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Concern over antibiotic use in Finland

Two well-known doctors say that antibiotics are prescribed needlessly in Finland.

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The overuse of antibiotics can lead to resistant bacteria. Image: AOP

Antibiotics are prescribed too much and needlessly in Finland, say two doctors, but the increase in antibiotic resistance could bring about a change to this overuse.

Asko Järvinen, who heads the infectious diseases unit at Helsinki University Central Hospital, said there are many reasons for the overprescription, for example the outdated belief that a course of antibiotics must always be finished.

"It’s a myth. For a long time there has existed this belief that antibiotic resistance can be prevented by finishing the treatment course. In fact, this idea is not based on much of anything," Järvinen said.

Antibiotic resistance occurs when bacteria change in response to the use of the antibiotic and become resistant to it. However, scientists have come to understand that the human body has a great amount of good microbes that each dose of antibiotics kills too, Järvinen said.

According to him, doctors across the world have been taught for decades that patients must complete the course of antibiotics. "Now we are facing a huge shift in thinking," Järvinen said.

"This topic has been covered somewhat in medical journals. It is not just my idea."

Two concrete proposals

Harri Saxén, chief physician at the Children's Hospital in Helsinki, echoes Järvinen's sentiment and says that most of the antibiotics courses in Finland are too long.

However there are also differences between countries in the use of antibiotics. For example in Finland doctors recommend a 5-day course to treat an ear infection, whereas in the US the guideline is 10 days.

"I doubt the outcome is very different," Saxén said.

He suggests that patients consult the doctor when they feel better to find out whether the dose could be reduced or the course of antibiotics suspended altogether.

As an alternative, Saxén proposes to change the law to allow pharmacists to open packages and measure the exact amount of medication needed. In this way, doctors could customise the prescriptions for each patient, regardless of the size of the packaging. At the moment, Finnish law does not allow this.

Finally, both Saxén and Järvinen say patients can always question the doctor about the treatment and ask for a rationale for prescribing antibiotics. "Not all physicians are going to like that," Saxén concedes.

However, the decision to stop a course of antibiotics should be made in consultation with a doctor.

The views by Järvinen were first reported in Apteekkari-lehti.

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