China is currently facing a challenge from abuse of antibiotics among many of its people. Studies indicate that China records a high rate of antibiotic abuse compared to other western countries. Reports by the Chinese Ministry of Health revealed that averagely, every individual in China consumes about 138g of antibiotics annually. This is higher amount than that of the International standard. Similarly, the Ministry of Heath revealed that about 70% of the inpatients are prescribed with antibiotics in Chinese hospitals. This is a much higher amount compared to 30% maximum use of antibiotics recommended by the World Health Organization (Mao, Vu, Zie, Chen & Tang, 2015).
This paper seeks to examine the root cause of antibiotic abuse among the people in China. The paper will also discuss the effects of antibiotics abuse on people and remedies for addressing antibiotic abuse in China.
Causes of Antibiotics Abuse in China
Although the root cause of antibiotic abuse in China is still under debate, a number of studies have been conducted in efforts to determine the major factors that have contributed to antibiotic problem in China. Two major causes of antibiotics abuse identified in China include patient demand and physicians’ motive for financial incentives (Mao, Vu, Zie, Chen & Tang, 2015).
Some studies indicate that financial incentives contribute significantly to antibiotic abuse in China. The prescription of medication has significant financial incentives in hospitals and physicians in China. About 50% of the hospital revenues in China are generated from the sale of drugs. Of all drug sales, the sale of antibiotics accounts to 47% of the hospital revenues. Also, hospitals in China are permitted to charge a 15% gain on sale of drugs. Physicians and hospitals in China receive performance bonuses based on the volume of revenues produced from drug sales to augment their salaries. Therefore, it is evident that financial motivation by doctors and hospitals in China is the major cause of antibiotic abuse among people in China (Sun, Dyar, Zhao, Tomson, Nilsson & Grape, 2015).
On the other hand, some studies point out that patients demand for prescription of antibiotics drug is a key factor in abuse of antibiotic by people in China. Most patients in China believe that if they are not administered an antibiotic injection or put on a drip, then they are not provided with quality care. Several researches have linked patients demand for antibiotics on lack of knowledge on appropriate use of antibiotics by patients. Evidence suggests that annually during wet winter, most Chinese people are seen heading to local hospitals for prescription of IV antibiotics dose for coughs. They believe that the use of antibiotics is treating coughs is much more effective than taking pills. Prescription or administration of antibiotics dose to patients by doctors just because they have demanded can be attributed to lack of professional knowledge on part of physicians on proper use of antibiotics. Also, unnecessary prescriptions of antibiotics to patients reflect on the poor quality of medical care offered by doctors in Chinese hospitals. Antibiotics are recommended to be prescribed only for bacterial infections and it is also important for medical providers to determine the type of infection before prescribing antibiotics. Therefore, health providers who prescribe antibiotics to patients because they have demanded represent antibiotic abuse (Curriea, Lin & Zhang, 2011).
Effects of Antibiotics Abuse in China
The prevalence of abuse of antibiotics is becoming threat in China due to its adverse consequences. Increased unnecessary prescription and antibiotic abuse has resulted in development of antibiotic-resistant bacteria (superbugs) among Chinese people. Superbugs are resistant to most or all types of antibiotics and this cause increased threats on health in individuals. The prescription and abuse of antibiotics has caused most Chinese people to develop antibiotic-resistant bacteria, which are higher compared to other Western countries. Studies indicate that about 6.8% of the tuberculosis medical conditions experienced in China are resistant to antibiotics treatments. Also, there is evidence of increased risks of syphilis infections among Chinese populations due to development of resistant bacteria (Mao, Vu, Zie, Chen & Tang, 2015).
Additionally, the development of resistant bacteria has significant impacts on affected individuals such as increases medical expenditures due to costs of treatment. Additionally, resistant bacteria lead to development of infections such that if they not controlled adequately they can result in death. Another adverse effect of resistant bacteria is that it leads to individuals developing drug reactions. Severe antibiotic drug reactions have contributed to increased deaths in China’s population. Treatment of the drug reactions is costly and this has impacted negatively on the productivity of the society (Mao, Vu, Zie, Chen & Tang, 2015).
The overuse of antibiotics in China has threatened the effectiveness of antibiotics, which is a risk to global health. The rate of use of antibiotics in China is more than the rate of production of replacement drug and this poses significant threats to the global health. The World Health Organization has called on China to be more responsible in using antibiotics to prevent the severe consequences of antibiotics abuse (Mao, Vu, Zie, Chen & Tang, 2015).
