Irrational use of antibiotics or overweight in children appears to be increasing more and more mengkawatirkan. The use of excessive or irrational use means the use of incorrect, inaccurate and not in accordance with the indication of illness. Actually this problem also faced by the first developed country like the United States.
According to the research of U.S. National Ambulatory Medical Care Survey in 1989, each year about 84% each year, each child get antibiotics. Other results obtained 47.9% prescriptions in children aged 0-4 years, there are antibiotics. This figure is according to the calculation of many experts is actually quite worrisome. In the same year, also found that bacteria resistance is quite high because of the excessive use of antibiotics.
In Indonesia there are no official data on using this antibiotic. So that all parties currently do not. Based on the level of education and knowledge society and the fact that found daily, apparently using antibiotics in Indonesia far more worrisome and more.
Danger of irrational use of antibiotics On Children
Actual use of antibiotics in a correct and appropriate indication should be given. Although there is the danger of side effects and high cost. But a problem that mengkawatirkan, when penggunaannnya excessive. Many of the losses occurred when the antibiotic is not excessive manageable quickly and completely.
Losses are increasing resistance of bacteria. Not to the behavior of these have the potential to increase the cost of treatment. Price antibiotic drugs are very expensive and is the largest part of the cost of treatment.
Side effects that often occur in the use of antibiotics is some interference organs. Moreover, when given to infants and children, because the body system and organ function in infants and children are still not perfect grow. Moreover, children at risk receive antibiotics most often, because more often sick due to resistance body more vulnerable. When in the year to 9 times the child is sick, then 9 times 7 days or 64 days children get antibiotics.
Disorders of body organs that can happen is dissolved channel interference, interference kidney, liver disfunction, interference marrow bone, blood interference and so forth. The other is due to allergic reactions because the drugs. Interference from the light, such as rash, itching to weight, such as swelling of lips or eyelid, crowded, to be life-threatening reactions or anafilaksis.
Excessive use of antibiotics or irrational can also kill bacteria that good and useful that we are in the body. So where are all the better by the bacteria will be filled by bacteria or by malicious or Namur called "superinfection". Giving antibiotics will cause excessive bacteria are not killed any mutation and become a resisten or germs called "superbugs".
So the type of bacteria that initially can be treated easily with antibiotics that light, when used with antibiotikanya irrational, then the bacteria mutation and become immune, so the need of a strong antibiotic. When these bacteria spread to the surrounding environment will be created when a condition where there is no longer the type of antibiotic that can kill bacteria that continuously bermutasi this. This will make a return to the days before antibiotics were found. At the time of the infection caused by bacteria that can not be treated so that the death rate will shoot up dramatically. Another thing that may happen later on the needs of next generation antibiotic with more weight, and makes the cost of treatment increased because more expensive.
Indications antibiotic use
Indications that the correct and appropriate use of antibiotics in children is when the cause is a bacterial infection. According to the CDC (Centers for Disease Control and Prevention) indication of when the antibiotic is cold and cough for more sustainable 10 14 hari.yang occur throughout the day (not only in the evening and morning).
Cough night and morning is usually associated with allergic or no longer in the phase of infection and do not need antibiotics when there are indications other symptoms of acute infection Sinusitis such as the heavy summer> 39 C with liquid purulen nose, pain, swelling around the eye and
face. Antibiotic treatment first choice for this case by simply giving Amoxicillin, Clavulanate or Amoxicillinm. When the 2 - 3 days afterwards treatment can continue for 7 days after the complaint or resolve usually for 10 - 14 days.
When you cough and runny nose and sustainable occur only in the evening and morning (not during the day) is usually associated with allergic or no longer in the phase of infection and do not need antibiotics when there are indications other symptoms of acute infection Sinusitis such as the heavy summer> 39 C with purulen liquids nose, pain, swelling around the eyes and face. Antibiotic treatment first choice for this case by simply giving Amoxicillin, Clavulanate or Amoxicillinm.
When the 2 - 3 days afterwards treatment can continue for 7 days after the complaint or resolve usually for 10 - 14 days. Another indication is a sore throat because of infection with bacteria streptokokus.
The disease usually attacks children in the age of 7 years or more. In children 4 years of age, only 15% of that sore throat because of this bacteria. When you cough and cold relief throughout the day (not only the night and morning) more than 10-14 days with nasal fluids mukopurulen (yellow or green). To find out whether there is a bacterial infection usually do with the culture that requires several days for observation. When the suspected urine infection, carried out sample checks in the urine and then do the examination culture in the hospital. After several days will be discovered when a bacterial infection following type and sensitivity to the type of medicine.
Other diseases that should get antibiotics is a urine infection and disease Typhoid To find out whether there is a bacterial infection usually do with the culture of blood or urine. When the suspected urine infection, carried out inspections kulut curine. After several days will be known when a bacterial infection following types and sensitivity to antibiotics. Typhoid disease to know must be done Widal blood and blood culture GAL.
