-2030 period, with a vision to 2045.

Specifically, from now until 2030, the strategy sets out four goals: raising awareness among local authorities and understanding among health workers, veterinarians and the public about antimicrobial resistance prevention; strengthening the antimicrobial resistance surveillance system to provide timely warnings about the emergence, spread, level and trends of antimicrobial resistance in microorganisms; reducing the spread of microorganisms and infectious diseases; using antimicrobials in humans and animals rationally, safely and responsibly.

Strive to basically control drug resistance by 2045, have an effective system for monitoring drug resistance, use and consumption of antibiotics.

According to experts, antibiotics are used to fight diseases in humans, animals and plants, including antibacterial drugs, antiviral drugs, antifungal drugs and antiparasitic drugs. Antibiotic resistance occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to drugs, making common infections more difficult to treat, increasing the risk of spreading disease, serious illness and death. The current state of antibiotic resistance leads to more and more infectious diseases (pneumonia, urinary tract infections, tuberculosis...) becoming more difficult to treat, even impossible to treat.

Source: https://www.sggp.org.vn/nhan-thuc-dung-de-cung-hanh-dong-post714631.html