In a recent development, the Ministry of Health (MOH) in Malaysia has disclosed that the antibiotic prescription rate for inpatients in both MOH and university hospitals is hovering between 44 per cent and 45.5 per cent. This announcement, made by Health Minister Dzulkefly Ahmad, is based on findings from the Point Prevalence Study (PPS) conducted from 2021 to 2023. The study reveals that intensive care units (ICUs) are primarily responsible for these elevated prescription rates, which has raised eyebrows and sparked discussions about antibiotic usage in Malaysia.
The ICU is a domain where patients are critically ill, necessitating intensive treatment. Dzulkefly highlighted this in his response to a query by Senator Koh Nai Kwong in the Dewan Negara on December 16. He pointed out that the critical condition of ICU patients often demands extended treatment periods, which contributes to the high prescription rates. This situation fuels concerns as Malaysia reportedly has the highest antibiotic prescription rate in Asia at 44 per cent.
The Point Prevalence Survey serves as a vital tool in monitoring antibiotic prescription rates across hospitals and clinics nationwide. Over three years, it has provided valuable insights into how antibiotics are used within healthcare settings. Interestingly, the survey extended its scope to health clinics, revealing antibiotic prescription rates for outpatients ranging from 3.4 per cent to 5.3 per cent. While there is an uptick in prescriptions for upper respiratory tract infections (URTI), Dzulkefly assures that most prescriptions align with medical guidelines following thorough evaluations by family medicine specialists.
Despite the high numbers, the reassuring aspect is that 98 per cent of antibiotics prescribed are consistent with the National Antimicrobial Guidelines 2019. These guidelines serve as a beacon for healthcare professionals, ensuring that treatments are evidence-based and appropriate.
To address burgeoning concerns over antibiotic misuse, MOH has rolled out several initiatives aimed at raising awareness among healthcare professionals and the public. A noteworthy effort is the creation of a “live document” containing the National Antimicrobial Guidelines for infectious diseases treatment. These guidelines will be perpetually updated with the latest clinical evidence and can be accessed online, providing an invaluable resource for medical practitioners.
Public education remains at the forefront of MOH’s strategy. Since 2015, Malaysia has observed Antimicrobial Resistance Awareness Week annually, underscoring the importance of understanding antibiotic use. This commitment extends through programmes like “Know Your Medicine” (Kenali Ubat Anda), which educates citizens on various aspects of medication, including the prudent use of antibiotics.
The Malaysian One Health Antimicrobial Resistance (MyOHAR) portal further supports these efforts by disseminating information on antimicrobial use. Social media platforms such as Facebook, Instagram, and TikTok also play pivotal roles under the “Know Your Medicine” campaign, reaching diverse audiences and enhancing public understanding.
However, while these initiatives are commendable, they are not without challenges. The rising prescription rates in ICUs point to a complex issue that requires a balanced approach. It highlights the necessity for critical evaluation of antibiotic use, particularly in environments where patients’ lives hang in the balance.
The global concern about antimicrobial resistance adds another layer of urgency to this issue. Excessive or inappropriate use of antibiotics can lead to resistance, rendering common treatments ineffective against infections. This resistance poses a severe threat to public health worldwide, making it imperative to adopt strategies that promote judicious antibiotic use.
In Malaysia, the focus remains on harnessing data from studies like the PPS to inform policies and practices. The continuous updating of treatment guidelines is a step in the right direction, ensuring that healthcare delivery aligns with current scientific evidence.
While strides have been made in addressing antibiotic misuse, there remains a long road ahead. The healthcare community must remain vigilant and adaptive, embracing new insights and technologies that enhance patient care without compromising on safety or efficacy.
As we navigate this complex landscape, it is essential to remember that every prescription counts. Each decision made by healthcare professionals can have far-reaching implications not only for individual patients but also for society at large. With continued dedication and collaboration, Malaysia can pave the way towards more responsible antibiotic use, safeguarding the health of its people now and in years to come.
