Antibiotics Prescription, Dispensing Practices and Antibiotic Resistance Pattern in Common Pathogens in Nepal: A...

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial resistance (AMR) poses a critical global health challenge.
• Nepal faces escalating AMR rates, largely attributed to prevalent irrational antibiotic practices.
• Understanding local antibiotic use patterns is crucial for effective AMR containment.

Purpose of the Study:

• To review antibiotic prescription and dispensing practices in Nepal.
• To assess the prevalence of antibiotic resistance in common bacteria within Nepal.
• To identify key drivers of increasing AMR in the Nepalese context.

Main Methods:

• Literature review of studies on antibiotic use and resistance in Nepal.
• Analysis of prescription and dispensing patterns of antibiotics.
• Examination of bacterial resistance data from Nepalese surveillance systems (where available).

Main Results:

• Widespread antibiotic consumption occurs without clinician prescriptions or through irrational prescribing.
• Approximately 50% of the Nepalese population easily obtains antibiotics from pharmacies without a prescription.
• Third-generation cephalosporins, critical last-resort drugs, are frequently prescribed and dispensed.
• Irrational prescribing is more pronounced in remote areas due to limited healthcare access.

Conclusions:

• Irrational antibiotic prescription, dispensing, and self-medication are major contributors to rising AMR in Nepal.
• Limited surveillance systems exacerbate the challenge of controlling antibiotic resistance.
• Urgent interventions targeting antibiotic use practices are necessary to mitigate the AMR crisis in Nepal.