Chijioke Iremeka
As Nigeria battles antimicrobial resistance, microbiologists and pharmaceutical experts have demanded strong actions to discourage drug outlets from selling antibiotics to individuals without prescription sheets.
They said antibiotics should be among prescription drugs and not be dispensed over-the-counter to patients.
The experts also called for policy statements to back up their stance.
Speaking exclusively with PUNCH Healthwise in different interviews, they said with such a policy statement, the country would have solved the problem of antibiotic abuse and overuse to a significant level.
According to the World Health Organisation AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death.
WHO noted that as a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
The global health body noted that AMR is one of the top global public health and development threats, estimating that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.
WHO stated that misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens, which affects countries in all regions and at all income levels.
It further noted that AMR’s drivers and consequences are exacerbated by poverty and inequality, which put many gains of modern-day medicine at risk.
“AMR makes infections harder to treat and makes other medical procedures and treatments such as surgery, caesarean sections and cancer chemotherapy much riskier,” the UN agency added.
Speaking against this background, a Professor of Clinical Microbiology at the Benue State University, Godwin Jombo, urged the government to put a policy in place to discourage pharmacies and other drug outlets from selling antibiotics to the public without prescriptions from a physician.
According to him, antibiotics are special drugs and should be prescribed on a sheet and dispensed by pharmacists to only people with doctor’s prescriptions.
He said, “Antibiotics are prescription drugs and people shouldn’t have access to it at will as it increases antibiotic abuse and overuse. This also increases the burden of antimicrobial resistance in the country.
“Selling of this class of medicine over the counter should be discouraged. We need a policy that will ensure that only those with prescription sheets can buy antibiotics. With this, we would have addressed the problem of AMR halfway.”
Also speaking, a pharmacist and the Managing Director/Superintendent Pharmacist of Engraced Pharmacy, Jonah Okotie, also maintained that antibiotics should be a prescription drug.
On why these drugs are sold over the counter, he said, “This boils down to ethical practice. Professionals should know where to draw the line. It is not about the pharmacy, doctors, or healthcare officers; it is about being professional and ethical in what we do.
“In practice, there is what is called self-care. There is a first level of care, a second level of care and a third level of care. At each level, there are medications that are allowed for each of those levels. So it is about following the steps.
“Antibiotics are not something anybody can just walk into the pharmacy and be able to get. But you and I know that unregistered drug stores sell all manner of antibiotics. And this is where I will call the regulatory bodies out.
“If the regulatory bodies are doing what they are supposed to do, we will not be having this conversation. There should be a basis before one gives antibiotics out. If a particular drug falls within the pharmacy-generated list, then I should be able to dispense at that point. But if it’s only prescription medication,, I shouldn’t.
“But the problem is that some doctors will have some of these prescription drugs under their tables and the drugs are not going out. You can’t be a judge in your case and that is why everybody has their responsibilities.
“As a doctor, when you send a patient for laboratory examination and the patient returns with a result, based on your findings, you make a prescription. That prescription should go out and the pharmacist should look at it and dispense accordingly.
“If there is any issue with the prescription, the pharmacist should find a way to reach out to the person who wrote the prescription and make suggestions. With that, the expert will be able to make the best choice based on what he or she is treating. So, antibiotics shouldn’t be a drug that everybody has access to.”
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