Rs120bn of antibiotics consumed in Pakistan in 2021

A person taking medication. Photo: The News/File

KARACHI: An unprecedented increase in the use of antibiotics was seen in Pakistan in 2021 when bactericidal drugs worth 120 billion rupees were consumed in the country, officials and experts have said, saying that more than 70% of antibiotics consumed by patients were unnecessary.

According to official data available to The News, oral and injectable antibiotics worth Rs 119,745,122,879 were consumed in Pakistan in the year 2021 alone, accounting for about 10% of total healthcare expenditure in Pakistan. According to the Drugs Regulatory Authority of Pakistan (DRAP), there are about 333 manufacturers of antibiotics, both oral and injectable, in Pakistan, manufacturing different brands of 87 molecules (generic antibiotics). These 333 drug manufacturers have 2,013 antibiotic drugs registered with DRAP, of which 1,604 are active products, meaning they are available in the local market.

“Last year (2021) was a unique year when an unprecedented increase in the consumption of antibiotics was observed all over the world, including in Pakistan. For example, more than 95% of patients with Covid- 19 in Pakistan consumed antibiotics when they had absolutely no role in the treatment of this disease,” said Dr. Faisal Mehmood, an infectious disease expert associated with Aga Khan University Hospital (AKUH), Karachi. , said in a conversation with The News. He said that in the last two years of the Covid-19 pandemic, most people who have had even minor fevers have used antibiotics either alone or on their own. the advice of doctors, relatives or family friends and added that azithromycin remained the drug most frequently used by Covid-19 patients, although it played no role in the treatment of disease.

The expert claimed that due to the overuse of antibiotics, most gram negative bacteria, which cause life-threatening infections, were not resistant to almost all the antibiotics available in the country, adding that the new antibiotics Effective against these drug resistant bacteria are highly expensive and not even available in the country. “At the moment we are faced with the problem of drug-resistant bacteria against which we have little or no options available. This is due to the extreme misuse of antibiotics in our society,” said Dr Mehmood , lamenting that antibiotics are more readily available in Pakistan than in any other country.

Saying that the majority of people consume antibiotics unnecessarily in the country, he called for an immediate end to the over-the-counter sale of bactericidal drugs, ensuring the presence of pharmacists in medical stores and hospitals, and rational prescribing. antibiotics by doctors in the country.

Pakistan Society of Health System Pharmacists (PSHP) Chairman Abdul Latif Shaikh said that according to Pakistani drug laws, only a qualified pharmacist is allowed to dispense antibiotics to a person in a pharmacy, but, unfortunately, barely one or two percent of pharmacies in Pakistan country have trained and qualified pharmacists available during their working periods. “Nowhere in the world do pharmacies and medical stores operate as they do in our country. We have uneducated and untrained people in pharmacies selling all kinds of drugs, including antibiotics, without even asking for a prescription. Likewise, our doctors also abuse their authority and prescribe antibiotics without any justification, which leads to antimicrobial resistance,” added Shaikh, who is a former Chief of Pharmacy Services at AKUH.

On the other hand, some of the pharmacists who tried to prevent the irrational use of drugs, including antibiotics, claimed that they were cursed and criticized when they tried to advise patients not to use antibiotics. , steroids or other drugs not recommended for the treatment of their illnesses. .

“Our pharmacists working in different branches of Ehad Medical Center in Karachi are often criticized for preventing self-medication or advising against the use of antibiotics for the treatment of viral ailments, especially colds and flu. non-prescription drugs and offered telemedicine consultation with a pulmonologist or infectious disease experts in case of suspected or even confirmed cases of Covid-19 at the height of the pandemic,” said Umaima Muzammil, Associate Pharmacist at Ehad. Karachi Medical Center.

As a member of Pakistan Society of Health System Pharmacists (PSHP), Muzammil said he introduced the concept of consultation with pharmacists at Ehad Medical Center where drugs are not sold to patients without prescription and in case of discrepancy in the prescription, it is referred to the pharmacist or doctor.

When approached, the Director General (CEO) of DRAP, Asim Rauf, said he was trying to introduce a common quality management system (CQMS) in the country in consultation with the provinces to prevent the misuse and abuse of antibiotics as well as other prescription drugs, adding that they already have the first meeting with provincial officials in this regard.

“To set a minimum standard for pharmacies nationwide, we plan to develop standard operating procedures (SOPs) for pharmacies nationwide and want to introduce good practices for dispensing, storing, and disbursing medications to users. finals,” Rauf said. , adding that the presence of trained and qualified pharmacists in every pharmacy in the country will be ensured to prevent self-medication and the misuse of prescription drugs.

He maintained that with the presence of trained and qualified pharmacists in medical stores and pharmacies, not only can the problem of misuse of antibiotics and other prescription drugs be avoided, but patients can also be properly guided by pharmacists regarding the appropriate dosage and duration of medications they should take.

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