In a significant move to curb the rampant antibiotic resistance, Nepal’s Department of Drug Administration has put a ban on 103 antibiotic combinations.
These combinations are not endorsed by the World Health Organisation (WHO), raising concerns over their continued use in the country.
Aiming for a Healthier Future
Antibiotic resistance is alarmingly high in Nepal, posing a severe threat to public health. The phenomenon occurs when microorganisms like bacteria, viruses, fungi, and parasites evolve and become resistant to medications, making infections increasingly challenging to treat and escalating the risk of disease spread and severe illness.
In Nepal, antibiotics, although prescription drugs, are readily available over the counter. This ease of access has led to misuse, as people purchase these drugs without proper diagnosis, and pharmacists often neglect to emphasise the importance of completing the prescribed course.
Knowledge of the effective usage of antibiotics is also lower. In a study conducted in 2019, 43% of the interviewees thought fever can be cured with antibiotics, and 35% believed that antibiotics were used for treatment of cold and flu. This has led to regular consumption of antibiotics for conditions that are not treatable with them.
Prescription Practices Under Scrutiny
Doctors often prescribe antibiotics based on clinical diagnosis. This is done even without laboratory test reports, leading to ineffectiveness if the infection is viral. The Nepal Health Research Council found that about 85 percent of doctors prescribe antibiotics by brand names, not generic, as there’s no mandatory policy for generic prescription in Nepal.
The Role of Combination Antibiotics
Narayan Dhakal, the director general of the department, explained, “We have not restricted individual antibiotics. Only combinations are prohibited.” Studies indicate that the irrational use of these combinations contributes significantly to increased antibiotic resistance worldwide.
The Widespread Impact
Antimicrobial resistance is not just a local issue; it’s a global concern. The indiscriminate use of antibiotics, not only in human medicine but also in agriculture, particularly livestock and poultry production, is a contributing factor. The result is persistent infections, ineffective medicines, and heightened risk of contagion.
Aligning with WHO Guidelines
“The UN health body published the list of non-recommended antibiotics in 2021,” stated Dhakal. Nepal’s decision to restrict these drugs aligns with both WHO recommendations and the advice of their own drug advisory committee.
Lack of Antibiotic Susceptibility Testing
The report reveals that only 32 percent of health workers have access to laboratories for antibiotic susceptibility testing. Meanwhile, just 49 percent of health workers recommend such testing before prescribing antibiotics. Astonishingly, 41 percent were unaware of national guidelines for antibiotic prescriptions. Additionally, of those aware, only 54 percent had access to them.
Warning from Health Experts
Public health experts are ringing alarm bells that the miraculous life-saving capacity of antibiotics is at risk. The irrational use of these drugs, spurred by a high resistance rate, is rendering them ineffective, affecting numerous patients across Nepal.
“We have directed our drug inspectors to monitor the recall of these drugs,” announced Dhakal. The department is halting the registration, renewal, and import approval of the banned medicines to eradicate their use.
Nepal’s proactive measures reflect the urgent need to address antibiotic resistance, a growing global health threat. Through banning harmful antibiotic combinations and reinforcing guidelines, the nation is positioning itself as a leader in the battle against antimicrobial resistance in Asia. By prioritising public health, Nepal is taking significant strides towards a healthier, safer future for its citizens and setting a commendable example for neighbouring countries to follow.