01-08-2025
#HEALTH: Do you really need antibiotics for a sore throat?
IN Malaysia, as in many other countries worldwide, there is growing concern over a silent, yet widespread epidemic caused by the excessive and often inappropriate use of antibiotics.
This issue is particularly evident in the treatment of sore throats, which are usually the result of viral infections and do not require antibiotics.
The widespread overprescription of these medications has serious and extensive consequences, leading to a troubling increase in antibiotic-resistant superbugs that pose a significant threat to public health, says Universiti Sains Malaysia senior consultant, department of otorhinolaryngology - head and neck surgery, Professor Dr Baharudin Abdullah.
The misuse of antibiotics can lead to a rise in mortality rates and exerts a significant burden on healthcare infrastructure and the economy, draining resources and complicating treatment efforts across the board.
"It is more critical than ever to enhance public awareness and promote responsible prescription practices to protect public health and ensure the continued effectiveness of existing antibiotics," says Dr Baharudin.
The World Health Organisation's Global Antimicrobial Resistance and Use Surveillance System has categorised Malaysia as a high-alert nation due to the increasing threat of antimicrobial resistance (AMR).
In comparison to other Asian countries, Malaysia is among the leading nations in terms of antibiotic overuse, akin to Thailand and China, where obtaining antibiotics without a prescription remains a prevalent issue.
The Health Ministry has consistently raised alarms about the escalating issue of AMR, yet the trend of overprescribing antibiotics remains prevalent due to several key factors.
IN DEMAND
Many Malaysians mistakenly believe antibiotics can cure viral infections, and even think they are effective for pain relief.
Many physicians in both public and private primary care settings are often influenced by patient expectations and diagnostic uncertainty, leading to the prescription of antibiotics even when they are not clinically indicated.
Studies show that in Malaysian hospitals, the challenge of AMR is becoming increasingly apparent, with a surge in drug-resistant strains like Methicillin-resistant Staphylococcus aureus and Carbapenem-resistant Enterobacteriaceae.
Dr Baharudin says this predicament results in extended hospital stays, increased healthcare expenses and a greater chance of treatment failures.
"Treating a resistant infection can be up to three times more expensive than a non-resistant one, placing a substantial financial burden on both patients and the healthcare system."
THE ECONOMIC IMPACT
In addition to its effects on healthcare, AMR has major economic and environmental consequences.
According to World Bank estimates, by 2050, AMR may cause the world economy to contract by as much as 3.8 per cent, which might result in the poverty of 28 million people.
The need for more costly second-line therapies and extended hospital stays will drive up prices for the already overburdened healthcare system.
Furthermore, the environmental impact is too great to overlook because overprescribed antibiotics frequently end up in wastewater, contaminating soil and rivers and facilitating the spread of antibiotic resistance in bacterial populations outside of hospital settings.
While the statistics paint a grim picture, Malaysia is not without recourse. The country has already made significant strides in public health, from implementing national antibiotic stewardship programmes to conducting public awareness campaigns.
However, these efforts need to be scaled up and reinforced with a long-term, multi-sectoral approach, says Dr Baharudin.
"Strengthening enforcement of antibiotic sales, improving diagnostic capabilities in primary care settings, and fostering stronger collaboration between healthcare providers, policymakers and the public are critical next steps."
Malaysia has a strong track record of advancing healthcare, which puts it in a unique position to lead efforts domestically and throughout Southeast Asia in the regional fight against AMR, he explains.
Since Malaysia has already made great progress in improving healthcare - from bolstering universal healthcare laws to spearheading programmes for managing infectious diseases - it can support a regional AMR action plan that unites Asean countries in concerted efforts to stop antibiotic abuse.
By advocating for stricter cross-border regulations on antibiotic sales, harmonising prescription guidelines and championing large-scale public awareness campaigns, Malaysia can set the benchmark for responsible antibiotic stewardship in Southeast Asia.
