|What is the role of the Nepalese pharmacist
in promoting rational antibiotic use?
From June 16-July 1, 1998, the Society for Infectious Diseases
Pharmacists (SIDP) sponsored a US-based pharmacist to work with the APUA's Project Manager in Nepal to assess the
role of pharmacists in antibiotic resistance monitoring in Nepal. The itinerary included stops at United Hands
to Nepal, the Department of Drug Administration, Nepal Health Research Council, Kathmandu University, Patan Hospital,
Tribuhaven Teaching Hospital and Nepal Medical College.
The goal of this trip was to understand pharmacists' role in the Nepalese healthcare system. In many countries,
such as the United States, the pharmacist plays a significant role in the rational use of antibiotics. Through
interviews with key healthcare professionals in the pharmacy arena, this brief visit provided an initial overview
of the Nepalese pharmacy system. Key recommendations stemming from this visit, which will be followed up on by
APUA, SIDP and APUA-Nepal, are summarized below.
According to the Department of Drug Administration (DDA), the majority of pharmacists in Nepal work in an industrial
or government setting. None of the 104 pharmacists are in a retail setting. Shopkeepers, who have a minimum of
10 years of education plus 2 years of training, which is equivalent to a high school education in the United States,
run the retail pharmacies. Very few pharmacists work in hospitals.
The DDA is making an effort to improve the education of the shopkeepers, but at the same time, the DDA is developing
a plan to gradually transition towards replacing the shopkeepers with trained pharmacists. This process will take
time to achieve public acceptance because shopkeepers who dispense drugs in the retail environment are currently
not as highly regarded as pharmacists. Placing trained pharmacists in a retail setting, however, will eventually
provide better control of antibiotic use and will also allow for counseling and education of patients.
Officials at the DDA are slowly implementing plans to improve pharmacy services and promote rational drug use throughout
the country. The most important recommendation is to continue to educate and disseminate information to the pharmacists
on the importance of prudent use of antibiotics and to suggest methods to curb the spread of antimicrobial resistance.
Other recommendations would be to encourage pharmacists to take part in educating their peers and the community,
as well as move pharmacists into retail settings.