Health ministry asks doctors to mention the REASON for prescribing antibiotics

In what can be said as a major step towards addressing the growing issue of antibiotic resistance, media reports have said that the Union Health Ministry has asked doctors to mention the reason while prescribing antibiotics.

According to sources, Dr. Atul Goel, the Director General of Health Services, has appealed to all doctors in medical colleges to "mandatorily mention the exact indication/ reason/ justification while prescribing antimicrobials" in a letter. Not only doctors but pharmacists have also been told to "implement Schedule H and H1 of the Drugs and Cosmetics Rules and sell antibiotics only on valid prescriptions. It is important that doctors mention the exact indication on their prescriptions while prescribing antimicrobials," according to the letter.

"It is in urgent appeal to all the doctors to make it a mandatory practice to write indication/reason/Justification while prescribing antimicrobials. Looking forward to your support the promote judicious use of antimicrobials to reduce emergence of AMR," it stated.

In the letter to all pharmacist associations in India, Goel said under Drugs and Cosmetics Rules 1945, antibiotics are included in the list of drugs specified under Schedule H which are required to be sold by retail on the prescription of a Registered Medical Practitioner (RMP) only. Some high end antibiotics are included in list of HI drugs.

"This is an urgent appeal to all the pharmacists in the country to strictly implement schedule H and H1 of the Drugs and Cosmetics Rules and stop over the counter sale of antibiotics and sell them only on prescription of a qualified doctor," the letter stated.

Antibiotic resistance can lead to a worrisome health menace

"Resistance to antibiotics means that the drug which is supposed to be working against a particular group of microorganisms is not able to work. So to say the organism is resistant to the effect of the medication, which is because of undergoing some chromosomal change," explains Dr Rajiv Dang, Senior Director and HOD - Internal Medicine and Medical Director, Max Hospital, Gurgaon.

"So you have often seen that after getting the culture report of urine, blood or some pus, the doctor likes to make changes in the antibiotic that he is using because as per the report, this is likely to be resistant, while we want a drug which should be sensitive so that the effect is seen and therefore the patient recovers. This is a big concern and a serious one because medical science at this point of time does not have a new drug that is undergoing investigation and research so we are not expecting any good new antibiotic in a short term. There is no such drug in the pipeline as of now, " he adds.


"Antibiotics should be sold only on prescription and not at free wish," says Dr. Saibal Chakravorty, Senior Consultant - Internal Medicine, Metro Hospital Noida. He urges active community participation in putting an end to the indiscriminate use of antibiotics. "We have to see at the level of the doctor, We have to see at the level of the patient as well as at the level of the chemists. So involvement of all three are equally important to curb this menace. At the level of the antibiotics, the antibiotics should be sold only on prescription and not at free wish. At the level of the patient, they should realise that all the infections are not bacterial," he explains.

Antimicrobial Resistance (AMR) is one of the top global public health threats

Considered to be the cornerstone of modern medicine, antimicrobials – including antibiotics, antivirals, antifungals, and antiparasitics – are medicines used to prevent and treat infectious diseases in humans, animals and plants. Antimicrobial resistance (AMR) is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths. "AMR puts many of the gains of modern medicine at risk. It makes infections harder to treat and makes other medical procedures and treatments – such as surgery, caesarean sections and cancer chemotherapy – much riskier," the World Health Organisation (WHO) warns.
(With inputs from PTI)