New rules for prescribing antibiotics have been approved in Ukraine: what will change for doctors and patients

This was reported by the press service of the Ministry of Health of Ukraine.

What standards have been approved?

The Ministry of Health has introduced separate standards for:

• • primary health care;

• • specialized medical care.

The documents were developed within the framework of the State Strategy for Combating Antimicrobial Resistance until 2030.

The new rules should make the treatment of infections more effective and safer, and curb the spread of antimicrobial resistance.

This phenomenon occurs when microorganisms stop responding to the drugs used to fight them. This makes infections more difficult to treat and increases the risk of severe disease and complications.

How will drug prescribing change?

Antimicrobial drugs should be prescribed only for clear indications, in the required dose and for the optimal duration.

Each prescription will need to be justified in writing in the medical record or electronic health system.

“The doctor must indicate the diagnosis or reasonable suspicion of infection, the name of the active substance, dose, method of administration, duration of treatment, and the date of its review,” the Ministry of Health explained.

Antibiotics will only be allowed to be prescribed for a confirmed or reasonably suspected bacterial infection.

To select them, the WHO AWaRe classification will be used, which divides antibiotics into three groups: access, surveillance, and reserve.

Doctors will also be prohibited from prescribing antimicrobial drugs only at the patient’s request, unless there is a medical indication for this.

In certain cases, bacteriological testing will be performed before starting antibiotic therapy. Once the results are received, treatment will be adjusted as needed based on the sensitivity of the pathogen.

The effectiveness of antibiotic therapy will be assessed 48–72 hours after starting treatment. If a bacterial infection is not confirmed or another diagnosis is made, the antibiotic should be discontinued.

The patient should also be informed in understandable language about the reason for prescribing the drug, dosage, duration of treatment, possible side effects, and actions to take in case of worsening of the condition.

What does the standard for primary care provide?

For primary care, the new standard includes recommendations for the treatment of common bacterial infections in adults and children.

The doctor may also use a delayed prescription. In this case, the patient begins taking the antibiotic only after the symptoms determined by the doctor appear, the condition worsens, or the bacterial nature of the disease is confirmed.

What will change in specialized care?

The standard for specialized care regulates the use of antimicrobials in both outpatient and inpatient settings.

It involves the use of laboratory test results and local antibiograms, control of prescriptions by clinical pharmacists, and prior approval of the use of reserve antibiotics.

The patient should also be switched from intravenous to oral administration of the drug as soon as their condition allows.

How will compliance with the rules be monitored?

The Ministry of Health emphasized that the new standards should not delay emergency treatment.

“In particular, in case of reasonable suspicion of septic shock, antibiotic therapy must be started within the first hour – immediately after taking the material for bacteriological examination,” the department specified.

Compliance with standards will be assessed using special quality indicators.

At the primary care level, it is desirable that at least 90% of prescribed antibiotics belong to the access group, and the proportion of reserve drugs is 0%.

For specialized care, separate indicators have been established depending on the treatment conditions. The share of reserve antibiotics should be 0% in outpatient settings and less than 2% in inpatient settings.