Replies to LegCo questions
LCQ20: Antibiotics prescribed by medical practitioners
Following is a question by the Ir Dr Hon Ho Chung-tai and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (December 1):
Question:
It has been reported that the Hospital Authority is planning to implement a monitoring system next year to review the appropriateness of medical practitioners' decisions to prescribe antibiotics, with a view to preventing the deterioration of bacterial drug resistance because of the abuse of antibiotics. In this connection, will the Government inform this Council whether it knows:
(a) the quantities of various types of antibiotics prescribed by medical practitioners in public hospitals in the past 12 months;
(b) the details of the above monitoring system; and
(c) if the relevant authorities have put in place measures to monitor the prescription of antibiotics by private medical practitioners?
Reply:
(a) According to the data collated by the Chief Pharmacist's Office of the Hospital Authority (HA), the cost of antibiotics used by public hospitals in 2003-04 amounted to $186 million, representing about 9.8 per cent of HA's total expenditure on drugs in that year.
(b) At present, the Infection Control Teams in public hospitals are responsible for conducting surveys on infection regularly and collecting data on bacterial drug resistance at the hospital level. To enhance monitoring of the situation in public hospitals, the Central Committee on Infectious Diseases of the HA and the Infection Control Branch of the Centre for Health Protection (CHP) will jointly establish a standard surveillance system, with a view to implementing it in all acute hospitals of the HA next year. The information to be captured by the new surveillance system includes data on bacterial drug resistance as well as the actual usage of various types of antibiotics. An analysis of these data should assist medical practitioners in prescribing the appropriate antibiotics for patients and enhance the cost effectiveness in the use of these drugs.
Apart from monitoring the use of antibiotics in public hospitals, the HA is also providing advice to its clinical staff on the proper use of antibiotics through the Drug Advisory Committees in public hospitals. This is to both enhance treatment outcomes and reduce the chance of emergence of drug-resistant bacteria. In addition, the HA will work to ensure that its clinical staff would receive the results of bacterial testing of individual patients as soon as possible, so as to facilitate the prescription of the appropriate antibiotics for treating the patients.
(c) The Department of Health (DH) issued a set of guidelines on the use of antibiotics for clinics in the primary health sector in early 2002. Intended as a reference for healthcare workers, the guidelines contain recommendations on the use of antibiotics in different situations. In order to encourage the prudent use of antibiotics by medical practitioners, the CHP has already initiated sentinel surveillance of drug-resistant bacteria in the community. The relevant results would be disseminated to all local doctors and healthcare workers through journals and publications on public health and epidemiology, so that they would be aware of the various trends in bacterial drug resistance and take necessary precautions. In addition, the results of drug resistance tests would also be made public. This information should assist medical practitioners in their professional assessment and enable them to prescribe the appropriate antibiotics for their patients.
The CHP is also planning to set up a working group to study possible measures for further strengthening the surveillance of the use of antibiotics in the community setting and controlling the development of drug-resistant bacteria. The working group will comprise representatives from DH and HA, and medical practitioners in private practice.
Section 4 of the Antibiotics Ordinance (Cap 137) provides for statutory control on the prescription of antibiotics by medical practitioners and on the sale and supply of antibiotics by pharmacists and authorised sellers of poisons. As a matter of fact, clinical guidelines on the proper use of antibiotics are covered in both the professional training and continuing education for medical practitioners. The Professional Code of Conduct by the Hong Kong Medical Council also requires medical practitioners to properly label all drugs dispensed to patients with the essential information, including the method of administration, dosage and applicable precautions, to ensure the safety of patients.
DH has along been publishing pamphlets to promote the proper use of antibiotics by the general public. To prevent abuse, the public is reminded of the importance to follow doctors' instructions when taking antibiotics. DH will continue with its efforts in public health education in this regard.
Ends/Wednesday, December 1, 2004
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