Experts flag need to stop OTC sale of antibiotics, spread awareness

Medical experts have flagged the need to stop over-the-counter (OTC) sales of antibiotics and spread awareness about the rational use of antibiotics to prevent cases of antimicrobial resistance (AMR) in India and other low- and middle-income countries (LMICs).

This comes after an analysis published in the Lancet journal pointed out that around 750,000 deaths associated with AMR could be prevented every year in LMICs by improving measures that prevent infections.

The study adds that an estimated 7.7 million die in LMICs due to bacterial infections, of which almost five million deaths are due to AMR bacteria.

Researchers also state that measures to prevent AMR include hand hygiene, regular cleaning and sterilisation of equipment in healthcare facilities, along with providing access to safe drinking water, effective sanitation, and paediatric vaccines.

AMR threatens the effective prevention and treatment of infections caused by resistant microbes, resulting in prolonged illness and greater risk of death.

Terming AMR a global problem, Bishnu Panigrahi, group head, medical strategy and operations, Fortis Healthcare, said that one of the main reasons behind the rise of AMR is that there is no rational use of antibiotics in general in many places.

“There is a pressing need to spread awareness among the public and patients on social media, in print media, and in electronic media, on the rational use of antibiotics,” he said.

The findings of the study come months after the Director-General of Health Services (DGHS) had urged all pharmacists to dispense antibiotics only on the prescription of a qualified doctor, hence limiting over-the-counter sales (OTC), to address the threat of AMR.

In a letter addressing all pharmacy associations in India, the DGHS had appealed to all pharmacists to strictly implement Schedules H and H1 of the Drugs and Cosmetics Rules, 1945, with regards to selling antibiotics.

Under the Drugs and Cosmetics Rules, 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 professional (RMP) only.

The Schedule H1 drugs are mainly allocated to restrict the selling of antibiotics through OTC sales, after it was noted that any number of these drugs could be bought from pharmacies across India without any limitations. This includes high-end drugs such as third- and fourth-generation antibiotics, anti-tuberculosis drugs, and certain psychotropic drugs.

Terming the Indian laws and schedules as very useful, Panigrahi said that there is a need to enforce checking and implementation of the schedules at the ground level.

“The sales of antibiotics should be prescription-based and the prescription should be kept by the pharmacies so that if the drug controller or anyone on the team wants to have a look at it, they can follow it up,” he added.