Children aged under 5 years of infection with the virus have often experienced overdiagnosis Typhoid disease. Frequent errors in reading the results of the perception laboratory. Infection with the virus increased sedkit examination scores have been sentenced widal symptoms of Typhoid and dihantam with antibiotics.
Most cases of the disease infection in the children's cause is a virus. In other words, should the possibility of the use of antibiotics that is not big or may be only around 10 - 15% of people with children. The disease is a viral disease that includes "self-limiting disease or disease that cured itself within 5 - 7 days.
Most of the diarrhea disease infection, cough, runny nose and fever virus is the cause. In general, every child will have 2 to 9 times the channel napas disease because the virus. Should not too easily diagnose (overdiagnosis) Sinusitis in children. If not, there are other complications naturally runny nose, cough and nasal fluid expenditures will be settle the long until 14 days after other symptoms improve.
A study of 139 children's symptoms in people with a cold (flu) virus because it was found that giving antibiotics in the control group did not improve mucopurulent fluid from the nose. Antibiotics are not effective channel napas treat infection and not on preventing infections hospitality. Most of the infections, including on Channel napas sine paranasalis very jarana complications occur once the bacteria.
Who Responsible
Problems in the excessive use of antibiotics, the party which is responsible to fix them. This problem is not as simple as that we see. Many of the parties involved and the role in this excessive use of antibiotics. The parties involved from the people (parents people), doctors, hospitals, pharmacies, sales representative, pharmaceutical companies and drug factories.
When the excessive use of antibiotics due to factors more doctors, the parents as a recipient of services, doctors in a difficult position. But parents object as the patient has the right to obtain information accurately as he explained the plan-treatment, the purpose of treatment and side effects due to treatment if the parents need to discuss with the little methods're not for the opportunities may not be whether antibiótica.
On the other hand, parents also often a factor of the occurrence of excessive use of antibiotics. Public opinion is not correct to continue growing, if that does not use antibiotics, the disease will be long recovery Not infrequently use of antibiotics is a request from the parents. More mengkawatirkan currently some parents with no burden to buy their own antibiotics without consideration of the doctor. Antibiotic that is a limited class of drugs, medicines, which must be prescribed by a doctor. But it runyamnya antibiotic drugs are easily obtained at pharmacies or drug stores, although without a prescription.
The issue becomes more complicated because the trading business of the antibiotic. Factory drugs, pharmaceutical companies, medical and pharmacy sales Representative as the provider of drugs have many interests. Antibiotic is their main business, so many strategies and how to do. Doctors as a result of the use of these antibiotics, should be more wise and should consider more background to ilmiuannya. According oath that doctors had spoken, any consideration of treatment for the sake of all people are, keperntingan not the other. Increased knowledge and ability to regularly and continuously doctor also play an effective role in reducing the behavior of the excessive use of antibiotics this.
Department of Health (Ministry), Center for Food and Drug Control (BPOM), a doctor Association of Indonesia (IDI), Children's Doctor Association (IDAI), Hospital Association of Indonesia (PERSI) and some other related intitusi should cooperate in handling. Education about the dangers of antibiotic use and indication of the true community must continue to be done through various media that exist. Control antibiotic drug sales by pharmacies and more specific drug stores more should be done without stopping.
Medical professional organizations must continue working to evaluate and conduct more stringent monitoring of the behavior that excessive use of antibiotics against these members. If you need to periodically conducted research on the use of excessive antibitioka this. Should practice and campaign strategies antibiotic drugs that are not healthy should also be attention. Not even used for medical purposes, even if only for the sake of scientific activities. PERSI as a hospital organization, also authorized its members to provide supervision for the continued evaluation of the strict formularium drugs used.
In the United States, because of the efforts and education campaigns continuously against the doctor and it can reduce the use of antibiotics dramatically. The proportion of children aged 0 - 4 years old who get antibiotics menuirun from 47.9% 1996 to 38.1% in 2000. The average number of antibiotics are prescribed to decline, from 47.9 1.42 peresepan children per 1996 to 0.78 children per peresepan year 2000. Average spending can also stressed enough, padfa 1996 of U.S. $ 31.45 to $ 21:04 per child in 2000.
Recommendations and campaign outreach to parents and doctors that have been done by the cooperation of CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics) provides the correct understanding about the use of antibiotics. Runny nose, fever and cough are the symptoms of the infection that caused Respiration on the virus. Changes in the color of sputum and nasal mucus changed into the thick yellow, slimy and greenery is a journey of clinical infection on Channel Napas because viruses, not merupaklan indication of antibiotics. Giving antibiotics will not curtail travel and prevent the disease bacterial infection Hospitality
This should be a good example of intitusi the authorities in Indonesia in overcoming the problems of this antibiotic. See the complexity of the problem of antibiotic that irasinol in Indonesia seems to be very difficult. But we must be confident with willpower, the intention is sincere, and the involvement of all parties, the problems will be. Do not happen, we all new tersadar the problem is in a very serious situation.
