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THE SCHEDULE HX
P A Francis | Wednesday, June 29, 2011, 08:00 Hrs  [IST]

The Union Health Ministry is all set to come out with a national antibiotics policy by incorporating a new Schedule namely, HX, in the Drugs & Cosmetics Act in a bid to prevent  large scale misuse of antibiotics in the country. The ministry has identified a group of 70 antibiotics to be included in this restricted category of drugs. Currently, antibiotics are placed under the Schedule H of the D&C Act. The Drugs Consultative Committee had already given its go-ahead to the proposal. The new Schedule will require doctors and chemists to retain prescriptions so that the abuse of antibiotics could be checked from now onwards. Once the policy takes effect, doctors, while prescribing antibiotics, will have to issue two prescriptions to every patient and one copy should be kept for a period of two years by the chemists. The officials from the DCGI office or state regulatory authorities can, thus, audit these prescriptions at any time. Violations under the new Schedule may be punished with a fine of Rs. 20000 or up to two years of imprisonment. The new policy will be applicable to practitioners both in public and private sector establishments. Antibiotics would be categorised as non-restricted, restricted and very restricted. Each category would have a distinct colour code for the benefit of consumers.

Growing antibiotic resistance is a serious public health problem world is facing today due to its irrational use by the patients. Repeated and improper use of antibiotics are two main causes for increase in resistant bacteria world over. It is estimated that up to 50 per cent of antibiotic prescriptions given in the community settings are not actually needed. Patients contribute to antibiotic resistance by requesting physicians to prescribe antibiotics even if they do not have a bacterial infection. Non compliance of patients to the antibiotic treatment regimen is another contributory factor for resistance which has become a significant patient safety concern today. In India, scientific debate on antibiotic resistance started in the wake of a recent controversy over a reference made in the medical journal, Lancet, regarding the superbug called New Delhi metallo-beta-lactamase 1 (NDM-1). The superbug is stated to be resistant to the most powerful antibiotics and the circulation of the Lancet report did hit the image of India as a destination for medical tourism. And it is in this background, the Union health ministry had set up a task force to review the current situation regarding manufacture, use and misuse of antibiotics in the country. The task force was also asked to initiate studies documenting prescription patterns and establish a monitoring system for the same. The report has been already placed before the Drug Consultative Committee several weeks ago for action. Now AIOCD, representing in the country, has taken serious objection to the ministry’s move to introduce the new schedule on the ground that it will affect the survival of 7.5 lakh chemists in the country. AIOCD's contention is that it is the doctors who prescribe the antibiotics without any checks and chemists just provide the drugs. This may be true in a number of cases. But, a large number of retail chemists do also indulge in selling antibiotics without prescriptions throughout the country. No one deny this fact. Therefore, some regulatory intervention is called for to fix this public health problem.

Comments

nidhi pandey Aug 26, 2011 9:17 AM
I think this is a superb initiation towards the misuse of an antibiotics.I completely agree in introducing the new schedule to D&C act 1945.
AJAY GAUTAM Jul 28, 2011 9:57 PM
Dear Sabina ,
I am not agree with such type of schedule but why Govt is trying to panic the prop. of Chemist counter ?
Why the Govt Authorities are not taking any action against RMP like Bangali Dr.'s ?
Is it possible These Bangali Drs will hold their Rx for TWO YEAR , When they wont holding their Rx for moment or day .
and one interesting Fact i would like Share with you that Non of the MBBS Doct. is Ready to hold their Rx then why only RETAIL OWNER.
so how Govt can torture the retail owner or Pharmacist over holding the Rx.
This is just like a TUGAHLAKI ORDER .
For retail counters Govt Have Drug Inspectors But what About the Drs. who will check their records i.e Other Drs ONLY
So this Rule is wastage of time , money , Energy
amar mohanty Jul 25, 2011 11:17 AM
really difficult to keep so many photocopies of the prescriptions at the busy hours. if this law will be implimentated then we have to keep a Xerox machine in our counter and one person will be deputed for that. this bill is not at all acceptable to us.
Dr A R Sajeev Jul 23, 2011 11:04 AM
It is already late to take this decision. Stop sale of antibiotics through Medical stores. It should be used under supervision of a qualified Physician or surgeon only.
Balbir Singh Negi Jul 20, 2011 1:44 PM
We are the member of Pharmabiz,can you please provide me the new Schedule namely, HX, in the Drugs & Cosmetics Act

