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Ukraine has approved new standards for the rational use of antimicrobial medicines, covering antibiotics, antivirals, antifungals and antiparasitic drugs, the Ministry of Health said.
The ministry approved two standards — one for primary healthcare and another for specialized medical care. They were developed as part of Ukraine’s state strategy to combat antimicrobial resistance through 2030.
New rules for prescribing medicines
The standards establish common approaches to prescribing, adjusting and stopping antimicrobial therapy.
Under the new rules, an antimicrobial drug should be prescribed only when medically indicated, at the appropriate dose and for the optimal duration.
Each prescription must be documented in the patient’s medical records or electronic healthcare system. Doctors must record the diagnosis or justified suspicion of an infection, the active ingredient, dosage, method of administration, treatment duration and the date when the therapy will be reviewed.
Antibiotics may be prescribed only for confirmed or reasonably suspected bacterial infections.
Doctors will use the WHO AWaRe classification, which divides antibiotics into three groups: Access, Watch and Reserve.
Antimicrobial medicines may not be prescribed simply at a patient’s request when there is no medical indication.
In specified cases, bacteriological testing should be performed before antibiotics are started, with treatment subsequently adjusted according to the susceptibility of the identified pathogen.
Antibiotic therapy must also be assessed 48–72 hours after treatment begins. If a bacterial infection is not confirmed or another diagnosis is established, the antibiotic should be discontinued.
Patients must be informed in clear language about the reason for treatment, dosage, duration, possible side effects and what to do if their condition worsens.
Primary healthcare
The primary-care standard includes recommendations for treating common bacterial infections in adults and children and allows doctors to issue a delayed prescription.
Under this approach, a patient begins taking an antibiotic only if specified symptoms appear, the condition worsens or a bacterial infection is confirmed.
Specialized care
The specialized-care standard covers both outpatient and inpatient treatment.
It requires the use of laboratory results and local antibiograms, clinical pharmacist oversight and prior approval for the use of Reserve antibiotics.
It also recommends switching from intravenous to oral administration as soon as the patient’s condition allows.
Emergency treatment remains unchanged
The Ministry of Health stressed that the standards must not delay emergency treatment.
In cases of a well-founded suspicion of septic shock, antibiotic therapy should begin within the first hour, immediately after samples are collected for bacteriological testing.
Compliance will be monitored through defined quality indicators.
At the primary-care level, the ministry recommends that at least 90% of prescribed antibiotics belong to the Access group, while the use of Reserve antibiotics should be 0%.
For specialized care, the recommended share of Reserve antibiotics is 0% in outpatient settings and below 2% in hospitals.
