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Antimicrobial Resistance as an emerging problem

Doctors in the Philippines have geared up for a more intensified fight against antimicrobial resistance (AMR) that is already a serious global threat.

01 PHOTOWearing cardboard gloves, doctors vow to intensify the fight against antimicrobial resistance on November 7 at the New World Makati in celebration of the World Antibiotic Awareness Week. (From left) Medical doctors Mario Panaligan, former Department of Health consultant Regina Berba, Philippine Pharmacists Association president Yolanda Robles and Angelica Claveria of Pfizer. CONTRIBUTED PHOTO

This comes a year after the Association of Southeast Asian Nations, led by the Department of Health (DoH), agreed to adopt and draft the “One Health” approach to tackle the issues surrounding AMR to ensure a holistic, multi-sectoral and multidisciplinary method in combating it at the regional and national levels.

The World Health Organization (WHO) in 2014 raised the alarm of a return to the post-antibiotic era where drug-resistant infections overtake cancer as the leading cause of human suffering and deaths by 2050.

AMR currently accounts for 700,000 fatalities per year globally. Experts said that if no action is taken, it is estimated that about 10 million deaths would occur yearly by 2050.
Medical doctor Mario Panaligan, president of the Philippine Society for Microbiology and Infectious Diseases, said that while antibiotics have served as the cornerstone of modern medicine, it could lead to adverse effects when misused.

“The tendency is that organisms eventually become immune to its [antibiotic] effects,” he said during the Philippine culmination of World Antibiotic Awareness Week on Wednesday.
Such immunity would eventually result in AMR, which could spread rapidly if not contained properly, he added.

Common examples of irrational antibiotic use are treating a simple cold or flu without following the doctor’s order of finishing the course of therapy within a given timeframe.
Unknown to most, antibiotics — which target bacteria — are ineffective in treating the common cold, most likely caused by a virus.

“When prescribed an antibiotic, take it exactly as instructed by the doctor and finish the course of medication without missing any doses, even when [a person] already starts to feel better,” Panaligan said.


Medical doctor Regina Berba, former DoH consultant for the National Steering Committee of Antimicrobial Stewardship Program, said minor infections could become life-threatening once microorganisms become immune to antibiotics.

“Many routine procedures could be too risky to perform because of the risk of becoming infected by a multi-drug resistant pathogen while in the hospital,” she said.

Berba said medical practitioners who treat people affected by AMR could spread it if they do not disinfect before interacting with other people in the hospital
Serious infections such as pneumonia or tuberculosis could become impossible to treat once AMR sets in, she added.

But the problem lies mostly with the people who are unaware of the risks of misuse of antibiotics, according to doctors.

Patients are advised to take antibiotics only when needed and prescribed for bacterial infections and to follow the doctor’s advice.

The doctors also warned against taking antibiotics prescribed for a different infection or sharing a prescription antibiotic (called prescription sharing) to a person who has not yet consulted a medical professional.

Medical doctor Yolanda Robles, president of the Philippine Pharmacists Association, said selling antibiotics in drugstores have become more stringent in recent years from health threats posed by AMR.

Robles, however, said the government needs to address the issue of access and affordability of antibiotics to protect the poverty-stricken who might contract AMR from their inability to continue the prescribed intake of medicine.

“Health centers should be present in all villages and medicine should always be at the ready so the people could meet the intake of medicine as prescribed. We need free and quality medicine and healthcare,” she said.

Actions taken

Berba said the Philippines has more competent and advanced anti-microbial stewardship (AMS) programs compared to other countries in the Asia-Pacific region, which the DoH is seeking to share with them to contain AMR. Among these are the One Health Approach and the Manual of Procedures for Implementing AMS Programs in Hospitals.

These action plans outlined the country strategies focusing on the following core areas: leadership and governance; surveillance and laboratory capacity; access to essential medicines of assured quality; awareness and promotion; infection, prevention and control; rational antimicrobial use among humans and animals; and research and development (R&D).

These have been brought to communities in the country through information drives, social media campaigns and caravans.

If not contained, AMR could threaten the gains achieved with the discovery of antibiotics in the 20th century and the achievement of Sustainable Development Goals, in particular, attaining good health and well being, doctors said.

“Remember is that there is really a genuine threat to the world right now­­ — it’s AMR. But there is AMS, which could be the solution to this. And we could all be part of this solution. All patients, the public and medical professionals should be part of this,” Berba said.

Panaligan said the public should do away with the hesitance in consulting doctors to further prevent the contraction and spread of AMR.

“It is important to keep the mindset that antibiotics can’t cure all kinds of diseases, common or serious. Always ask your doctors because there are normal procedures for normal infections,” he said.

Robles added that prevention was always important, saying “keeping vaccinations up to date, washing hands regularly and preparing food hygienically” could help stop the spread of AMR.
Meanwhile, pharmaceutical companies maintained that boosting drug R&D is vital in containing and ending AMR.

Pfizer, for example, created AMR surveillance tools that provide physicians and health communities in over 70 countries free access to critical data on the efficacy of various antibiotic treatments and emerging resistance patterns.

“We are driven by our desire to protect public health and address the medical needs of people suffering from different illnesses, including infectious diseases,” said medical doctor Angelica Claveria, senior medical manager of Pfizer Philippines.

“We always look forward to collaborating closely with different stakeholders to develop solutions and share resources to help reduce the impact of AMR for a healthier Philippines,” she added.
World Antibiotic Awareness Week was launched by the WHO in 2015 that aims to increase global awareness of antibiotic resistance and to correct the usage of antibiotics across all fields in order to prevent further instances of AMR.


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