Waiting for the reply
Balbir Singh Negi Jul 20, 2011 1:20 PM
Can you please provide the e-copy of new Schedule namely, Schedule HX

Thanks waiting for the reply
MANOJ AGNANI Jul 18, 2011 6:14 PM
sabhi chemisto ki taraf se HX ka virodh karte hai & lagu hone par andolan kiya jayega .manoj agnani
Kaushik Basu Jul 8, 2011 12:27 PM
The article is very interesting & informative. Can I have the list of 70 schedule HX drugs.Or otherwise please let me know where I can get the list?
This will be usefulful for me to take further action from our company's side.
JSD PANI Jul 5, 2011 2:21 PM
Atlast a good move. Quacks, Indian Medicine ( AYUSH)doctors prescribing antibiotics will come to an end
THIYAGARAJAN Jul 2, 2011 7:52 AM
WHILE PUBLISHING SUCH ARTICLES,THE LIST OF THE DRUSGS MENTIONE BY THE GOVT. AND THE RELATED FORMULATION AVAILABLE IN THE MARKRT MAY BE PUBLISHED.IT WILL HELP ALL THE PEOPLE TO UNDERSTAND THE ARTICLE VERY EASY.
VINOD GUPTA Jun 30, 2011 12:08 PM
DEAR SIR,
IT IS DIFFICULT NOT TO AGREE WITH YOU THAT SOME KIND OF MECHANISM NEEDS TO BE IN PLACE TO CHECK ANTIBIOTIC MISUSE.

HOWEVER, THE HEALTH MINISTRY SHOULD HAVE TAKEN STAKEHOLDERS, AIOCD & IMA IN CONFIDENCE BEFORE HAND TO ENSURE SMOOTH COMPLIANCE OF SCHEDULE HX PART 2, CONTAINING 74 COMMON USE ANTIBIOTICS, WHICH REQUIRES PRESCRIPTION IN DUPLICATE.

PART 1 OF THE LIST CONTAINING 14 HIGHER ANTIBIOTICS IS GOING TO GENERATE NO LESS HEAT WHEREBY BOTH RETAIL & WHOLESALE TRADE R SOUGHT TO BE BYPASSED.......vinod gupta

Sudhir Ketkar Jun 29, 2011 5:37 PM
It is not only the patients who buy antibiotics from the shelf with their previous experience but only the rampent use by the practitioners in the first instance. Basically it is because of the structure of the health services provided in the country.Private practitioner way outnumber the central agencies also because the infrastructure provided by the government can in no way cope up with requirements. I suggest following:
take the antibiotics out of the shelf and have some means of monitoring and penalising the defaulters in signeficant manner.
stop practitioners of other system from prescribing antibiotics in allapathic forms. Monitor it and penalise them.
monitor prescription pattern of the practitioners.
the BIG ? is , is it possible to monitor these in INDIA. as even in a day the breakers of red light on traffic points can either be not monitored or the instances compromised.
Bandu Katti Jun 29, 2011 1:49 PM
Nowadays antibiotics are the most important role in betterment of human health. It is very difficult to imagine the world without antibiotic power. But it is also true much dangerous antibiotics are easily available in the market. Hazards ignored and use of the antibiotics and even multiple doses is a common practice. The Union Govt. took a right decision to curb this unethical practice. But India is a big country with a huge amount of rural inhabitants. It is very difficult to find out qualified medicos or specialists in and around village India. In this scenario it is necessary to relax for some proved antibiotics from the restrictions of schedule HX drugs.

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