Strict rules target antibiotics abuse

Doctors and pharmacists who are found overprescribing antibiotics to patients are to be stripped of their licenses to prescribe the drug, according to China's new health regulations.

On Tuesday, the Ministry of Health issued the management provisions on the clinical application of antibiotics, which will take effect on Aug 1. The provisions aim to clamp down on the overuse of antibiotics by hospitals nationwide.

The rules put antibiotics in three categories - non-limited, limited and special antibiotics - depending on their cost, side effects and incidence of drug resistance. Doctors and pharmacists will be required to receive training and pass exams, and will only be able to acquire the antibiotics prescription rights granted for their own level of professional qualification.

Those who prescribe excessive antibiotics or prescribe antibiotics that are beyond their prescription rights - except in emergencies - more than three times, may have their prescription rights limited. If such behavior has serious consequences, even once, they will be deprived of their prescription rights.

Also, the regulations forbid special antibiotics from being prescribed to outpatients.

It asks medical administrative authorities at provincial levels to formulate their own catalog of antibiotics, according to its classification standards. Medical institutions should follow the catalog when they purchase and prescribe antibiotics.

In the regulations, the Ministry of Health says it will set up a nationwide network to watch the use of antibiotics by medical institutions and cases of drug resistance. It asks provincial medical authorities to set up their own such networks, which will be integrated into the national one.

These regulations apply "to medical institutions of all grades and all kinds".

The overhaul of medical institutions to check for antibiotics abuse has seen a positive outcome, said Wang Yu, head of the department of medical administration of the Ministry of Health. "From the inspection of more than 400 hospitals of Grade 2 and above, the proportion of antibiotics in prescriptions for outpatients dropped from 27.8 percent in 2006 to 15 percent in 2011," said Wang. "And the rate of antibiotics use for inpatients in these hospitals dropped from 80.5 percent to 58 percent in 2011."

Xiao Yonghong, an expert in epidemics at the First Affiliated Hospital of Zhejiang University, said the regulations were a very important part of the legislative effort to keep antibiotics abuse at bay. "It will guide the efforts to limit antibiotics use through a legal aspect," he said.

"However, the regulations are just the first step. We need a way to ensure that hospitals will obey them in the long run," Xiao said. He said he believed that because many hospitals rely on drug sales as an important part of their revenue, it is a main cause of antibiotics abuse. "Also, doctors need to know more about (the side effects of) antibiotics to reduce the number of prescriptions."

Zou Xiaofang, a doctor working at the burns department of the Air Force General Hospital, who said he uses relatively strong antibiotics for critical cases, said, "The key is implementation. Of course, it's a good thing, if the regulation can be implemented."

Contact the writer at wangqingyun@chinadaily.com.cn