1. 1. AWaRe Classification of Antibiotics

      • The 5th edition incorporates the WHO AWaRe (Access, Watch, Reserve) classification of antibiotics. DG Drug Administration+2pdfcoffee.com+2

      • According to DGDA, this was the first time this classification was officially adopted in a national formulary in Bangladesh. DG Drug Administration

      • This change is significant for antimicrobial stewardship — it helps prescribers understand antibiotic risk categories and encourages more rational antibiotic use.

   2. Updated Essential Drugs List

      • The formulary marks “essential drugs” (ED) explicitly. pdfcoffee.com

      • The essential drug list referenced has been revised/updated (the formulary notes that the national essential medicines list was revised in 2016). pdfcoffee.com

   3. Expanded Content / Size

      • The 5th edition is quite comprehensive (924 pages per the WHO downloadable PDF). World Health Organization

      • Given the page count and the inclusion of AWaRe, it's likely that many drugs were re-evaluated, re-categorized, and possibly new ones added.

   Interpretation & Implications

   • Antibiotic Stewardship: The adoption of AWaRe is especially important because it aligns Bangladesh’s drug reference with global practices for monitoring and optimizing antibiotic use.

   • Rational Prescribing: By clearly marking essential medicines (ED) and providing updated drug information, the formulary supports more rational prescribing — which is critical for both cost-effectiveness and patient safety.

   • Policy & Regulation: DGDA’s move to incorporate AWaRe in the national formulary suggests a stronger regulatory and policy push toward controlling antimicrobial resistance.

1. The Bangladesh National Formulary 2019 is the fifth edition of the country’s official pharmaceutical reference, published by the Directorate General of Drug Administration (DGDA) to promote rational, safe, and cost-effective use of medicines nationwide. This formulary compiles updated, evidence-based information on drugs commonly used in Bangladesh, including their therapeutic uses, recommended dosages, contraindications, cautions, drug interactions, side effects, and available commercial preparations. Organized into major therapeutic categories, the book allows healthcare professionals to quickly access essential prescribing information.

   A significant feature of the 2019 edition is the inclusion of the WHO AWaRe classification of antibiotics—introduced in Bangladesh for the first time—to strengthen antimicrobial stewardship and address rising antimicrobial resistance. Medicines listed as Essential Drugs (ED) are clearly marked to guide priority prescribing in line with national health policy. The formulary also provides regulatory guidance on controlled drugs, prescribing rules, and safe medication practices.

   Serving as a comprehensive and authoritative resource, the BDNF supports physicians, pharmacists, nurses, and medical students in making evidence-based clinical decisions. By standardizing medicine information across the healthcare system, it plays a crucial role in enhancing treatment quality, reducing medication errors, and supporting public health initiatives in Bangladesh.

1. Strengths / Positives:

   1. Antimicrobial Stewardship

      • The inclusion of the WHO AWaRe classification is a big plus. DGDA adopted it in BDNF 2019 to better regulate and monitor antibiotic use. DG Drug Administration

      • This aligns the national formulary with global frameworks and helps guide prescribers in responsible antibiotic use.

   2. Comprehensive & Contextualized Drug Information

      • The formulary provides detailed prescribing information tailored to the drugs available in Bangladesh. World Health Organization+1

      • It’s very useful for clinicians, pharmacists, nurses, and students who need locally relevant, authoritative drug information.

   3. Regulatory Support

      • Having a national formulary published by DGDA gives legitimacy and consistency across the healthcare system.

      • It helps standardize prescribing practices, potentially reducing medication errors and irrational drug use.

   4. Educational Utility

      • For medical education and training, BDNF 2019 is an excellent reference: it can be used in pharmacology, pharmacy, and clinical teaching.

      • It supports evidence-based prescribing and rational drug therapy, contributing to better patient safety.

   Criticisms / Challenges:

   1. Accessibility and Updates

      • While BDNF is a rich source of information, there might be limitations in how frequently it’s updated (a common challenge for national formularies).

      • Some past commentary (from older versions) noted capacity issues within regulatory bodies to keep the formulary fully up-to-date. app.bangladeshhealthwatch.org

   2. Implementation Gaps

      • Having the AWaRe classification is valuable, but its real-world impact depends on how well prescribers, pharmacies, and regulatory authorities enforce or adopt those guidelines.

      • There is potential for divergence in prescribing practices if clinicians do not regularly refer to or trust the formulary, especially in private settings.

   3. Limited Critical Scholarly Review

      • There seems to be a lack of in-depth, peer-reviewed academic critique specifically targeted at BDNF 2019. This makes it harder to assess its weaknesses or missed opportunities from a research or public-health policy perspective.

   Overall Assessment:

   • The BDNF 2019 is a very strong and essential reference tool for Bangladesh’s healthcare system. Its adoption of the AWaRe antibiotic classification marks a progressive step in national drug policy.

   • As a prescribing and regulatory guide, it holds great potential to improve rational medicine use, enhance patient safety, and align prescribing practices across the country.

   • However, for maximum benefit, it needs to be actively used, regularly updated, and integrated into both clinical practice and health system regulation.

