Rx Vision: An artificial intelligence enabled digital tool helping promote responsible antibiotic use in Bangladesh

Misuse and overuse of antibiotics are major drivers of antimicrobial resistance, posing human, animal and environmental health threat worldwide. In Bangladesh widespread use of fluoroquinolones has become a concern with studies reporting high levels of Ciprofloxacin resistant Escherichia coli, in poultry and humans. The concerning fact is Ciprofloxacin, a synthetic broad-spectrum fluoroquinolone is commonly used to treat infections such as urinary tract infections caused by E. coli, which are frequent in pregnant women. In a densely populated country like Bangladesh with high density of livestock and poultry, now actions are required at every level from farmers to medicine sellers to human and animal health professionals by promoting prudent use of antibiotics and preventing dispensing of antibiotics without valid prescriptions issued by registered veterinarians and human doctors.

To support the effort, FAO Bangladesh One Health Program developed Rx Vision – an artificial intelligence (AI) based mobile application that helps veterinary medicine sellers document and support prescription-based dispensing of fluoroquinolones. The app can transcribe prescription information from photographs within seconds. It uses AI-based handwritten text (Bangla/English) recognition and text classification to detect and process prescription information from uploaded prescription images from local device storage. 

The concept is simple: when a farmer presents a valid prescription for fluoroquinolones, the medicine seller photographs and submits it through Rx Vision. If the farmer has no valid prescription but requesting fluoroquinolones, the seller encourages the farmer to obtain one or facilitates access to a Bangladesh AMR Response Alliance (BARA) veterinarian for telemedicine support with a valid prescription based on Standard Treatment Guidelines of Bangladesh.

Initially focused on the fluoroquinolones use in poultry sector, this point-of-sale intervention has potential for using in large animal and human health sector and helps to support compliance with prescription requirements for antibiotics in Bangladesh. It can generate evidence on antimicrobial prescribing and dispensing patterns, identify geographic and seller-level trends, strengthen accountability at the point of sale.

A medicine seller sees an opportunity

In May 2025 Rx vision was first piloted in Rajshahi under the Upazila-to-Community (U2C) – Bangladesh AMR Response Alliance (BARA) initiative, with the Department of Livestock Services. MD Selim, owner of Selim Enterprise in Rajshahi, was among the first medicine sellers to use Rx Vision. Through his experience with the application, he saw an opportunity to serve society with greater accountability.

His experience also highlighted an important practical issue: most of the farmers visit medicine shops without a valid prescription. Instead of simply dispensing the antibiotic, a seller can facilitate communication between a farmer and a veterinarian. The process connects three key actors-farmers, veterinarians and medicine sellers and makes responsible antibiotic use more achievable at community level.

From a pilot to wider adoption

After the successful piloting, MD Selim highlighted the need to aware and include other medicine sellers through a workshop. FAO in collaboration with DLS organized a workshop in October 2025 with participation of representatives from Drug Administration (DGDA), DLS officials, veterinarians and medicine sellers. All participating medicine sellers voluntarily committed to using Rx Vision.

“As medicine sellers, we have an important responsibility to make sure antibiotics are not used without proper veterinary advice. Rx Vision makes it easier for us to check and document prescriptions, while helping farmers connect with veterinarians when they need guidance.”  

MD Selim, owner of Selim Enterprise in Rajshahi.
Photo credit: Saikat/FAO

FAO and DLS jointly monitored and followed up the sellers through several visits. Now, a total of 21 medicine sellers of seven upazilas of Rajshahi district are using the mobile app.  

The experience demonstrates that digital tools can help translate responsible antimicrobial use from policy into everyday practice. It also shows the importance of engaging the people who directly provide medicines to farmers.

Supporting One Health response to AMR

Rx Vision is a practical intervention designed to strengthen antimicrobial stewardship by encouraging veterinary consultation, improving documentation, strengthening surveillance and supporting responsible dispensing of antibiotics.

Further evaluation, institutional support and regulatory engagement will be important for its potential expansion. If successfully scaled, approaches such as Rx Vision could help strengthen prescription-based antibiotic use in other parts of Bangladesh and support the country's broader One Health response to antimicrobial resistance.