DRAP’s advisory for prescription-only antibiotics amid AMR threat

ISLAMABAD: In an unprecedented move, the Drug Regulatory Authority of Pakistan (DRAP) has advised the provincial health departments of all the four provinces, Azad Jammu and Kashmir, Gilgit-Baltistan, and Islamabad Capital Territory (ICT) to ensure that all kinds of antibiotic medicines are sold only on the prescription of registered medical practitioners.

This directive aims to combat the growing threat of Antimicrobial Resistance (AMR) and curb the dangerous practice of self-medication, which can lead to misuse and overuse of antibiotics, exacerbating resistance and undermining the effectiveness of these crucial drugs, DRAP officials said Friday.

In Pakistan, the annual sales of antibiotics are substantial, with antibiotics worth approximately Rs135 billion consumed in 2022, local pharmaceutical industry data reveals. A significant concern is the irrational use of these antibiotics, with over 70 to 80 per cent prescribed and consumed unnecessarily for self-limiting conditions, leading to a serious threat of antimicrobial resistance (AMR). This misuse makes antibiotics ineffective against disease-causing microorganisms, posing a major public health challenge.

“Antimicrobial resistance has been declared a global threat by the World Health Organization (WHO) since 2014, and the misuse and overuse of antibiotics is one of the main causes of AMR. It has been observed that the sale of antibiotics without a prescription in LMICs, including Pakistan, has led to misuse, overuse and abuse through self-medication,” DRAP Chief Executive Officer (CEO) Asim Rauf told The News.

The DRAP chief maintained that as antibiotics and antibacterials are sold on prescription only all around the world, Pakistan too has no choice but to restrict their sale to prevent self-medication. He added that they have advised all provincial health departments, governments of Kashmir, Gilgit-Baltistan and the Islamabad administration to ensure that these medications are sold on the prescription of registered medical practitioners only.

In response to concerns about unethical and incentivized prescriptions, he said they are going to approach the Pakistan Medical and Dental Council (PMDC) and healthcare commissions across Pakistan to take action against healthcare professionals who are prescribing antibiotics irrationally or in exchange for incentives. “We are also going to hold the pharmaceutical industry responsible, and stern action will be taken against those offering incentives for prescribing antibiotics irrationally,” Asim Rauf vowed.

An advisory issued by DRAP’s Director of Pharmacy Services, Dr Obaidullah, emphasised that DRAP shares the responsibility of combating AMR, being the ‘National Focal Point’ for Antimicrobial Consumption Surveillance (AMCS).