High prices for common drugs in HDB heartland

I read this blog and its comments on "High prices for common drugs in HDB heartland"

Mr Wang Bakes Good Karma blog

I posted a reply but it does not show up on the blog so I decided to put it here.

Here's some information for all people out there wondering how doctors can "decide" whether or not you need antibiotics in a typical flu or cold.

Actually there is a way to assess patients to help decide if they need antibiotics. We all learnt it in med school. Yet it is not widely practised. Read on to find out more and why.

Here's how :

Patient comes in with upper respiratory tract symptoms. Doctor suspects it might be bacterial in nature based on clinical symptoms and signs. Do note however that majority of common flu, colds, sore throats and bronchitis are caused by viruses.

Check out what the US CDC Campaigns are like.

What's the cause of your flu, cold, sore throat, bronchitis?

Get smart about antibiotics

Anyway the doctor explains to the patient the possibilities and advises that they perform a "Throat Swab culture and sensitivity" or a "Sputum culture and sensitivity".

This involves swabbing the back of the throat with a sterile cotton swab near the tonsils. The swab is placed in a tube of culture medium. The culture is a laboratory test done to isolate and identify organisms that may cause infection in the throat. What happens is that the test is sent off and the patient gets symptomatic treatment.

The lab will grow the organisms in the culture and identify them. They will also place antibiotics chips into the agar and see which antibiotics kills the bacteria (you can see a zone of clearing around the antibiotic chip). The doctor then gets a report that details the type of bacteria found, and which antibiotic kills it. (Remember there is antibiotics resistance abound these days).

The doctor then gives the patient a call and asks if he/she is better. If not better come back to get the appropriate antibiotic that kills the identified bacteria in her system that is causing the infection.

Information on throat swabs

This way we choose the appropriate antibiotic and know it is necessary. It might be Klacid, it might be something as cheap and simple as Penicillin!

Now for my patients who want to know more about whether they need antibiotics, this is what I tell them. The problem is this. The Labs charge $43.50 for the Throat Swab Culture. This is the COST PRICE to me the doctor. I tell patients this is the cost price which is what they will pay. I won't earn a cent from doing the test. You still want to do the test?

Most responses would be "What? $43.50 to do a test to decide if I need to take antibiotics that cost at the most $30? I think no need lah. You decide doctor. Want to give antibiotics you give. If don't need then don't need."

So I will tell them most flu and colds are viral in nature and antibiotics don't work. And I give them a print out of

Get smart campaign by US CDC

and

Chart of bacterial vs viral infections

for further reference.

But I do tell them that if they don't get better after a 3-4 days or get worse, please come back and consult me because yes sometimes it is a bacterial infection that needs antibiotics.

Communication is the key lah!