13:17 19.11.2019

E-prescription and reimbursement can be an effective tool in the fight against antibiotic resistance - experts

4 min read

The electronic prescription and the mechanism of reimbursement of the cost of antibiotics can be effective tools in the fight against antibiotic resistance.

This was the conclusion of the conference "Resistance to antibiotics and microbiomes: what will happen if bacterial infections become incurable", held at the second International Congress "The rational use of antibiotics in the modern world of Antibiotic resistance stop!" in Kiev. The conference was organized by the Biocodex Microbiota Institute - the first international platform for posting information on human microbiome.

"If there is no prescription, then there is always the temptation to release an antibiotic without a prescription. An electronic prescription will simplify the task of monitoring the prescription of antibiotics, random appointments and their use," said the head of the Department of Pharmacology of the National Medical University named after Bogomolets Anna Zaichenko. She noted that doctors "must do everything for correctly executing prescription for the antibiotic".

Zaychenko also emphasized that in order to combat antibiotic resistance it is important not to allow a generic replacement of drugs prescribed by a doctor. "This is an important point because the bioequivalence of antibiotics is poorly understood. In the best case, only one generic antibiotic has a proven bioequivalence, many generic manufacturers do not want to do this," she said.

In addition, Zaichenko noted that primary care physicians and pharmacists often do not have the skill to present information about adverse reactions to the use of drugs, including antibiotics. "Our task is to teach primary care doctors and pharmacists how to do this," she said.

In addition, according to Zaichenko, there is a problem of industrial use of antibiotics, which leads to the fact that a significant amount of antibiotics enters the human body from food, not from drugs.

In turn, the dean of the faculty of pediatrics Shupyk National Medical Academy of Postgraduate Education Marina Mamenko emphasized that "the less we use antibiotics to treat common respiratory infections, the more tools we have left to save patients."

"The fact that antibiotics can be bought without a prescription is a disaster, that cannot be justified either by the war, - but by a difficult economic situation," she said. Mamenko also noted the importance of following the doctor’s prescriptions.

"If the doctor says that you need to protect the microbiome, then you need to listen to the doctor. The patient needs to be told that not only the antibiotic prescribed by the doctor should be taken, but also the probiotic prescribed by the doctor. Because only the doctor understands the situation how which drug works, "she said. The expert also noted the problem of the lack of standards for probiotics.

For his part, the head of the Department of Gastroenterology, Dietetics and Endoscopy Shupyk National Medical Academy of Postgraduate Education Natalya Kharchenko noted that "bacteria are this form of life, without which we will not survive, and by prescribing antibiotics, we destroy it."

“Already after the first antibiotic intake, the microflora will never be the same as it was originally, each antibiotic intake will lead to significant changes in the microflora, and one should not hope that taking beneficial bacteria will help correct dysbiosis. No matter what beneficial bacteria we prescribe, they do not will take root and will be excreted from the body. Only its strong flora will push out the pathogenic, "she said.

In turn, Ivan Galuskov-Balter, a member of the administrative board of the World Alliance Against Antibiotic Resistance (WAAAR), urged Ukraine to join this organization and emphasized that, with the unreasonable and uncontrolled use of antibiotics, therapies in many cases are ineffective.

“World experience shows that in some countries the costs of fighting antibiotic resistance are comparable to defense spending. By 2050, antibiotic-resistant superbacteria will kill 10 million people a year worldwide,” she said.

Galuskova-Balter emphasized the need to tighten control over the appointment and use of antibiotics, as well as the effectiveness of the reimbursement mechanism in this matter.

"Reimbursing allows you to control the use of antibiotics. This is a very effective tool to ensure that doctors are responsible for prescribing the drug, and patients do not self-prescribe and self-medicate," she said. The expert noted that the additional cost of treating antibiotic-resistant infections in the world is $ 20 billion per year.

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