A good start to action on antibiotic overuse
The proliferation of bugs resistant to medicines is a worrying problem, and efforts to tackle it deserve praise. However those efforts rely on voluntary cooperation from doctors, and there should be a plan B to deal with non-compliance
Antibiotic resistance and the proliferation of superbugs are global problems. The fact that they know no borders means that no country or territory can responsibly except itself from efforts to end overprescribing and misuse of drugs. So it is good to see Hong Kong’s latest measures to get a more accurate picture of the extent and pattern of antibiotic prescribing by the city’s private doctors. The government will ask them to report the use of antibiotics through the existing electronic health record system shared by private and government doctors. The Centre for Health Protection says it will also consider looking at past medical records and collecting prescriptions from doctors.
The government is right to step up its response to the growing superbug menace both in hospitals and in the community. The latest measures are part of a five-year plan, the cross-departmental Hong Kong Strategy and Action Plan on Antimicrobial Resistance. The unwieldy title does not convey the gravity and urgency of a problem that not only renders treatment of some diseases and infections less effective, but threatens to make some common ailments as lethal as they once were before the advent of antibiotics.
Despite growing global awareness however, medical science is unlikely to be able to conquer the threat as long as antibiotics continue to be used extensively, including in Hong Kong, to promote growth and prevent disease in livestock and poultry farming. Indeed, agricultural misuse of antibiotics remains the biggest obstacle to be overcome. According to a recent Hong Kong Consumer Council study, more than 60 per cent of tested chicken samples from local markets were found to contain a superbug resistant to antibiotics used for treating infectious diseases. As a result, the government plans to ban farmers giving antibiotics to animals unless prescribed by a vet and will ask them to keep records of usage. The effectiveness of the two reporting mechanisms depends on compliance by doctors and farmers, since they are voluntary. If it is compromised by non-compliance, the government should have a plan B to safeguard the reputation of our public health system with deterrent penalties.