The Union Health Ministry has mandated doctors in medical colleges and associations to include indications and justifications when prescribing antibiotics. Dr. Atul Goel, Director General of Health Services, urged pharmacists to strictly adhere to the Schedule H and H1 of the Drugs and Cosmetics Rules, limiting over-the-counter antibiotic sales to prescription-only.
In 2014, the government introduced the Schedule H and H1 notification to monitor antibiotic use and combat antimicrobial resistance. A recent letter emphasized the need for vigilant monitoring following a study by India’s National Centre for Disease Control, revealing high antibiotic prescription rates and concerns about resistance.
The World Health Organization’s AWaRe classification system categorizes antibiotics into Access, Watch, and Reserve groups. The study disclosed that 57% of prescribed antibiotics fell into the “Watch” category, raising concerns about potential misuse.
The Health Ministry’s initiative aims to rationalize antimicrobial use, promoting an evidence-based approach in medicine. Infectious disease specialists support the move, believing it can improve patient outcomes, reduce treatment costs, and mitigate unwarranted side effects.
Experts emphasize the importance of an evidence-based approach in prescribing antimicrobials, asserting that documenting indications can lead to more rational use. While acknowledging the benefits, they also stress the need for regular audits to scrutinize justifications provided.
Studies suggest a link between air pollution and antibiotic resistance, prompting calls for genomic surveillance. The Tata Institute of Genetics and Society, in collaboration with the BBMP, plans to expand wastewater surveillance for both COVID-19 and antimicrobial resistance, aiming to establish a comprehensive system adaptable for various cities.
Genomic surveillance, widely used during the COVID-19 pandemic, holds promise in tracking outbreaks and predicting effective antibiotic treatments. Dr. Gupta highlights its potential to define local epidemiology, improve antimicrobial application, and decrease resistance selection pressure, offering insights into transmission dynamics and pandemic preparedness.