telangana-joins-kerala-in-crackdown-on-misuse-of-antibiotics

Facing the growing threat of antimicrobial resistance (AMR), considered one of the top global health threats by the World Health Organization, the Telangana government has launched a major crackdown on the illegal sale of antibiotics and uncovered widespread violations. They include sales without prescriptions, lack of qualified pharmacists, and failure to maintain mandatory drug registers.

 

The Telangana Drug Control Administration (DCA) launched a comprehensive state-wide crackdown on the indiscriminate sale of antibiotics. The operation, aimed at curbing AMR — which the World Health Organization has declared as one of the top ten global public health threats facing humanity — has revealed alarming violations.

 

Raids conducted across 193 medical establishments in multiple districts uncovered medical shops brazenly selling antibiotics without proper prescriptions, operating without registered pharmacists, and failing to maintain mandatory drug registers. The action follows the Kerala government’s recent decision to suspend 450 pharmacy licences and the cancellation of five more in a crackdown on the misuse of antibiotics. The move is part of the state’s Antimicrobial Resistance Strategic Action Plan.

 

The Health Department in Kerala has introduced stricter rules on prescriptions and has already reduced unnecessary antibiotic use by up to 30 per cent.

 

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Widespread regulatory non-compliance

The investigation uncovered multiple layers of non-compliance that paint a troubling picture of antibiotic governance in the state.

 

“Medical establishments were found selling antibiotics without prescriptions from quacks, issuing medicines without proper sale bills, and operating in the absence of qualified pharmacists. Perhaps most concerning was the widespread failure to maintain Schedule H1 Drug Registers and Prescription Registers specifically for antibiotics — critical documentation systems designed to track and monitor antibiotic distribution,” said the DCA in a statement.

“Antimicrobial resistance or AMR is a global health care crisis,” said Shahnawaz Qasim, Director General of the Drug Control Administration.

 

“The WHO has declared that AMR is one of the top ten global public health threats facing humanity. It is estimated by WHO that bacterial antimicrobial resistance was directly responsible for 12.7 lakh global deaths in 2019.”

 

The statistics are particularly sobering for India, which reports among the highest rates of antimicrobial resistance worldwide.

 

What is antimicrobial resistance?

Antimicrobial resistance represents a complex challenge that extends far beyond simple medication misuse. The phenomenon encompasses resistance to antibiotics, antivirals, antifungals, and antiparasitics, with bacterial antibiotic resistance showing the most alarming global increase.

 

When bacteria develop the ability to withstand antibiotic effects, common infections become increasingly difficult or impossible to treat, leading to the emergence of dangerous “superbugs”. "When used incorrectly, bacteria start to acquire resistance to the antibiotics designed to kill them,” Qasim said.

 

“As a result of drug resistance, antibiotics become ineffective and infections become difficult or impossible to treat. When bacteria become resistant, they develop into superbugs which can spread from person to person.”

 

The development of antimicrobial resistance, while a natural evolutionary phenomenon, has been dramatically accelerated by human actions.

Over-prescribing by healthcare providers, inappropriate use in agriculture and livestock, and the unregulated over-the-counter sale of antibiotics have created a perfect storm for resistance development.

 

Need for stronger enforcement

The legal foundation for the current crackdown rests on the Drugs and Cosmetics Act of 1940 and associated rules, which classify antibiotics as prescription drugs under Schedule H and Schedule H1 classifications.

 

These regulations explicitly prohibit the sale of antibiotics without proper medical prescriptions, making the violations discovered during the raids punishable offences.

 

“Antibiotics are prescription drugs,” Qasim said.

 

“Antibiotics cannot be sold by medical shops or pharmacies without the prescription of a qualified doctor. Over-the-counter sale of antibiotics to patients by medical shops and pharmacies is punishable under the Drugs and Cosmetics Act.”

 

The 193 show cause notices issued represent the first step in a systematic enforcement process that could result in significant penalties for violating establishments.

 

The DCA has indicated that appropriate action will be taken in accordance with existing legal provisions, signalling a zero-tolerance approach to antibiotic misuse. DCA also said that the fight against AMR requires coordination across multiple sectors and stakeholders. Healthcare providers must implement rigorous infection prevention and control measures while ensuring antibiotics are prescribed only when necessary and appropriate.

 

The agricultural sector faces pressure to eliminate the use of antibiotics for growth promotion in livestock, poultry, and fish farming.

 

Environmental factors also play a crucial role, with pollution from pharmaceutical manufacturing units and inappropriate disposal of unused antibiotics contributing to resistance development.

 

“Preventing antimicrobial resistance is a complex task and requires a multifaceted approach involving doctors and other health care professionals, regulatory authorities, industries and the general public,” Qasim noted.

 

Beyond enforcement, the DCA has launched an extensive public education campaign emphasising individual responsibility in combating antimicrobial resistance. The educational component emphasises that antibiotics are effective only against bacterial infections, not viral conditions, and stresses the importance of completing full treatment courses even when symptoms improve.

 

The campaign also discourages sharing antibiotics or using leftover medications from previous treatments.

 

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