Reducing the overuse of antibiotics in Malta requires a two-pronged approach that educates doctors and addresses patients’ expectations, according to Medical Association of Malta president Martin Balzan.
“I find one of the main issues is that there is a public expectation for doctors to prescribe antibiotics. And if the doctor doesn’t prescribe, patients visit other doctors until somebody does,” he said.
A recent Eurobarometer survey showed that Malta has the highest rate of antibiotics use, with 48 per cent of those polled saying they had taken them in the last 12 months.
I would rather have a patient go elsewhere than do something I feel is not right
Nearly a third of Maltese wrongly popped antibiotics for a sore throat and the flu, compared to the EU’s average of 11 per cent and 18 per cent, respectively.
A separate EU-funded project, which looked at attitudes influencing the prescription of medicines in select countries, also showed that Maltese patients consumed a high amount of medicines.
The study highlighted a culture – typical of Mediterranean countries – where people accepted ‘prescriptions’ from their relatives and neighbours. It also pointed out that, compared to other countries, doctors in Malta had a higher tendency to prescribe, and pharmacists gave medicines without prescriptions.
Dr Balzan believes that for these factors to be addressed there need to be ongoing campaigns to educate both doctors – to prescribe only for good reasons – and patients.
One of the factors that may lead doctors to overprescribe is the fear of ending up in trouble with the law. Over the years there had been several cases of doctors taken to court for delaying antibiotic therapy, he said.
Another matter to be taken into account was the contribution of pharmacists who dispensed prescription-only drugs without a prescription.
Paediatrician Mark Bailey agreed that patients exerted pressure to be given prescriptions but he looked at the bigger picture – antibiotics do not help a child suffering from a virus.
“In general, there is quite a bit of pressure on the doctor to prescribe antibiotics. For me, I would rather have a patient go elsewhere than do something I feel is not right,” he said adding that he avoided using anti-biotics when he suspected it was a viral infection, unless there were complications.
He said his patients were used to the way he worked. “Probably some doctors would give antibiotics in 49 out of 50 cases. In my case it’s the opposite. I prescribe antibiotics probably in one out of 50 cases,”
The Eurobarometer survey showed that only 23 per cent of Maltese were aware that antibiotics were ineffective against viruses and 37 per cent were aware antibiotics were ineffective against colds and flu.
The overuse of antibiotics is making the war on hostile bacteria harder to wage and there is increasing concern about their decline in effectiveness.