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antibiotics: Govt asks doctors, pharmacists to mention reasons for prescribing antibiotics

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The Union Health Ministry has called on doctors in medical colleges and medical associations to make it mandatory to mention the indication and reason for prescribing antibiotics. Director General of Health Services Dr Atul Goel has also urged pharmacists to strictly follow the Drugs and Cosmetics Rules and refrain from selling antibiotics without a prescription from a qualified doctor.

In a letter dated January 1, Dr Atul Goel emphasized that the misuse and overuse of antimicrobials contribute to the development of drug-resistant pathogens. He highlighted the importance of prudent antibiotic use in order to delay the emergence of resistance, as there are limited new antibiotics in the research and development pipeline.

The letter, addressed to all doctors of medical colleges and medical associations, emphasized that antimicrobial resistance (AMR) is a major global public health threat. In 2019 alone, bacterial AMR was responsible for approximately 1.27 million deaths worldwide, with an additional 4.95 million deaths associated with drug-resistant infections.

AMR not only jeopardizes the effectiveness of infection prevention and treatment, but also leads to prolonged illness, increased risk of death, and longer periods of infectivity. The high cost of second-line drugs further hinders the treatment of these diseases for many individuals.

While reminding pharmacists to adhere to the Drugs and Cosmetics Rules and sell antibiotics only with valid prescriptions, the letter stressed the importance of doctors including the indication or reason for prescribing antimicrobials on the prescriptions. The Health Ministry urgently appealed to all doctors to make it mandatory to provide the indication/reason/justification when prescribing antimicrobials, in order to promote the judicious use of these drugs and reduce the emergence of AMR.

In a separate letter to all pharmacist associations in India, Dr Atul Goel highlighted that antibiotics are included in Schedule H of the Drugs and Cosmetics Rules 1945, which requires them to be sold only with a prescription from a Registered Medical Practitioner (RMP). High-end antibiotics are included in the list of Schedule HI drugs. The Health Ministry urgently appealed to all pharmacists to strictly implement Schedule H and H1 of the Drugs and Cosmetics Rules, and to refrain from over-the-counter sale of antibiotics.