To stop the rising threat of antimicrobial resistance (AMR), the Union Health Ministry is calling for increased vigilance from doctors and pharmacists. The directive, led by Director General of Health Services Dr. Atul Goel, has called on doctors to specify the exact reason when prescribing antibiotics. Simultaneously, pharmacists are urged not to dispense these medications without a valid prescription as specified by the law.

In a letter, Dr Goel urged all doctors to include the exact reason when prescribing antibiotics. The goal is to stop the misuse and overuse of these antimicrobial drugs, a practice known to contribute to the emergence 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," stated Dr Goel.

Antimicrobial resistance stands as a formidable global public health threat, causing 1.27 million deaths worldwide in 2019 alone. The misuse of antibiotics not only threatens the natural prevention and treatment of infections but also leads to prolonged illness and an increased risk of death. Additionally, treatment failures result in longer periods of infectivity, and the high cost of second-line drugs can prevent the treatment of these diseases in many individuals.

Dr Goel's letter also highlighted the important role of pharmacists in this initiative. Pharmacists are urged to strictly implement Schedule H and H1 of the Drugs and Cosmetics Rules, immediately halting the over-the-counter sale of antibiotics and selling them exclusively on the prescription of a qualified doctor.

"While pharmacists are reminded to implement Schedule H and H1 and sell antibiotics only on valid prescriptions, it is crucial that doctors clearly indicate the reason for prescribing antimicrobials," stressed Dr Goel in his letter. He further appealed to medical practitioners to mandatorily state the reason and indication when prescribing antibiotics, reinforcing the collective effort to reduce the emergence of AMR.

"This is an urgent appeal to all 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, selling them only on the prescription of a qualified doctor," wrote Dr Goel, underscoring the critical role of pharmacists in this campaign against antibiotic misuse.

This directive comes in the wake of a recent survey by the National Centre for Disease Control (NCDC), revealing that a staggering 71.9% of patients in tertiary care hospitals were prescribed antibiotics. Alarmingly, more than half of these prescriptions were not intended to treat infections but were administered as preventive measures before procedures and surgeries.

Commenting on this trend, Dr Purva Mathur, professor of microbiology and part of the hospital infection control team at the trauma center of All India Institute of Medical Sciences, expressed concern over the high level of prophylactic antibiotic use. She said there is a need to discourage the practice, especially among surgeons who often prescribe antibiotics for prolonged periods due to concerns about postoperative infections.

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