Having a Runny Nose? Avoid Antibiotics, or We Could Pay a Deadly Price

With the rise of superbugs, the impact of drug resistance is becoming more serious. One woman tells Talking Point how it left her blind and "like a child". Read more at

It started with a fever. To fight off the infection, Madam Siti Hajar had to rely on antibiotics, as her immune system was weak owing to her diabetes.

But even when she returned to work, she did not feel any better. In fact, her vision began to be affected. So the next day, she went to Changi General Hospital’s accident and emergency department.

“I only remember going to hospital and then registering and seeing the nurse, and from there, I can’t remember anything else,” she told the Mediacorp programme Talking Point. (Watch the episode here.)

After admission, she was diagnosed with a strain of klebsiella pneumoniae that was resistant to multiple antibiotics. That bacterial infection in 2016 left her blind and in embattled health as it spread to her other organs.

Since their discovery, antibiotics have been wonder drugs for millions of patients in the fight against diseases. But they could not help Mdm Siti, 45, who is now living with the effects of a superbug infection.

Like her, one in nine hospital patients here have now been infected by superbugs, bacteria that have become invulnerable to antibiotics over years of exposure.

Worldwide, overuse of antibiotics has led to the rise of antimicrobial resistance. And in Singapore, the problem is compounded by a lack of knowledge of how these drugs work.

Research done by public health experts has found that 78 per cent of Singaporean patients think antibiotics cure infections like common colds and sore throats.

And 66 per cent also believe that antibiotics help these upper respiratory tract infections, which are commonly caused by viruses, to heal faster.

That is why a third of patients expect to be prescribed these drugs - which work only against bacteria, not viruses - when they visit their general practitioners. And if these are not given, some patients would visit another doctor.

Family physician Kelvin Goh from the Northeast Medical Group has faced such pressure from patients, some of whom may insist on antibiotics owing to a “bad experience”.

“They may have seen a doctor for a viral infection. They were told (they) didn’t need antibiotics and subsequently developed a bacterial infection that necessitated either hospital or specialist care,” he explained.

The way to distinguish between bacterial and viral infections, he said, is through a good clinical history and good physical examination, supplemented by blood tests and other culture infection tests.

A minority of infections are caused by bacteria, noted Assistant Professor Mark Chen from the National University of Singapore’s Saw Swee Hock School of Public Health, and “some doctors may prescribe antibiotics because they’re worried about missing these respiratory infections”.

But doctors should be more willing to take swabs and do simple tests instead, highlighted Dr Goh.

“We need to educate both the professionals and the public. The doctors must gain the patients’ trust,” he added. “(Only then would) the patient take the advice of the doctor that … no antibiotic is needed.”

If all else has failed, Dr Goh has given these drugs to patients who asked for them, “but we’ll tell them clearly that (they have) a viral infection”.

There are patients, he said, who obtain antibiotics online or from overseas if they cannot get them from any one of the 2,600 GPs here.

While such behaviour is not common, Talking Point did find a number of websites claiming to be online pharmacies – operating outside Singapore – that sold these drugs, allowing patients to get them without prescription.

Though antibiotics cannot be bought over the counter here, patients could still buy them on established platforms like eBay and Carousell, and have them delivered to their home.

But the consequences of misusing and developing a resistance to these drugs can be “very worrisome”.

For one thing, the discovery of new antibiotics has slowed in the past few years because the endeavour “is no longer profitable”, said Dr Andrea Kwa, a clinician scientist and specialist pharmacist (infectious diseases) at the Singapore General Hospital.

Resistance to the new drugs occurs within two to three years now, which is “way shorter than their patent period”, she explained.

“Simple procedures like hip replacement, appendectomy (and) emergency caesarean may get more and more difficult to perform, because the infections that could come about as a complication can be more resistant,” she added.

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Associate Professor Hsu Li Yang, who leads the Saw Swee Hock School of Public Health’s Antimicrobial Resistance Programme, said:

We’re concerned that … people with the simplest types of infections, like (from) a prick on a rose thorn or cuts, can die.

