Physicians investigated on antibiotic network recipes

This summer, I ordered antibiotics online against gonorrhea at different sites. Not because I needed the drug, but for journalists to know how network commerce works.

Gonorrhea is classified as a common disease. A doctor who suspects that a patient is infected should report the case to the infectious health professional of his county council. In addition, the doctor is obliged to take samples quickly and to ensure that infection monitoring is started. The goal is to find the source of the infection and stop the spread.

The doctor's online site appeared follow completely different routines. It is managed by a company from West India, Curacao, belonging to the Netherlands. My order started with a questionnaire in Swedish: "Why and for which diagnosis do you ask for the above-mentioned medicine?" I wrote that I was suffering from gonorrhea. Next question: "Was this diagnosis made by a doctor, and did the doctor prescribe the above medicine?" The form continued with general health problems.

A few days later, the drug arrived by mail. The attached prescription of 1,000 milligrams of azithromycin was signed by a doctor with a Swedish medical certificate and used in a hospital in Östergötland. He wrote the drug without testing, without contagion and without asking any questions. The drug costs 485 SEK – but would have been free as part of the usual care. One reason to pay for the drug may be to avoid contraception and answer questions about sexual contact.

"We are very serious about this," says Britt Åkerlind, infectious physician from the Östergötland region.

According to European directives Gonorrhea should be treated with two different antibiotics. But I only have one. In addition, the dose was only half that recommended. For the patient, these aberrations mean that the treatment may fail. At the same time, the risk of bacteria becoming resistant and contaminating others increases.

The Gonorrhea Medication Order was included in an analysis of the journal Research & Progress, which I temporarily left vacant at DN. Now, the review has prompted the authorities to respond.

Britt Åkerlind and his employees of the County Council of Östergötland – where the doctor who drafted the order – analyzed the case and decided to proceed with a notification to the inspectorate of the health and care (Ivo).

The authority has never Previously examined a doctor who was printing antibiotics via a network, according to Anders Bergmark, Ivos coordinator for eHealth services. The phenomenon is relatively new and many online health services abroad for Swedish patients use foreign doctors, with the exception of the Swedish authorities, unless they violate the laws. about drugs.

"But if you have Swedish references, then we are under our supervision," says Anders Bergmark.

Ivo has now decided to initiate such a check at the doctor who wrote the anti-gonorrhea antibiotics. The case is interesting, says Stephan Stenmark, a contraceptive doctor in Västerbotten and president of Strama, an organization fighting for the misuse of antibiotics.

– That was right for patient safety, traceability of infectious diseases and infections. And you have not taken into account the risks of antibiotic resistance. It's noisy. We can only salute the Ivo review and raise the issue, "says Stephan Stenmark.

Ivo can not give anything Notify when the investigation is complete. One possible result is that the doctor faces the board of health. It is a court proceeding that can limit the doctor's right to print prescription drugs or withdraw his identity.

DN sought the current doctor. He puts the handset without answering any questions.