I refer to the letter by Heal Thyself on the prescription practices of doctors in Malaysia.

The scenarios that were described are biased and certainly do not reflect the true nature of doctors in Malaysia. In the event that such unscrupulous doctors exist, then some bad apples should certainly not spoil the entire basket.

Even in the Western world, the resistance of bacteria is an increasing problem. The blame has often been put on general practitioners who remain the front line in the treatment of bacterial infections.

The common cold is, on most occasions. due to viruses and there is little need for antibiotics. However, in certain circumstances there is a concurrent bacterial infection that may need antibiotic coverage. The usage of antibiotics is also based on best guess.

This means that doctors often use antibiotics based on the common organisms for certain infections. If the infection does not resolve, then a more thorough test on the type of organism and its sensitivities needs to be done.

Even in hospitals, both here and in the Western hemisphere, wide usage of antibiotics are common. This has also led to increasing resistance patterns of bacteria.

In terms of resistance patterns of bacteria, the situation in Malaysia does not differ much from that in the western world. Therefore, to put the blame on unscrupulous prescriptions by our doctors is ill researched and unjustified.

On many occasions, patients bear some responsibility towards this worsening of resistance problem. Many fail to complete the course of antibiotics prescribed despite being reminded to do so. Many also practice 'doctor-hopping' when their infections do not subside.

This practice is common worldwide and should be discouraged. This will only compound the problem when antibiotics is repeatedly prescribed unnecessarily.

Different doctors have different assessment techniques. Their approach to problems also differ. For example, the swelling in Heal Thyself's daughter's eye. If indeed it was an infection around the eyes and beyond, then the worry of it spreading to the meninges and then the brain is justified as these structures are very closely related.

Waiting for it to subside could be dangerous and life threatening to his/her daughter. She was fortunate that the swelling subsided spontaneously.

Having aversions to antibiotics can on occasions be detrimental. The conservative nature of the second doctor could have been more dangerous without a proper referral to an opthalmologist, as treatment delays can cause complications.

Lastly, threatening legal action is the last thing Malaysia needs. This will drive up escalating healthcare costs and would only force doctors into practising defensive medicine. This involves making, on many occasions, unnecessary tests as is happening in the western world.

Obviously, Heal Thyself has not fully experienced both the local and 'western' situations long enough. Look closer. There are more similarities than you think.