To prevent the build-up of bacterial resistance, the development of new drugs must be accelerated or the improper use of antibiotics must be reduced, he said, citing the example of patients with viral infections.

“We can also increase vaccination, even (against) conditions like influenza,” he added. “If patients do not present (themselves) at the doctor’s with coughs and colds, then the doctors won’t prescribe antibiotics, so … we also reduce the antibiotic pressure overall.”

To help stop the rise of superbugs in hospital, Dr Kwa has a team monitoring antibiotic use and also developing counter-strategies, such as by designing tests of antibiotic combinations if an individual drug is not useful.

As new cases start to reveal the effects superbugs can have, the war against them is likely to intensify.

Mdm Siti is already one of the casualties. “This bacterium (klebsiella pneumonia) has affected my whole life,” she said. “Now I’m like a child, a toddler learning to how to walk … how to carry on with life.”

Watch this episode of Talking Point here. New episodes air on Mediacorp Channel 5 every Thursday, 9.30pm.

The profiteers of vaccines don’t like to be questioned.
I hope more people will get behind this idea by Sen. Mike Folmer of Pennsylvania
“Informed Consent
Posted on Jan 03, 2018
The ability to make decisions about what goes into our bodies is a basic human right. This personal autonomy is challenged whenever government requires mandatory vaccinations. Indeed, sticking needles into a human body is the very definition of intrusive.

For this reason, I am introducing “Informed Consent” legislation to require patients and parents be given information before they consent to vaccinations. Consistent with my successful medical cannabis initiative, I believe all medical decisions should be between a patient and their physician – including the right to informed consent or informed refusal in the use of vaccines.

I am also introducing a Resolution calling upon Congress to repeal the 1986 National Childhood Vaccine Injury Act. This federal law prevents those harmed by a vaccine from suing pharmaceutical companies making these products. I believe this Act violates patient’s rights by limiting options to refuse vaccinations or seek due process of law as guaranteed by the 5th Amendment to the US Constitution.

My goal is to ensure people are first given an explanation of the potential benefits and the potential risks whenever a vaccine is administered. Only then are people able to exercise their basic human right to decide whether or not to allow intrusion into their bodies.

Informed Consent is already required for a number of medical treatments and procedures: surgery, chemotherapy, radiation, and blood transfusions. My legislation would extend patients’ rights to Informed Consent to vaccinations by requiring them to be informed of the potential risks and benefits of the vaccinations they are being given. More importantly, my legislation will require patients be given this information prior to their consenting to receive a vaccination.

I believe Informed Consent should, at a minimum, mean the person from whom consent is being sought be given the opportunity to understand what they are being given, what the risks and benefits are, and other potential consequences of the procedure they are facing.

Physicians and researchers are divided on the impacts of vaccines on children – especially the relationship of vaccines to autism – plus a number of other conditions and medical circumstances where vaccination may not be considered safe.

From the 1940’s when the first autism cases were diagnosed to the 1980’s when the vaccine schedule was expanded, the rate of autism remained relatively stable. In the early 1990’s, parents and physicians witnessed an alarming rise, which some call an epidemic, in autism rates. In one decade, the rate of autism increased 500%: from one in 2,500 to one in 500.

A reanalysis of a 2004 CDC study showed a higher connection between incidences of autism for children receiving the MMR (measles, mumps, and rubella) vaccine prior to 36 months of age. In 2008, the National Vaccine Injury Compensation Program awarded a family roughly $1.5 Million for a vaccine’s role in an autism-related diagnosis.

Until these issues are further researched and/or a Vaccine Safety Commission is established, I believe no patient or parent should be required to submit to a vaccination without Informed Consent.

I hope my colleagues in the Senate and House will agree: Informed Consent is a basic human right of consenting or refusing a medical treatment or procedure – including vaccinations.”

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