China’s irrational use of drugs is serious. Experts suggest that the policy “combination boxing” be
[China Pharmaceutical Network Industry News] Reasonable and safe drug use is a long-term work, which is of great concern and attention worldwide. China’s irrational use of drugs is serious. Expe...
[China Pharmaceutical Network Industry News] Reasonable and safe drug use is a long-term work, which is of great concern and attention worldwide. China’s irrational use of drugs is serious. Experts suggest that the policy “combination boxing” be played.
According to the National Food and Drug Safety Science Action Plan (2011-2015), it will become the “National Safe Drug Month” in September each year. However, the reporter of the "Economic Information Daily" learned that the current irrational use of drugs in China is still relatively common and has become a prominent problem that endangers the safety of public medication. Experts said that rational and safe medication is a long-term work, and it is necessary to start from multiple levels and take a number of measures to comprehensively intervene.
Unreasonable use of drugs is serious
At the beginning of September, the State Food and Drug Administration issued the "Notice of the General Administration of Food, Drugs and Drugs on the National Safe Drug Month in September", saying that the "National Safe Drug Month" activity was held in September, requiring local food and drug supervision and administration departments to focus on Promote the scientific concept and practical knowledge of safe medication, and sort out and interpret common misunderstandings such as inappropriate self-medication, excessive use of antibiotics and injections, blindly credulous imported drugs and high-priced drugs.
Safe medication has long been widely called. According to statistics, in 2014, the National Adverse Drug Reaction Monitoring Network received a total of 520,000 cases of adverse drug reactions/incident reports of national essential drugs (accounting for 39.2% of the 2014 overall report), of which 29,000 cases were reported, accounting for 5.6%. Case reports involving chemical and biological products accounted for 82.9%, and cases of proprietary Chinese medicines accounted for 17.1%.
The results of a “People's Safe Drug Survey” show that the irrational use of drugs in China is very serious, accounting for 12% to 32% of the drug users. At least 2.5 million of the more than 50 million inpatients in the country are associated with adverse drug reactions, causing approximately 190,000 deaths.
Yu Lei, a clinical pharmacist at the Department of Clinical Pharmacy of the West China Hospital of Sichuan University, said that irrational use of drugs may result in poor treatment, easy to cause adverse reactions, and may also cause drug resistance, and many patients lack awareness. Not aware that these hazards are a major hazard to your health.
In irrational use, the toxic side effects and bacterial resistance caused by excessive and unreasonable use of antibacterial drugs have become increasingly serious and have become a serious public health problem worldwide.
According to Cheng Nansheng, deputy director of West China Hospital of Sichuan University, antibacterial drugs are various antibiotics, sulfonamides, anti-tuberculosis and other chemical drugs that have bactericidal or antibacterial activity and are mainly used for systemic applications. At the end of 2014, the US Centers for Disease Control and Prevention identified the top ten public health challenges of the year, which may eventually lead to humans' inability to fight the antimicrobial resistance of various bacteria, second only to the Ebola epidemic. The situation of antibiotic resistance in China is also becoming increasingly serious and cannot be ignored.
Cheng Nansheng said, for example, Staphylococcus aureus is a clinically common and highly toxic bacteria. After the advent of penicillin, the infectious diseases caused by Staphylococcus aureus are greatly controlled, but with the unreasonable use of penicillin, some golden yellow Staphylococci produce penicillinase and evolve into "superbugs". They are generally resistant to three or more classes of antibiotics, and some are resistant to seven antibiotics at the same time. According to statistics, about 50% of the patients with Staphylococcus aureus infection in China currently carry this “superbug”.
The current cycle of resistance to a new type of bacteria has been greatly reduced, from several decades to several years. Liang Zongan, director of the Department of Respiratory and Critical Care Medicine at West China Hospital of Sichuan University, said that antibiotic abuse and antibiotic environmental pollution can quickly increase bacterial resistance.
Abuse of antibacterial drugs in pharmacies and aquaculture
In terms of the use of antibacterial drugs, Cheng Nansheng introduced that the State introduced the “Administrative Measures for the Clinical Application of Antimicrobial Drugs” in 2011. After four years of remediation, the antibacterial drug management of large hospitals is currently better. Taking West China Hospital of Sichuan University as an example, the use rate of antibiotics in the hospital dropped from 60.15% before rectification to 34.18% now. The rate of microbiological examination before treatment with special grade antibiotics increased from 59.92% before rectification to 88.29% now. .
