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  2. Vol 56, No 2 (2024)
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Antimicrobial Resistance Issue: A Matter of Practice and Capacity to Conduct an Audit

Erni Juwita Nelwan

Abstract


The World Health Organization released the practical toolkit for antimicrobial stewardship in health-care facilities in low- and middle-income countries in 2019 due to increasing rates of antimicrobial resistance (AMR) causing the diminishing of treatment options and that the available antibiotics seem to no longer work. The introduction of this toolkit indicates the need to be more down-to-earth in combating the problems of antimicrobial resistance. This situation happened because we have taken antibiotics for granted for too long with less awareness, which results in the potential loss of its use and benefits. On the other hand, even though medicine is available, a major issue on the limited access to antibiotics are still reported in many parts of the world.

The problem of antimicrobial resistance extended to the community; the population that is difficult to evaluate. In a hospital setting, patients are expected to be monitored which allows data to be gained easily. The commitment to combat resistance is demonstrated by the Indonesian government through the establishment of the National Committee of Antibiotics mentioned in Permenkes no. 8 (2015) that is located in each hospital and the upscaling of the issues of Antimicrobial Resistance to become one of the national priorities and program.

In this issue, Fadrian, et al.7 conducted a study to measure the quality of antibiotics use at the western part of Indonesia. Every year between 18 to 24 November, we are celebrating the World AMR Awareness Week, with a strong hope to reduce the number of deaths which is at an estimate of 1.27 million people in 2019 who have been presumed to have died as a result to drug resistance.
The hope must be followed by a strong commitment and understanding of the risk of overprescribing antibiotics, and if we ignore this, there will be a chance of a 9 times increase in mortality rates which translates to up to an estimate of 10 million deaths per year after 2050.


Keywords


antimicrobial resistance; antibiotic; microbiology

References


Antimicrobials stewardship programmes in health-care facilities in low- and middle-income countries [Internet]. Available from: https://iris.who.int/bitstream/handle/10665/329404/9789241515481-eng.pdf

Limato R, Lazarus G, Dernison P, et al. Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention. The Lancet Regional Health - Southeast Asia [Internet]. 2022;2. Available from: https://www.thelancet.com/journals/lansea/article/PIIS2772-3682(22)00013-0/fulltext

Ginting F, Sugianli AK, Barimbing M, et al. Appropriateness of diagnosis and antibiotic use in sepsis patients admitted to a tertiary hospital in Indonesia. Postgraduate Medicine [Internet]. 2021;133(6):674–9. Available from: https://scholar.unair.ac.id/en/publications/appropriateness-of-diagnosis-and-antibiotic-use-in-sepsis-patient

Nelwan EJ, Guterres H, Pasaribu AI, Shakinah S, Limato R, Widodo D. The comparison of point prevalence survey (PPS) and Gyssens flowchart approach on antimicrobial use surveillance in Indonesian National Referral Hospital. Acta Med Indones - Indones J Intern Med [Internet]. 2022;53(4):505. Available from: https://www.actamedindones.org/index.php/ijim/article/view/1779

Apriyanti YF, Saepudin, Siti Maisharah S. Gadzi. Five years outpatients antibiotics consumption at public tertiary hospital in Bengkulu according to access, watch and reserve classification. Jurnal Farmasi dan Ilmu Kefarmasian Indonesia [Internet]. 2023;10(3):360–8. Available from: https://e-journal.unair.ac.id/JFIKI/article/download/50344/27453/270342

Permenkes no. 8 tahun 2015 Tentang Program Pengendalian resistensi antimikroba di Rumah Sakit [Internet]. [cited 2024 Jul 9]. Available from: https://peraturan.go.id/id/permenkes-no-8-tahun-2015

Fadrian, Aliska G, Utami WN. The relationship between appropriateness of antibiotic use based on the Gyssens algorithm and mortality:

A retrospective cohort study in Indonesian tertiary hospital. Acta Med Indones - Indones J Intern Med. 2024;56(2):137-44.

World Antimicrobial Awareness Week 2024 [Internet]. www.who.int. Available from: https://www.who.int/campaigns/world-amr-awareness-week/2024.


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