September 18: The government has issued directive to the consumers and stakeholders against using 103 types of antibiotics.    

Director General of the Department of Drug Administration (DDA) Narayan Prasad Dhakal said the directive has been issued to minimize, prevent and control use of antibiotics.    

The World Health Organization (WHO) has also recommended not touse those drugs. Dhakal said there is no rationality for using these antibiotics. "The WHO has published a list of 103 types of antibiotics which should not be used. We will neither register these drugs nor give permission for using them," he added.    

According to Dhakal, the DDA has already registered 13 of the 103 antibiotic drugs prior to the publication of the list by the WHO in 2021.     

Although the DDA did not mention the specific names of the 103 antibiotics, the WHO has published the list of combination of commonly used antibiotics on its website which it has recommended not to use.

“The use of the fixed-dose combinations of multiple broad-spectrum antibiotics is not evidence-based, nor recommended in high-quality international guidelines. WHO does not recommend their use in clinical practice.”

The DDA said it has prepared a national plan of action to reduce the rate of illness, death rate and the economic consequences resulting from resistance to antibiotic, in line with the global action plan on antibiotic resistance. The plan is said to be in final stage of approval.    

Dhakal, the DDA Director General, said directives have been issued to the concerned agencies not to register, renew the registration and import as well as use these antibiotics. This directive, he said, is issued in line with the recommendation of the Drugs Advisory Committee.

According to the WHO, improving use of antibiotics through antibiotic stewardship is one of the key interventions necessary to curb the further emergence and spread of antimicrobial resistance (AMR). It is also important for ensuring appropriate treatment, WHO wrote on its website.

For that reason, WHO in 2017 introduced the Access, Watch, Reserve (“AWaRe”) classification of antibiotics in its Essential Medicines List. The classification is a tool for antibiotic stewardship at local, national and global levels with the aim of reducing antimicrobial resistance.

Antibiotics are classified into three groups, Access, Watch and Reserve, taking into account the impact of different antibiotics and antibiotic classes on antimicrobial resistance, to emphasize the importance of their appropriate use. The 2021 update of the AWaRe classification includes an additional 78 antibiotics not previously classified, bringing the total to 258. (With inputs from RSS)