Back to Previous Page Print this Page APUA: Alliance for the Prudent Use of Antibiotics http://www.apua.org

Nepal Nepal has organized a core group of Nepali medical and scientific professionals committed to APUA's mission and to cooperating and sustaining related projects. The group consists of representatives of key interest groups such as DDA, Tribhuvan University. In the summer of 1997, APUA piloted a surveillance project which has identified major technical barriers and developed a model for surveillance of antibiotic resistance in remote areas. The pilot identified important considerations that need to be part of a viable surveillance structure in Nepal and other developing countries. A surveillance software package that is being developed will facilitate the surveillance there. APUA has established arrangements for a lease of space for an office and laboratory in Khatmandu, and has arranged for a part time coordinator to lay the groundwork for a culturally sensitive program which will identify and involve in-country resources for antibiotic resistance surveillance. The chapter has a proposal for an antibiotic resistance surveillance and intervention program and is planning a workshop for emergency room doctors in the hospitals. The Nepal government spends 42% of the national health budget on drugs, and international donors spend nearly three times as much. Drug distribution and use in Nepal is largely unregulated and the pharmaceutical industry is a major and growing market. 80% of the drugs are purchased outside of the government-supplied health system, mostly through private retail shops and pharmacies. Nine thousand druggist shops in 75 districts supply 80% of the drugs. Even when antibiotics are prescribed, they are not used correctly. 72% of all drug prescriptions are in non-compliance with standard norms, and 38% of patients misunderstood dosage and administration requirements. Ciprofloxacin is becoming the treatment of choice for physicians, drug sellers and the public. Although valid research on antibiotic resistance in Nepal is limited, there have been several studies noting multidrug resistant tuberculosis, methicillin-resistant Staphylococcus aureus, and resistance of V. cholera to tetracycline and H. pylori to amoxicillin and tetracycline. The most up-to-date surveillance analysis of antibiotic resistance in Nepal is being conducted by APUA with a pilot recently completed in the summer of 1997. These results are being compiled and will be presented at the American Society for Microbiology meeting in May. Information on antibiotic supply and distribution and resistance patterns is minimal. Upcoming International Chapter Events

DISCLAIMER: The Alliance for the Prudent Use of Antibiotics accepts no legal responsibility for the content of any posted information, nor for the violation of any copyright laws by any person contributing to this website. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by APUA in preference to others of a similar nature that are not mentioned. The material provided by APUA is designed for educational purposes only and should not be used or taken to be offered as medical advice. APUA is not engaged in rendering medical services.