Thailand’s antibiotic resistance spreads through food, water and the environment
Easy access to antibiotics in Thailand is driving resistant bacteria to circulate through food, water and the environment. Experts warn that resistance rates for many medicines are high to extremely high, reaching 83% for some antibiotics, reducing treatment effectiveness and contributing to an estimated 38,000 deaths each year.
Chulalongkorn University, in collaboration with the Working Group on Promoting Rational Drug Use (RDU) and private-sector partners, held an academic forum under the campaign “Drug Resistance Can Be Stopped” on Friday (21 November). The event, themed “Stop Resistance, Stop Challenging the System: Building a New Public Perspective on Drug Use in Thailand”, aimed to address the country’s worsening antibiotic-resistance crisis.
Asst Prof Dr Pison Chongtrakool, Chair of the RDU working group, said Thailand has faced a severe and prolonged antimicrobial-resistance (AMR) problem for more than a decade, driven largely by the excessive use of antibiotics among both the public and healthcare workers. Misuse, such as self-diagnosis, purchasing antibiotics without understanding their necessity, and confusing them with other medicines, has compounded the issue.
Easy access to strong antibiotics in pharmacies, grocery shops, local markets and online platforms continues to accelerate resistance, he noted. “Nearly all antibiotics in Thailand show high to extremely high resistance rates—some as high as 83%, such as amoxicillin—meaning the medicines we have are no longer fully effective.”
38,000 deaths a year linked to drug-resistant infections
The rapid rise in resistance has made once-routine infections harder and costlier to treat. Cases involving drug-resistant bacteria require significantly more expensive medicines and longer hospital stays, pushing Thailand’s direct and indirect healthcare burden to an estimated 40 billion baht annually.
The impact is grave: around 88,000 people in Thailand are infected with drug-resistant bacteria each year, and an estimated 38,000 die as a result. Hospitals face mounting pressure from bed shortages and prolonged treatment times, Dr Pison said.
He emphasised that solving the crisis requires a dual approach, strengthening public awareness and improving antibiotic stewardship among medical professionals. This includes strict adherence to antimicrobial stewardship (AMS) protocols in hospitals and pharmacies, ensuring antibiotics are prescribed only when truly necessary.
Antibiotic residues circulating in food and water fuelling AMR crisis, expert warns
Asst Prof Dr Kitiyot Yotsombat, Assistant Dean at the Faculty of Pharmaceutical Sciences, Chulalongkorn University, said antimicrobial resistance (AMR) has become one of the most critical global and national health threats, affecting everyone, not only patients needing antibiotic treatment. The problem, he said, stems from irrational antibiotic use across humans, animals, the environment and the food system.
This aligns with the One Health approach, which stresses that controlling AMR requires an integrated, cross-sector effort. Antibiotics, he noted, now permeate “almost every dimension of daily life”, while Thailand still faces easy access to antibiotics, widespread misconceptions among the public and overuse in hospitals and livestock farming. This continued misuse has resulted in antibiotic-resistant bacteria circulating in food, water and the wider environment.
Dr Kitiyot emphasised that public communication must go beyond simply providing information. Effective communication requires an understanding of social structures and human behaviour. While messages must be grounded in scientific evidence, they should be easy to understand, relatable and able to drive real behavioural change. The goal, he said, is to make the avoidance of unnecessary antibiotics a widely recognised sign of being informed, rational and socially responsible.
Public misconceptions driving resistance
Common misunderstandings remain widespread, such as the belief that antibiotics are needed for diarrhoea, or that a sore throat requires pharmacies to dispense “strong drugs”. Many hospitals also continue to prescribe antibiotics unnecessarily, partly due to heavy workloads and partly due to patient expectations for “quick-fix” medicines.
This situation highlights the need to build a genuine Health Literacy Movement and strong Rational Drug Use Literacy. Public knowledge must go beyond memorising terms: people should learn to ask the right questions—whether a medicine is necessary, whether alternatives exist, and how to use it safely.
Equally important is teaching people to assess their own symptoms, recognise which illnesses do not require antibiotics and understand what to expect from the healthcare system. This, Dr Kitiyot said, is the essence of public “empowerment”, enabling individuals not just to receive information passively but to make informed, responsible health decisions.
Experts outline communication strategies to raise public awareness on antibiotic resistance
Asst Prof Dr Teerada Chongkolrattanaporn, Head of the Department of Public Relations at Chulalongkorn University’s Faculty of Communication Arts, said effective communication is essential to helping the public understand that AMR is not a distant threat but an immediate, everyday risk. However, major gaps and challenges remain.
Thai society, she explained, is currently caught between two powerful forces: a heightened awareness of personal health following the COVID-19 pandemic, and a surge of unverified, emotionally driven health content circulating online. As a result, accurate medical information is often overshadowed by misunderstandings, sensational stories and non-scientific advice—making the effort to combat AMR even more difficult.
Communication strategies, she stressed, must therefore address both dimensions simultaneously: enabling the public to understand their risks without creating unnecessary fear. This requires trustworthy messaging that makes AMR visible, relevant and easy for people to grasp.
In today’s environment, effective communication must “create conversations, not lectures”. Providing open spaces for people to ask questions, learn and exchange views on equal footing is key. Using clear, non-judgemental language that does not shame the audience will help ensure that messages on responsible antibiotic use are more widely received and retained.
Agencies urged to manage the health-information ecosystem
Napat Kanchanachai, Managing Director of JC&CO Communications, said that in an age where health information flows uncontrollably online, developing strong Health Media Literacy, the ability to question information before believing it, is a crucial public skill. It enables people to distinguish verified facts from misconceptions or content designed to provoke fear.
He emphasised that the role of PR professionals and communication agencies must evolve. They must go beyond content creation and become “guardians of the information ecosystem”, delivering messages that are scientifically vetted and fostering accurate public understanding. This ensures that people make health decisions based on evidence rather than emotion.
“When the public has strong information immunity, and all sectors, from government and academia to media and content creators, work together to raise the standard of health communication, AMR will no longer feel like a distant issue. It will become a crisis that Thai society can confront and mitigate in the long term,” he said.
The “Drug Resistance Can Be Stopped” campaign is open to the public. Those interested can follow updates and educational materials via the Facebook page กินยาสมเหตุ หายโรคสมผล ทุกคนสมใจ (Pill Properly):
