The High Court on Thursday asked the government to prevent sale of antibiotics without prescriptions issued by registered doctors.
The bench of Justice Sheikh Hassan Arif and Justice Razik-Al-Jalil also asked the Directorate General of Drug Administration to issue a circular in two days asking deputy commissioners and civil surgeons to take necessary steps to prevent sale of antibiotics without prescriptions.
The court order came in the face of alarming threat caused by growing antimicrobial resistance.
After hearing a public-interest-litigation writ petition filed by Supreme Court lawyer Syed Sayedul Haque Suman, the court asked the government to explain why the sale of antibiotics without prescriptions would not be declared illegal.
The health and public administration secretaries, the drug administration director general, the deputy commissioners and the civil surgeons were asked to reply to the ruling in four weeks.
The petitioner argued that drug stores across the country developed the undesirable practice of selling antibiotics without prescriptions.
A recent study revealed that 400 of 900 patients admitted to the intensive care unit at Bangabandhu Sheikh Mujib Medical University died because of antimicrobial resistance, he contended.
He argued that researchers’ demand to prevent misuse of antibiotics and ban the sale of microbial medicines without prescriptions fell on the government’s deaf ears.
Growing antimicrobial resistance posed a grave health crisis in Bangladesh, the petitioner contended.
Report headlined ‘Health catastrophe in the making’ New Age published on March 3 referring to a study published in the March issue of International Journal of Infectious Diseases showed a horrific picture of antibiotic resistance against many common bacteria in Bangladesh.
The study titled ‘Antibiotic resistance in Bangladesh: A systematic review’ analysed 46 studies carried out between 2004 and 2018 on antibiotic resistance.
It found that bacteria causing common ailments like urinary tract infection, pneumonia and ear infection were becoming resistant to most of the antibiotics in Bangladesh.
The study showed that Escherichia coli, a bacteria available even in jar water or street food in Dhaka and the most common causative organism of urinary tract infection, was studied in 21 articles and found high resistance to commonly used antibiotics — ampicillin in 94.6–100 per cent cases, amoxiclav in 67.1–85.5 per cent cases, ciprofloxacin in 65.2–80.5 per cent cases and co-trimoxazole in 72–82.2 per cent cases.
Resistance to ampicillin, amoxiclav, ciprofloxacin and co-trimoxazole was 100 per cent, 58 per cent and 67.4 per cent and 72.7 per cent respectively in Klebsiella bacteria that caused pneumonia.
Co-trimoxazole was ineffective against 86.6 to 98.7 per cent cases of tested Pseudomonas bacteria, which causes ear infection, and 87.5 to 100 per cent ineffective against Enterococcus bacteria, common among people who lacked the practice of hand wash after defecation.
Antimicrobials have been a driver of unprecedented medical and societal advances, but their overuse has resulted in antibiotic resistant bacteria, with the World Health Organization reporting new surveillance data in January 2018.
‘The report confirms the serious situation of antibiotic resistance worldwide,’ WHO Antimicrobial Resistance Secretariat director Marc Sprenger said at the launch of the report.
‘Some of the world’s most common — and potentially most dangerous — infections are proving drug-resistant,’ Sprenger observed.
Antimicrobial resistance continues to be a global health priority. At the fall 2018 UN General Assembly High-Level Meeting, there were side panels and sessions on this topic, including drug-resistant tuberculosis. The United States launched a year-long campaign called the Antimicrobial Resistance Challenge.
During a high-level meeting convened by the UN General Assembly president on the sidelines of the 71st General Debate in September 2016, UN member states adopted a political declaration on antimicrobial resistance. They called for action, and outlined initiatives to be carried out nationally to address the crisis.
The then UN Secretary-General Ban Ki-moon remarked that antimicrobial resistance posed a fundamental, long-term threat not only to human health, but also to sustainable food production and development in all parts of the world. He reported that more than 200,000 newborn children were estimated to die each year from infections that did not respond to available antibiotics.
According to a study ‘Identifying antibiotics posing potential health risk: microbial resistance scenario in Bangladesh’ published in the International Journal of Medical and Health Sciences in 2015, 13 among 35 antibiotics developed high level of resistance in Bangladesh.
The study said that these antibiotics were cheaper as well as effective and high level of resistance to these drugs caused alarming threat to public health.
Bangabandhu Sheikh Mujib Medical University pharmacology chairman Sayedur Rahman said that as there was a shortage of new antibiotics, it was of utmost importance that the existing ones were used cautiously.
‘Rampant taking of antibiotic, taking without maintaining due time, and not fulfilling course of antibiotic are the major reasons of growing trend of antibiotic resistance,’ he said.
The pharmacologist said that antibiotics were available at drug stores across the country and anyone seeking prompt cure from simple viral infection like fever, cold and diarrhoea, which did not require antibiotic to cure at all, used to buy antibiotics from the drug stores and take them whimsically.
Unregulated pharmacies and quacks are also contributing to the antibiotic resistance, he said.
‘There are about 2.3 lakh pharmacies and 4 lakh quacks in the country and they sell or prescribe antibiotics for unnecessary reasons rampantly,’ said the pharmacology professor.
According to Drug Administration officials, antibiotic was the second best-selling drug in Bangladesh.
According to a review on the pharmaceutical industry business in Bangladesh by LankaBangla, the sale of antibiotic was Tk 1,687.61 crore in 2018, the second most sold medicines after acidity drugs.
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