What GOI & IMA should do to combat AMR?

 Does Auditing of Prescriptions Reduce Alarming Antibiotic Usage in India? Any Other Measures Does Goi and Organizations Like Ima Should Implement to Combat Amr? Do The Indian Physicians Accept Prescription Auditing?

 

Auditing of prescriptions in India has been shown to effectively reduce alarming antibiotic usage by promoting rational and evidence-based prescribing. 

 Studies at Indian tertiary care centers reveal that regular and timely prescription audits increase awareness among doctors about proper antibiotic selection, including reliance on culture reports and hospital antibiograms, leading to reduced inappropriate antibiotic use. 

Over 95% of doctors involved in these audits accepted and followed standard prescribing protocols, and antibiotic stewardship programs with audits have demonstrated lowered antibiotic consumption and potentially reduced antimicrobial resistance (AMR). Prescription auditing thus plays an important role in improving prescription quality and patient safety while reducing antibiotic misuse in India.

In addition to prescription auditing, the Government of India and organizations like the Indian Medical Association (IMA) could implement several other measures to combat AMR effectively:

·         Enforce stricter regulations on over-the-counter (OTC) antibiotic sales and promote Schedule H1 drug regulations.

·         Increase awareness and training programs for healthcare professionals on antimicrobial stewardship.

·         Implement multi-centric surveillance systems for antibiotic consumption and resistance patterns.

·         Encourage vaccine use in the Universal Immunization Program to reduce infections requiring antibiotics.

·         Promote rational use of antibiotics through treatment guidelines and continuous education.

·         Encourage incorporating antibiograms and culture-guided therapy in routine clinical practice.

The majority of doctors resist prescription auditing programs due to several concerns and challenges. Key reasons include:

• Perceived interference in clinical autonomy
• Fear of punitive action
• Administrative burden:
• Influence of commercial interests
• Resistance from pharmacies and chemists
• Lack of awareness or training
• Concerns about patient privacy and trust

Despite these challenges, many doctors do accept and follow guidelines after sensitization, especially when audits focus on improving patient safety and reducing irrational antibiotic use. However, executing audits effectively requires addressing these concerns with education, encouragement, streamlined procedures, and protecting physician autonomy while promoting rational drug use.

Overall, prescription audits along with multifaceted stewardship policies are crucial strategies in India’s fight against AMR and improving antibiotic prescribing behavior among physicians.