Remedies for Preventing Antibiotics Abuse in China
The aim of preventing antibiotics abuse is to promote good health among people in China and eliminate the threat of overuse of antibiotics on global health. Encouraging responsible use of antibiotic is a major factor towards preventing antibiotics abuse in China. Responsible use of antibiotics in China can be promoted through providing appropriate health reforms to remove financial incentives, establishing education programs for the public, and establish tighter regulation on use of antibiotics (Currie, Lin & Meng, 2014).
Establishment of health reforms will contribute towards eliminating financial incentives for physicians. The removal of financial incentives will hinder physicians from overprescribing antibiotics. Examples of health reforms that can be implemented include establishing National Essential Medicine List in public hospitals in China and take away pharmacies from hospitals in China. Although these reforms had been introduced and have not demonstrated significant outcome in reducing antibiotic abuse, it is important for a monitoring program to be established to supervise the implementation of the health reforms. For instance, in Beijing, the municipal health bureau has taken significant steps to address the antibiotic abuse. The municipal health bureau conducts survey on use of antibiotics in various hospitals in Beijing. The hospitals that are found overusing the antibiotics drug are punished by downgrading their ranking. Downgrade of a hospital rank has direct impact on fees the hospital charges and thus this affects their revenue generation. This move has limited the overuse and over prescription of antibiotics in hospitals in Beijing. Shanghai has also taken a similar scheme to address the problem of antibiotic abuse in hospitals (Bao, Peng, Wang, & Ma, 2015).
Developing a program to educate the public on consequences of overuse and abuse of antibiotics would contribute to reduction on increased demand of antibiotics drugs. Knowledge on appropriate use of antibiotics among the public will minimize unnecessary demand and prescription of antibiotics. Similarly, public awareness on proper use of antibiotic will as well reduce drug expenditures thus contribute towards preventing or reduce antibiotic abuse in China. Studies indicate that people who have knowledge on appropriate use of antibiotic drugs have low likelihood of demanding antibiotics dose or to be prescribed unnecessarily by the doctor. Therefore, patient education will dramatically minimize antibiotic abuse in China (Curriea, Lin & Zhang, 2011).
Establishment of tighter regulation on antibiotic use will promote reduction of antibiotic abuse. New laws on antibiotics use will curtail doctors and hospitals from unnecessary or over prescription of antibiotics on patients. Additionally, the new laws will prevent the patients from demanding antibiotics before diagnosis for a bacterial infection (Currie, Lin & Meng, 2014).
Two major factors have been identified as major causes of antibiotics abuse in China. Patients demand on antibiotic dose and physicians’ motive for financial incentives has contributed to major antibiotic abuse challenge in China. From the above discussion, it can be concluded that financial incentives among doctors and hospitals in China is the root cause of abuse of antibiotics in China. The need for physicians and hospitals to obtain financial gain carries more weight compared to other factors that contribute to antibiotic abuse problem. The hospital revenues and the award of performance bonuses are determined by the revenues generated from the sale of drug. The sale of antibiotics generates a high percentage of revenue, 47% compared to the sale of other drugs. Therefore, the financial motivation is the root cause of increased problem of abuse of antibiotics by people in China.
Bao, L., Peng, R., Wang, Y., & Ma, R. (2015, March). Significant Reduction of Antibiotic Consumption and Patients’ Costs after an Action Plan in China, 2010–2014. PLoS ONE, 10(13), 1-13. doi:10.1371/journal.pone.0118868
Curriea, J., Lin, W., & Zhang, W. (2011, September). Patient knowledge and antibiotic abuse: Evidence from an audit study in China. Journal of Health Economics, 30(5), 933-949.
Currie, J., Lin, W., & Meng, J. (2014, September). Addressing Antibiotic Abuse in China: An Experimental Audit Study. Journal of Economic Literature, 110, 39-51. Retrieved on 31st August 2016 from: http:/www.haiweb.org/medicineprices/surveys/200411CN/ survey_report.pdf
Mao, W., Vu, H., Zie, Z., Chen, W., & Tang, S. (2015, March). Systematic Review on Irrational Use of Medicines in China and Vietnam. PLoS ONE, 10(3),1-16.
Sun, Q., Dyar, O., Zhao, L., Tomson, G., Nilsson, L., & Grape, M. (2015, March 19). Overuse of antibiotics for the common cold attitudes and behaviors among doctors in rural areas of Shandong Province, China. BMC Pharmacology, 1-7. doi: 10.1186/s40360-015-0009-x. Retrieved on 31st August 2016 from: http://dx.doi.org/10.1186/ s40360-015-0009-x
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