Due to lack of strict regulatory measures, the use of antibiotics is getting proliferated all over the country, especially in Kerala, and measures are needed to control and rationalise its use, a national meeting of pharmacists observed.

In the convention which was organised by the Indian Pharmaceutical Association Community Pharmacy Division in Kerala, regulatory officers present there opined that the recent schedule H1 was an efficient step to control the use of select 46 medicines, of which 21 were antibiotics.

M R Pradip, the intelligence wing deputy director of the Kerala drugs control department, while delivering a lecture on the subject ‘Regulatory viewpoint on rational use of Antibiotics’, said, the dosage forms of antibiotics should be convenient for both the physicians as well as the patients for suitable prescription and for proper consumption. There are over prescription, under prescription and multiple prescriptions by different doctors for the same patient. The latest issue of antibiotic misuse is dispensing without valid prescription. Several important antibiotics are widely misused. Strict regulatory interference is the only solution to check this sort of humanly created menace.

Like NHS in the UK, the regulatory implementation will be more efficient if all the healthcare professionals are coming under one controlling agency. In India, the doctors are not coming under the control of drug regulatory agency, so it is difficult to have a control on their prescriptions. As there is no primary physician and referring system here, most of the patients first consult the specialists and get the advanced antibiotics prescribed even for minor infections. This trend of seeking higher level of care and advanced medicines forces the doctors for over prescription.

Patients, who have limited resources, generally do not complete the full course of the medication. This will result in the development of resistance.

“Kerala is in need of a drug formulary and select antibiotics should be enlisted in it. Formulary control is needed at different levels of the healthcare systems such as primary, secondary and tertiary sectors. Treatment protocols are also necessary to guide the prescribers on standard use of antibiotics. Use of generic medicines needs to be promoted efficiently. Likewise, measures have to be taken to control the strategies adopted by pharmaceutical companies to bypass the regulatory control on essential medicines. Poor communication between healthcare professionals and regulatory officials gives more room for irrational and aggressive marketing of medicines”, he said.

In Kerala, there are eight centres of pharmacovigilance programme. As per 2013 report, only 90 adverse drug reactions (ADRs) have been reported, and the figure is comparatively lower than the real incidences of ADRs, the meeting observed.