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State reason for prescribing antimicrobials, Health Ministry tells doctors

The Union Health Ministry has asked doctors to make it a mandatory practice to write the indication (reason/justification) while prescribing antimicrobials, and directed pharmacists to stop over-the-counter sale of antibiotics, and sell them only with the prescription of a qualified doctor.

The Ministry’s latest direction cites the misuse and overuse of antimicrobials, which it said is one of the main drivers of antimicrobial resistance (AMR).

The letter issued by the Ministry to all medical and pharmacist associations and doctors of medical colleges said that it is estimated bacterial AMR is directly responsible for 1.27 million global deaths in 2019, while 4.95 million deaths were associated with drug-resistant infections.

Stating that AMR puts many of the gains of modern medicine at risk, the Ministry said that misuse and overuse of antimicrobials is one of the main drivers in the development of drug-resistant pathogens. “With few new antibiotics in the Research and Development pipeline, prudent antibiotic use is the only option to delay the development of resistance,” the Ministry said in its communication.

It further explains that AMR threatens the effective prevention and treatment of infections caused by resistant microbes resulting in prolonged illness and greater risk of death. Treatment failures also lead to longer periods of infectivity, and the prohibitively high cost of second-line drugs may result in failure to treat these diseases in many individuals, the Ministry added.

According to the Ministry’s direction, the change must begin from the medical college itself. It notes that medical colleges not only provide tertiary healthcare in the country but are also hubs for the education of the younger generation of doctors, so this makes it important that doctors at medical colleges set an example of the judicious use of antimicrobials for the next generation of doctors who will face crises in much more severe forms.

Pharmacists have been told to implement Schedule H and H-1 of the Drugs and Cosmetic Rules, and sell antibiotics with only one valid prescription. “It is important that doctors mention exact indications on their prescriptions while prescribing antimicrobials,” the communication noted.