Ukraine's Ministry of Health has approved two new standards for the rational use of antimicrobial medicinal products. According to RBC-Ukraine, citing the ministry's press service, the documents cover not only antibiotics but also antiviral, antifungal, and antiparasitic drugs. The Ministry of Health says the standards were developed to implement the State Strategy for Combating Antimicrobial Resistance through 2030 and establish a unified approach to prescribing, adjusting, and discontinuing antimicrobial therapy.
Two standards: primary and specialized care
The approved documents divide the rules for using antimicrobial agents by level of medical care — primary and specialized. A separate standard is provided for each level: the first governs the procedure for prescribing and initiating treatment under primary care conditions, while the second covers the use of antimicrobial agents in specialized (inpatient and outpatient) settings. The ministry emphasizes that the new rules must not delay emergency treatment: when there is a justified suspicion of septic shock, antibiotic therapy must be started within the first hour, immediately after the sample is taken for bacteriological testing.
Fighting resistance: why restrictions are needed
The key goal of the standards is to counter antimicrobial resistance (AMR), which arises when microorganisms stop responding to the drugs intended to fight them. As a result, infections become harder to treat, and the risks of complications and severe outcomes increase. That is why an antimicrobial agent may now be prescribed only for a confirmed or reasonably suspected bacterial infection, and prescribing "at the patient's request" without medical indications is explicitly prohibited.
Written justification and the WHO AWaRe classification
The core principle of the introduced changes is that every prescription must be recorded in the medical documentation or the electronic health system. The doctor is required to specify the diagnosis or a justified suspicion of infection, the name of the active substance, the dose, the route of administration, the duration of treatment, and the date of its review. For selecting antibiotics, the ministry says the WHO AWaRe classification will be applied, which divides drugs into three groups: "access," "watch," and "reserve." This is intended to help use the most effective agents rationally and preserve them for cases when no alternatives exist.
Monitoring effectiveness and patient rights
The standards provide for a mandatory assessment of antibiotic therapy effectiveness 48–72 hours after it begins. If a bacterial infection is not confirmed or another diagnosis is established, antibiotic use must be stopped. In addition, a principle of mandatory patient information has been introduced, requiring that the prescription, the goals, and the duration of therapy be explained in plain language. Compliance with the new standards will be monitored through a system of quality indicators, with separate metrics established for specialized care depending on the conditions in which medical care is provided.
Recall that the Ministry of Health previously expanded the service for searching the cheapest medicines, simplified access to drugs in small villages and communities near the front line, and allowed the sale of a range of drugs at Ukrainian gas stations. The new antimicrobial therapy standards are the next step in the systematic work on the quality and safety of pharmaceutical care.