1. The Bangladesh National Formulary 2019 (BDNF) is the official reference guide for medicines used in Bangladesh, published by the Directorate General of Drug Administration (DGDA). It provides up-to-date information on drug indications, dosages, side effects, precautions, interactions, and available formulations. The 5th edition includes the WHO AWaRe antibiotic classification and highlights Essential Drugs (ED) to promote safe, rational, and cost-effective prescribing. Designed for doctors, pharmacists, nurses, and students, the BDNF serves as a reliable and standardized resource for improving patient care across the country.

1. • Official National Drug Reference
     Published by DGDA as the standard guide for safe and rational use of medicines in Bangladesh.

   • WHO AWaRe Classification Included
     First BDNF edition to adopt Access–Watch–Reserve antibiotic categories for antimicrobial stewardship.

   • Essential Drugs (ED) Marked
     Clearly highlights medicines on the National Essential Medicines List.

   • Comprehensive Drug Information
     Provides indications, dosage, contraindications, side effects, cautions, interactions, and available strengths.

   • Therapeutic Class Arrangement
     Drugs organized into major therapeutic groups for easy reference.

   • Prescribing Guidance Section
     Includes practical guidelines for rational prescribing, dose adjustment, and safe drug use.

   • Controlled Drug (CD) Marking
     Special identification and regulatory guidance for narcotic and psychotropic medicines.

   • Bangladesh-Specific Content
     Contains brand names, formulations, and drug availability relevant to the local healthcare system.

   • Evidence-Based & Updated
     Aligned with current national and international drug standards and treatment guidelines.

   • Supports Healthcare Professionals
     Designed for doctors, pharmacists, nurses, and students as a quick and reliable reference.

The Bangladesh National Formulary 2019 (BDNF) is the official drug reference book of Bangladesh, published by the Directorate General of Drug Administration (DGDA). It provides updated, evidence-based information on commonly used medicines, including indications, dosages, precautions, interactions, side effects, and available formulations. The 5th edition introduces the WHO AWaRe classification of antibiotics for the first time in Bangladesh to promote rational antibiotic use and combat antimicrobial resistance. It highlights Essential Drugs (ED) and includes guidelines for safe, effective, and cost-efficient prescribing. Designed for physicians, pharmacists, and healthcare workers, BDNF 2019 serves as a national standard for rational drug therapy and supports improved patient care across the country.

The Bangladesh National Formulary 2019 (BDNF), 5th edition, is a comprehensive national reference developed by the Directorate General of Drug Administration (DGDA) to promote safe, rational, and cost-effective use of medicines across Bangladesh. This edition integrates updated pharmaceutical and therapeutic information consistent with national regulations and international guidelines. A major advancement in the 2019 formulary is the incorporation of the WHO AWaRe classification of antibiotics—introduced for the first time in Bangladesh—to strengthen antimicrobial stewardship and support the national response to antimicrobial resistance.

The formulary provides standardized prescribing information, recommended dosages, contraindications, side effects, and essential precautions for commonly used medicines, highlighting those listed as national Essential Drugs (ED). It also aligns with the revised National Essential Medicines List and includes updated therapeutic guidelines to assist physicians, pharmacists, nurses, and other healthcare professionals in clinical decision-making. With expanded content, clearer formatting, and evidence-based recommendations, the BDNF 2019 serves as the authoritative source for rational drug therapy in Bangladesh and plays a vital role in ensuring patient safety, optimizing treatment outcomes, and guiding public health policy.

The Bangladesh National Formulary (BDNF) is an official publication of Directorate General of Drug Administration (DGDA), Ministry of Health and Family Welfare (MoHFW), Government of the People Republic of Bangladesh. The BDNF aims to provide prescribers, pharmacists, and other healthcare professionals with sound up-to-date information about the use of medicines.

The BDNF includes key information on the selection, prescribing, dispensing and administration of medicines that are generally prescribed and available in the local market that support the health care providers to offer the most effective drug therapy. The 5th edition of BDNF comprises sound and updated information about the use of drugs with their properties such as presentation, dosage and administration, side effects, cautions, indications, contraindications, proprietary preparations etc. to physicians, pharmacists and other healthcare professionals. Such a comprehensive information is very important and inevitable for public health care and will help physicians to know the efficacy, price, risks and other information about a drug before prescribing. The latest edition includes a comprehensive list of temperature sensitive drugs, drug-food interactions and side effects of some-common drugs.

Bangladesh is conscious of the growing concems over antimicrobial resistance (AMR) and DGDA is committed to take necessary steps towards combating it. DGDA has a major role in the National Action Plan (NAP) to control AMR. Fighting AMR requires the collaboration of many stakeholders working in the human and animal health sectors. From DGDA side, additional vigilance is exercised over the quality and use of antimicrobial drugs. To promote better prescribing practices, the WHO Access, Watch and Reserve (AWaRe) classification of antibiotics as per 20th WHO model list of essential medicines has been incorporated into the 5th version of BDNF. The relevant section of the WHO model essential medicines list has been included (Appendix 21) for reference and to promote better understanding and awareness to combat AMR:

The Information in the BDNF is composed from Directorate General of Drug Administration, Directorate General of Health Services, the manufacturers product literature, medical and pharmaceutical literature, and professional bodies, Advice is constructed from clinical literature and reflects, as far as possible, an evaluation of the evidence from diverse sources. The BDNF also takes account of authoritative national guidelines and emerging safety concern. The editorial team receives advice on all therapeutic areas from expert clinicians on respective areas; this ensures that the BDNF's recommendations are relevant to practice.