Dr Wirat Tongrod (Thailand)

Thailand is a country of over 60 million people where antibiotic use accounts for approximately 20% of total drug use and antibiotic usage continues to increase each year. Dr Tongrod explained this is because antibiotics continue to be freely available for purchase at the pharmacy without a prescription. Recent publications have further emphasized AMR as a major and urgent health problem in Thailand both in terms of patient mortality and cost to the healthcare system.

In 2008, the Thai FDA initiated the Antibiotic Smart Use (ASU) program with support from the WHO. This programme focused on three common ailments; sore throat, acute diarrhoea and simple wounds, and provided tools to educate both prescribers and patients. After two years, hospitals had reduced antibiotic use by almost 30%. This program has been publically endorsed by the Prime Minister of Thailand who is visible on poster campaigns with the quote, “I don’t want to see Thai people ill and dying from irrational drug use”.

The National Action Plan to combat AMR runs from 2017 to 2021 and details six key strategies to achieve a distinct set of goals:

50% reduction in AMR morbidity
20% reduction in antimicrobial consumption in humans
20% increase in public awareness on AMR, and antimicrobial use
30% reduction of antimicrobial use in animals

Antibiotic use in Thailand accounts for about 20% of all
the drugs in Thailand. Their use is also increasing and if you ever go to Thailand you can buy antibiotics from the pharmacy without a prescription

Dr Wirat Tongrod

In Thailand, most pharmacies will provide a mirror and flashlight to enable patients to examine their sore throat themselves. This
provides the pharmacist with an opportunity to explain that there is no need to use antibiotics for viral infections. Whilst working for the Faculty of Pharmaceutical Sciences at Huachiew
Chalermprakiat University (HCU), Dr Tongrod developed the HCU Sore Throat application. This is a self-diagnosis tool that enables the patient to take a photo of their sore throat, assess a
symptom checklist that uses the McIsaac sore and read a leaflet providing advice on whether they need an antibiotic. This tool won several awards including from the Ministry of Public Health. Based on this success, Dr Tongrod has developed a second version of this application that includes a video about self diagnosis for sore throat and provides information on symptomatic relief.

With regards to future plans, the action plan for ASU includes the development of guidelines for pharmacy, development of a self-screening card, and the launch an education programme
together with the Pharmaceutical Association of Thailand. Dr Tongrod concluded by confirming that they will continue to develop the HCU Sore Throat Application for use by patients to help differentiate between viral and bacterial infections to avoid the inappropriate use antibiotics.