Controlling antibiotic abuse  

Visible actions on unbridled sale of antibiotics have been long overdue. But the relevant government agency -- the Drug Administration (DA) -- preferred to remain indifferent to this major public health issue. Against this backdrop, a High Court bench, responding to a public-interest litigation (PIL) writ petition late last week, asked the DA to ensure the sale of antibiotics only on prescription written by registered physicians. A Supreme Court lawyer out of his concern over widespread abuse of antibiotics and growing antimicrobial resistance to the same, as a natural consequence, filed the PIL. The HC Bench also issued a rule seeking to know from the authorities concerned why the sale of antibiotics without prescriptions would not be declared illegal. 

Antibiotics do help the doctors save millions of lives across the world every year. Physicians found the first modern antibiotic, Penicillin, discovered accidentally by Scottish bacteriologist Professor Alexander Fleming in 1928, as a miracle drug because of its surprising ability to kill microbes. Physicians, these days, are helpless without effective antibiotics. But the effectiveness of antibiotics in dealing with microbial infections has led to their abuse. That, in turn, has contributed to the worrying emergence of drug-resistant 'superbugs'. Experts at a function in Dhaka last year said more than 300 million people across the world are at risk of dying by the year 2050 because of greater number of microbes developing resistance against an array of antibiotics.

The abuse of antibiotics takes place at both physicians' and consumers' end. Instances are galore where doctors prescribe these drugs unnecessarily. But the abuse to the maximum extent does happen when patients themselves choose to consume antibiotics without consulting qualified physicians. Besides, employees at drug stores or quacks often prescribe antibiotics for poor and illiterate patients.

In fact, a sort of free-for-all situation prevails in marketing and sale of pharmaceutical products in Bangladesh. Though drug stores are required by law to have qualified pharmacists, most of these operate without them and the Drug Administration (DA) appears to be least concerned about the violation of rules in this connection. Pharmacies sell medicines of all types without prescriptions in defiance of a legal bar to do so.  One can easily buy even sensitive drugs like sedatives or steroids as much as one likes. Thus, lapses of a huge proportion on the part of the DA have led to the mushrooming of pharmacies.

The HC has rightly asked the DA to take measures for ensuring the sale of antibiotics only on prescriptions from registered physicians. But the same rule should apply in the case of all prescription drugs. The pharmaceutical companies do clearly print instructions on the containers of prescription drugs asking the consumers not to use the same without consulting registered physicians. The drug manufacturers should go a step ahead and instruct the drug stores not to sell such medicines sans prescriptions. But much would depend on the alertness and efficiency of the DA to deal with the problem. 

The growing resistance to antibiotics is a global problem. The factors that are largely responsible for the development of such resistance, however, are widely prevalent in Bangladesh. So, all the relevant parties, including the government health officials, drug manufacturers and sellers, physicians and consumers in particular, should try to stop uninformed use of antibiotics, to the maximum possible extent.