The recent BMJ study and the international hype around it did pique one local newspaper journalist enough that further questions were asked of Ms Winnie Lee and myself. A pretty nice and informative article was published in the Lianhe Zaobao yesterday (in Chinese).

Lian He Zao Bao

Scanned picture of the Lianhe Zaobao article on antibiotics, courtesy of Ms Winnie Lee.

Antibiotics are over-prescribed in Singapore, as they are in virtually all developed countries. Part of it is because of the uncertainty (that we do not know what is the “correct” exact duration of antibiotics for each infection and individual patient, as well as a culture of medical practice and training where antibiotics are recommended if the suspicion of a bacterial infection is high. This is not necessarily a bad thing, because antibiotics can be life-saving, and under-prescribing antibiotics has worse short- and medium-term consequences in terms of human health comparison to over-prescribing antibiotics. But of course, excessive antibiotic prescribing will exert an even greater selection pressure resulting in more rapid development of antibiotic resistance in the future. The difficulty of crafting public messages or even those for healthcare workers based on such nuanced understanding is the key challenge for the immediate future.

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Antimicrobial resistance, Antimicrobial stewardship, Public Health, Singapore