Availability of national data on AMR is limited and is only reported by thenational referral hospital and two regional referral hospitals. Only three referralhospitals have microbiology culture facilities. Drug resistance in Acinetobacter,E.coli, Pseudomonas, Salmonella, staphylococcus aureaus are increasinglybeing reported. A national comprehensive plan on AMR has been draftedand a national focal point on AMR has been designated. The Drug TechnicalAdvisory Committee (DTAC) functions as a multisectoral steering committee.A national programme for surveillance of AMR has been initiated in the threeregional referral hospitals and is slowly picking up since Jan 2014. The needis being felt to expand microbiology laboratory network to produce evidencebaseddata and strengthen national AMR surveillance. There is no nationallycoordinated collective mechanism for regular data collection, analysis, anddissemination. Though it is done it is not very regular. Educational activitiesfor prescribers have been initiated. Physicians were trained on writing rationalprescriptions. There is a system of prescription audit at tertiary hospitals but itis not antibiotic-specific. As per a drug usage study, expenditure on antibioticsprescribed through form II is quite high. Approximately 30% of the drug budget ison antibiotics. Every third prescription coming to the pharmacy has an antibiotic.The Drug Regulatory Authority (DRA) of Bhutan through legislation regulates theproduction, distribution, prescription and sale of antimicrobial agents. There islegislation banning over-the-counter sale of selected antimicrobial agents. Noantibiotics are sold without prescription. Hospitals have a policy for rational useof antimicrobials. There is a draft national policy for antibiotic use in humans.National guidelines on antibiotics were developed in 2007 and revised in 2012.Educational products are being distributed to communities, consumers, andprescribers. Laboratory capacity infection control practices and antimicrobialstewardships in hospitals need further strengthening.
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