We are pleased to see the increasing awareness of antibiotic resistance and applaud the study by the Singapore General Hospital on not using antibiotics to treat non-bacterial infection (Stopping antibiotics early may help patients: SGH, Nov 27).

Antibiotics work on bacteria by stopping their growth or killing them. They do not work on infections caused by viruses.

The basic principles of appropriate antibiotic use include not using antibiotics for non-bacterial infections and using the right antibiotics for the target bacteria for an appropriate duration.

This reduces overuse of antibiotics that can accelerate the development of resistance against the effects of antibiotics.

Antibiotic resistance makes infections harder to treat and requires the use of more potent and costly antibiotics, sometimes with more side effects. In some cases, we may run out of antibiotic options.

As the world becomes better connected through travel, trade and commerce, antibiotic resistance can spread quickly. Globally, antibiotic resistance is increasing and Singapore has not been spared.

A comprehensive programme to reduce the development of antibiotic resistance employs multiple strategies to achieve this, including educating and raising awareness among prescribers, surveillance to monitor the trends of antibiotic resistance and antibiotic use, and providing antibiotic recommendations to medical teams.

One of the ongoing initiatives Singapore has taken was the setting up of antimicrobial stewardship programmes (ASP) in all public hospitals in 2011.

An ASP promotes appropriate antibiotic use with the aim of improving patient outcomes while reducing the risk of bacteria developing resistance.

Studies have shown that antimicrobial stewardship is safe, effective and improves patient outcomes while reducing the use of antibiotics and healthcare costs.

The typical ASP team, consisting of infectious diseases physicians and pharmacists, reviews patients systematically, taking into account clinical history, physical findings and diagnostic test results. Advice on appropriate antibiotic use is given to medical teams to stop, or adjust antibiotic choice, dose or duration.

The fight against antibiotic resistance is not restricted to hospitals or prescribers. Public awareness of sound antibiotic use, such as not using antibiotics for viral infections and adhering to recommended duration of antibiotic treatment, plays a part in reducing the risk of antibiotic resistance.

Dr Lee Tau Hong

Head

Antimicrobial Resistance

Coordinating Office

National Centre for Infectious Diseases