Genesis of Antibiotic Resistance XXI Non‐Existent F‐Tag‐428 implementation in developing countries, exacerbate genesis of antibiotic resistance (AR)

As per the American Society of Consultant Pharmacists (ASCP) mandated guidelines, the F428: Category = Quality of Care, drug regimen review is a prime requirement to avoid prescription drug induced and unforeseen clinical outcomes in patient care. The clinical directive by the ASCP is that the drug regimen of each resident must be reviewed at least once a month by a licensed pharmacist. Surveys and data analysis conducted in developing countries in regard to rural patient care, rehabilitation centers, hospice care, and physicians in private practice concerning the relevance of tag F‐428 and the antibiogram of each patient show that F‐428 is an almost fictitious concept. Prominent pharmacies and pharmacists along the border regions of the United States and Mexico and in developing countries such as India and Nigeria that are strongly influenced by United Kingdom, acknowledge a genuine lack awareness of F‐tag‐428 principles and the necessity for its implementation. The survey data indicates that pharmacists in these developing regions are not part of the clinical decision making process for antibiotic prescription and physicians who are in private practice are not mandated to keep record of antibiotic prescriptions. Information concerning individual culture sensitivity assay results are on file. There do exist prevailing and synergistically compounding factors that make implementation of F‐428 a futile exercise in developing countries. The following factors are considered derogatory to F‐428 implementation; the inappropriate prescription of antibiotics by physicians, poor compliance by patients, the over‐the‐counter availability of antimicrobials as a nonprescription commodity, patient ‐ time pressures, purulent discharge, diagnostic and treatment uncertainties, no availability of a rapid and low cost antibiotics, culture and sensitivity, lack of facilities for conducting antibiogram in rural settings, lack of antibiotic guidelines, inadequacy or absence of regional laboratories to provide periodic and continuing information concerning antibiotic resistance, patient requests and expectations, patient literacy regarding antibiotics (principally women), patient pressure for antibiotics prescriptions for the abatement and expeditious relief from infectious disease, and tenuous pathways for maintaining the continuing medical education requirement for physicians (Medicos with MBBS and M.D.) F428 implementation goals contrasted with the above program frustration, and in consideration of present data analysis irrefutably indicate that antibiotic usage in developing countries poses imminent risk factor for Antibiotic Resistance Pandemic (ARP). Data analysis and adequate literature sources will be presented at EB 2017. Support or Funding Information Professional development funds to Subburaj Kannan