ISLAMABAD: After concerns about misuse of antibiotics for years, the government has finally decided to regulate its sale in the federal capital.

“As a first step an advisory has been issued to all medical stores to ensure that antibiotics are not sold without prescriptions. Moreover, medical stores have been asked to maintain the record of antibiotics and its sale, including copies of the prescriptions,” Senior Drug Inspector Islamabad Sardar Shabbir told Dawn.

Antibiotics resistance occurs when bacteria develop the ability to defeat the drugs designed to kill them. When bacteria become resistant, antibiotics cannot fight them, leading to dangerous infections. On the other hand, when antibiotics fail to work the consequences are longer-lasting illnesses, more doctor visits or extended hospital stays, and the need for more expensive and toxic antibiotics. In some cases, the antibiotic-resistant infections can lead to serious disability or even death.

In the first three months, medical stores staff will be sensitised to ensure drugs are not sold without prescription, drug inspector says

As per World Health Organisation (WHO) estimates, antimicrobial resistance (AMR) is expected to cause 10 million deaths in the next 35 years. The estimated cost of management would be $100 trillion by 2050 if nothing is done to reverse the trend.

According to a letter available with Dawn, medical stores have been told that AMR is an emerging challenge in Pakistan. One of the major factors contributing to the alarming situation is over the-counter (OTC) sale of antibiotics.

“Antibiotics are included in Schedule B and G of the ICT Drug Rules 2013 which entails that such drug cannot be sold without prescription. Furthermore, the said rules also require retaining copy of the prescription and maintenance of proper sale record,” it states.

All pharmacies and medical stores operating in the capital have been directed to put an immediate ban on the OTC sale of all antibiotics/antibacterial and ensure sale of such drugs on prescription of registered medical practitioners with maintenance of proper record.

The letter, copies of which have been sent to hospitals and other stakeholders, added that the instructions should be followed in the larger interest of the public.

Mr Shabbir said though it had been decided that no one would be allowed to sell antibiotics without prescription, in the first three months owners and staff of medical stores would be sensitised and pushed to ensure that the drugs would not be sold without a prescription.

“In the past we ensured that practice in case of controlled drugs as medical stores were directed to keep a photocopy or picture of the prescription and submit a detailed record. We have decided to follow the same policy for antibiotics. After three months, we will go for fines and other actions, including closure of medical stores,” he said.

The official said medical stores would not only keep the record of the stock of antibiotics but would also have to submit details of the purchasers.

Dr Waseem Khawaja of Pakistan Institute of Medical Sciences (Pims) said people should only use antibiotics when prescribed by a certified health professional and always take full prescription even if they started feeling better. Not completing the prescribed dosage helps bacteria to become antibiotic resistant.

He said in Pakistan around 88pc of unnecessary antibiotic prescriptions is for self-limiting Upper Respiratory Tract Infections and it was also creating problems.

Special assistant to PM visits Drap

Special Assistant to the Prime Minister on National Health Services Dr Zafar Mirza in his maiden visit to the Drug Regulatory Authority of Pakistan (Drap) headquarters issued directions to take concrete and immediate measures towards transform the organisation.

“We must make a long-term investment in improving the quality and capacity of professionals in health regulation. I would soon invite all stakeholders to chart a course for making the field a truly professional one by introducing postgraduate level programmes of health regulatory sciences in universities,” he said.

Published in Dawn, April 28th, 2019