Meet The Infectious Disease Specialists™ – Seminar On Antibiotic Use & Misuse

Saturday, 13th May 2017, 2 to 5pm

Dr Wong Sin Yew, chairperson, welcomed the 205 family physicians/ medical specialists and 24 Nurses/healthcare professionals at the Regent Hotel for the seminar

As A/Prof Hsu was overseas, Dr Wong delivered the lecture entitled “Antimicrobial Resistance in Singapore and the Region: Is It Too Late?” Dr Wong highlighted the following;

  • WHO has listed antimicrobial resistance as a global security threat
  • Antibiotic use is one of the main drivers of antimicrobial resistance
  • Antibiotic use in Singapore hospitals is higher than most developed countries
  • MDR and XDR organisms are detected frequently in our restructured hospitals
  • Restructured hospitals receive funding for their antibiotic stewardship programmes and have been working on reducing antibiotic use in the hospital setting
  • We also need to work on “appropriate antibiotic use” in the outpatient setting
  • Everyone (including the public) have a role in reducing antimicrobial resistance

Dr Chan Si Min, Consultant and Head, Division of Paediatric Infectious Diseases, NUH, discussed on the use of antibiotics in paediatrics. Prescribing or withholding antibiotics is a challenging, complicated and controversial topic. She then went through some case studies whilst discussing the following:

  • Antibiotic prescribing in children- reasons, myths, unwanted effects
  • Common infections: Respiratory, Gastrointestinal, Urinary tract
  • The young febrile child- is it a serious bacterial infection? To identify a febrile infant at risk of serious bacterial infection, she emphasized using a combination of clinical judgment, clinical pathways and “scoring systems”, clinical and laboratory indices, immunisation status and other risk factors to guide antibiotic use

Dr Lam Mun San discussed the following areas in her talk on the Hidden Dangers of Antibiotic Use:

  • The various adverse outcomes associated with antibiotic use
  • Antibiotic associated diarrhoea including pseudomembranous colitis
  • Severe cutaneous adverse reactions including SJS/TEN
  • Other adverse effects including tendinitis/tendon rupture associated with quinolone use
  • Management of complications

Our second guest speaker, A/Prof Bernard Thong, Senior Consultant and previous Head, Department of Rheumatology, Allergy and Immunology, TTSH gave an interesting lecture entitled “Systematic Approach To Antibiotic Allergy”. He emphasized the following:

  • Diagnosis of antibiotic allergy obeys the usual “rules” in drug allergy
  • Pattern recognition is important
  • Cross-reacting antibiotics
  • Accurate characterization of the drug reaction and accurate labelling during the index reaction

The final topic, Appropriate Antibiotic Use In Adults: Case Study Approach was presented by Dr Wong. He presented 3 cases and concluded that:

  • Antimicrobial resistance in the community setting is important as most of the antibiotic use occurs in the outpatient setting
  • For urinary tract infections: he discussed on ciprofloxacin resistant E coli; ESBL producing Enterobacteriaceae
  • For skin and soft tissue infections: he gave examples of macrolide resistant Streptococci; CA-MRSA etc
  • For respiratory tract infections: macrolide resistant pneumococci and macrolide resistant Mycoplasma were discussed

We wish to thank our guest speakers, Dr Chan and A/Prof Thong for spending their valuable Saturday afternoon to be speaking in this seminar. We are also wish to thank all the 200 plus family physicians and other healthcare professionals who attended our seminar.

We are also grateful to MSD for sponsoring this seminar.

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