Lax attitude to illegal sale of antibiotics

PUBLISHED : Sunday, 29 May, 2011, 12:00am
UPDATED : Sunday, 29 May, 2011, 12:00am


Senior medical professionals are concerned that the courts are too lenient on pharmacies selling antibiotics illegally at a time when drugresistant infections are a major public health concern.

Worries are so high that the Department of Health may look at increasing penalties for the offence.

Although antibiotics are widely available without prescription, the department's latest figures show there were only 12 convictions for illegal sales of the medications by pharmacies from 2008 to last year.

'We want to bring to the attention of the courts that selling antibiotics over the counter is a serious offence,' said Dr Heston Kwong Kwok-wai, the department's assistant director.

He said that 'during prosecutions, our health officers have increasingly stressed to the court the serious public health impact of the illegal sale [of antibiotics]', and that, since 2009, health officials have stepped up undercover 'test purchases' of antibiotics at the city's 550 pharmacies.

Of the 12 convictions, the heaviest penalty handed down was a HK$5,000 fine and two months' imprisonment, suspended for 12 months.

The penalties in the remaining 11 cases were fines ranging from HK$2,000 to HK$6,000.

The maximum penalty for the illegal sale of antibiotics is a HK$30,000 fine and 12 months' imprisonment, compared with a maximum HK$100,000 fine and two years in prison for the illegal sale of other types of controlled drugs such as cough syrup, slimming pills and Viagra.

During the three-year, 2008-2010 period, the Pharmacy and Poisons Board, the sector's licensing authority, held only three disciplinary hearings on illegal sales of antibiotics. One pharmacy had its licence suspended for five days, another for 21 days and a third was issued only a warning letter.

A Centre for Health Protection study of more than 1,500 people found that 5.7 per cent of those taking antibiotics had bought the medication over the counter without a legally required prescription.

The widespread and inappropriate use of antibiotics is the major cause of superbugs - bacteria that have become resistant to drugs used to treat diseases such as tuberculosis and urinary tract infections.

Kwong said the department conducted some 6,000 undercover operations last year to buy dangerous drugs at local pharmacies.

Of those, 800 operations targeted antibiotics but only about 10 pharmacies were found to be selling the drugs illegally.

The 'hit rate' of the department's undercover operations is low compared with similar undercover investigations carried out by local media.

For example, a Sunday Morning Post undercover visit to two pharmacies in Kwai Fong last week resulted in the purchase of two first-line antibiotics - co-amoxiclav and amoxicillin - without a prescription. First-line antibiotics are medications usually used in the initial treatment of an infection.

Hong Kong Medical Association president Dr Choi Kin said the illegal sale of antibiotics had long been rampant and its abolition was long overdue.

'The situation has not improved in the past decade. Every day I encounter patients who are on an antibiotic bought over the counter. The penalty for the offenders is so lenient that it has no deterrence at all,' Choi said.

Society of Hospital Pharmacists vice-president William Chui Chun-ming (pictured) said the penalties were too low to deter the crime.

'In the past, society did not know much about the problem of drug resistance, so the illegal sale of antibiotics was not regarded as something serious. Now drug resistance is a global concern, the law should be reviewed to give a heavier penalty for that crime,' Chui said.