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The Chinese government's antibiotics crackdown

It has become harder for the Chinese to self-medicate.


China's Ministry of Health banned over-the-counter sales of antibiotics in 2004 and imposed price limits on hundreds of prescription drugs to reduce the incentive for hospitals to over-prescribe. After state-run media reported in January 2009 that misuse of antibiotics kills 80,000 people in China a year due to adverse reactions, the ministry launched a program to train 40,000 Chinese medical staff in the proper use of antibiotics.

With public fear about the spread of the swine flu virus at a high this winter, patients are eager to stamp out any flu-related symptoms. But antibiotics have become a prickly subject with doctors and pharmacists. In early December the central government issued a revised edition of the national Medication Catalog, including for the first time guidance for physicians on the use of antibiotics. Of the 2,151 drugs in the catalog, 843 are restricted, up by 12 percent from the 2004 edition.

In the new Medication Catalog, antibiotics are sorted into specific categories, such as those that can only be used after all other antibiotics are proven ineffective, those requiring a bacterial culture analysis, or the supervision of a managerial level doctor, and so on, “to prevent their abuse,” Yao Hong, chief of the Medical Insurance Bureau of the Ministry of Human Resources and Social Security, told the People’s Daily newspaper.

One physician at Shanghai’s Minhang District Hospital said that he could not discuss the subject without permission from the Ministry of Health.

These sweeping regulations are difficult to enforce in a nation where gentamicin sulfate, a cheap but potent antibiotic for treating stomach bacteria, is dispensed as freely as antacids in local pharmacies. Its use is limited in Western countries due to a potentially devastating side effect that damages the inner ear.

A businessman named Chen said his wife went out and bought cephalosporin “just in case” at a small local pharmacy after spending some time cajoling the pharmacist.

“If you have the guanxi (good connections), then you can still get them,” he said.