In a move to curb the misuse of antibiotics or antimicrobial drugs in India, the central government has made it mandatory for doctors to write ‘exact indications’ while prescribing these drugs.
Making an ‘urgent appeal’ in this regard, the Directorate General of Health Services (DGHS) – a wing under the Ministry of Health and Family Welfare – has written letters to all doctors of medical colleges, medical associations and pharmacist associations in India, News18 has learnt.
DGHS has asked pharmacist associations to dispense antibiotics ‘only on prescription’ of a qualified doctor and ‘stop over the counter sale of antibiotics’.
News18 has accessed all three letters written by Atul Goel, Dr Atul Goel, the Director General of Health Services, dated January 1.
In the context of prescriptions, “exact indications” refer to specific and accurate reasons or medical conditions for which antibiotics or antimicrobial drugs are being prescribed.
The central government has mandated that doctors specify the precise purpose or medical necessity for using these medications to prevent their misuse or overuse.
Why govt has made this move?
The move is seen as a major step towards curbing the over-prescription of antibiotics, which leads to antimicrobial resistance (AMR)– one of the top ten public health threats, according to the World Health Organisation (WHO).
According to the letters, AMR is one of the top global public health threats facing humanity.
“It is estimated that bacterial AMR was directly responsible for 271. million global deaths in 2019 and 4.95 million deaths were associated with drug-resistant infections,” it said.
In a letter sent to doctors and medical associations, DGHS said that “AMR puts many of the gains of modern medicine at risk.”
“It threatens the effective prevention and treatment of infections caused by resistant microbes resulting in prolonged illness and greater risk of death.” it added.
DGHS told all three stakeholders that “treatment failures also lead to longer periods of infectivity and prohibitive high cost of the second-line drugs may result in failure to treat these diseases in many individuals.”
Highlighting a crucial point, the letter said that the “misuse and overuse of anti-microbial drugs is one of the main drivers in the emergence of drug-resistant pathogens.”
“With few new antibiotics in the research & development pipeline, prudent antibiotic use is the only option to delay the development of resistance.”
Messages sent to doctors in medical colleges, pharmacists
According to the letter sent to doctors in medical colleges, the medical colleges not only provide tertiary health care in the country but also are hubs for education for the younger generation of doctors.
This makes it important that the doctors at medical colleges set the example of judicious use of anti-microbials for the next generation of doctors who will face this crisis in a much more ‘severe form’.
While the letter to pharmacists reminds them to implement Schedule H and HI of the Drugs and Cosmetic Rules and sell antibiotics only on valid prescriptions, the letter to doctors tells them to mandatorily mention the reason for taking antibiotics.
“…it is important that doctors mention exact indication on their prescriptions while prescribing antimicrobials,” the letter said.
“It is an urgent appeal to all doctors to mandatorily mention exact indication/reason/justification while prescribing antimicrobials,” it added.
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