In terms of internal management, the hospital has further strengthened the system control of antibacterial drugs. Chen Min, head of the Medical Education Department of West China Hospital of Sichuan University, said that on July 10 this year, the hospital added prescription control rules to the interface of the outpatient medical order system to control the dosage and course of the drug. "Common amount" and "one-day limit", if it exceeds the "normal amount", it will enter the hospital prescription review, and it will not be able to open more than "one-day limit".
At present, the difficulty in the regulation of antibacterial drugs in China is mainly in the pharmacy and aquaculture industry. Liang Zong'an believes that due to the national system and policies, antibacterial drug abuse is currently well controlled in hospitals, but there is still no effective supervision in pharmacies and aquaculture. In particular, many farmers are raising pigs, cattle and sheep. In the process of waiting for animals, in order not to make the animals sick, they will feed a large number of antibacterial drugs. This practice will bring huge health risks, cause many bacteria to develop drug resistance, and many clinical drugs will not work. "Because animals will also Antibiotics are resistant, so farmers need to continually invest in new antibiotics, and the amount of addition will increase. Liang Zongan said.
The reporter learned that in April this year, Shanghai Fudan University School of Public Health conducted urine tests on more than 1,000 children in Jiangsu, Zhejiang, Shanghai and other places. The results showed that nearly 60% of children had antibiotics in their urine.
At present, the common use of drugs by the people is a major cause of unsafe medication. "Yu Lei said that after many people have uncomfortable symptoms, they often do not go to regular hospitals to see a doctor, but they buy medicines themselves according to the symptoms, and they are themselves pharmacists. But each body is different, and the cause behind each symptom is different. Therefore, it is easy to use the wrong medicine. Yu Lei also said that many people blindly believe in Internet consultations and use drugs online after searching for drugs. This is also very unsafe because even the symptoms of a cold may be caused by different diseases. And there are a lot of rumors about medication on the Internet that you can't trust.
Many people think that non-prescription drugs do not require a doctor to prescribe, it is very safe, so you can go to the pharmacy to buy and eat at random, this is also a big misunderstanding. Yu Lei said that non-prescription drugs also need to be taken in accordance with the doctor's advice.
Experts suggest to play the policy "combination boxing"
Rational and safe medication is a long-term work that is of great concern and attention worldwide. Relevant experts and scholars believe that the rational use of drugs also needs to start from multiple levels and take a number of measures to comprehensively intervene.
Yu Lei suggested increasing publicity so that everyone can develop the habit of consulting pharmacists in their daily lives. The common people have the symptoms of the disease, can not be disposed of by their own medication, to go to the regular hospital to see the disease, identify the cause, according to the doctor's advice or the advice of the pharmacist.
At the same time, in the use of antibacterial drugs, antibacterial drug management is a multi-disciplinary, multi-sectoral system engineering. At present, China's control measures for large hospitals are strict, but there are corresponding policies in pharmacy sales channels and aquaculture. "Blank", it is recommended to put a policy "combination boxing" on the application management of antibacterial drugs in China.
Liang Zong'an suggested improving relevant policies and establishing a long-term mechanism for the management of antimicrobial drugs. On the one hand, it is necessary to train a group of young and middle-aged cadres with the ability to diagnose and treat bacterial and fungal infections to improve the diagnosis and treatment of infectious diseases and the use of antibiotics in China; on the other hand, it is necessary to strengthen the establishment of a comprehensive clinical monitoring system for antibacterial drugs in various medical institutions. Improve the support of antibacterial drug management including doctors, pharmacists, and laboratory departments, and monitor, analyze, evaluate and train the clinical application of antibacterial drugs.
The proper configuration of licensed pharmacists is also very important. According to the rigid requirements of the new GSP, pharmacies should be equipped with licensed pharmacists in accordance with relevant state regulations, responsible for prescription review and guiding rational use of drugs. This is a huge test for ordinary pharmacies.
As of July 31 this year, there were 206,899 registered pharmacists nationwide. However, for nearly 440,000 retail pharmacies nationwide, the rate of licensed pharmacists was only 38.6%. According to statistics from the Chengdu Food and Drug Administration, less than 10% of pharmacies in Chengdu are licensed pharmacists, and less than 6% of pharmacies in Sichuan have licensed pharmacists. The lack of full-time licensed pharmacists has also led to many misunderstandings. In this regard, Yu Lei suggested that the state needs to further increase the standardized training and management of licensed pharmacists. (Source: Economic Information Daily)