As part of their advocacy on proper antibiotic use, Reckitt Benckiser Healthcare Philippines organized a round table discussion with various medical specialties to talk about the rising number of antimicrobial resistance. According to Prof. Roman Kozlov, the head of the World Health Organization (WHO) Collaborating Center for Capacity Building on Antimicrobial Resistance Surveillance and Research, about seven hundred thousand people die globally from the effect of antimicrobial resistance each year. Antimicrobial resistance, or AMR, is defined by the WHO as when microorganisms develop immunity against antibiotics. This renders the medicines specific to the microorganisms ineffective, making the diseases spread by these microorganisms fatal.
In 2014, The Review on Antimicrobial Resistance by O’Neill, estimated that if no one does anything about it, AMR will kill 10 million individuals annually by 2050.
Because of the rising rate of AMR, more than 120 countries have pledged to develop global action plans against AMR. This led to the establishment of GLASS, or the Global Antimicrobial Resistance Surveillance System. Through GLASS, AMR across the world can be monitored. Along with this, GLASS also provides specific guidelines for countries to implement in their action plan against AMR. Fortunately, Dr. Kozlov had noted that these guidelines brought about very “substantial changes” in the control of AMR.
In the Philippine setting, Dr. Mario Panaligan, president of Philippine Society of Microbiology and Infectious Diseases (PSMID) said that their organization developed the Antimicrobial Stewardship Program in 2015 which they started implementing at “level 3 hospitals” in 2016. As of 2019, Dr. Panaligan reported that they were just finishing implementation at level 1 hospitals.
However, the path to controlling AMR is quite difficult, despite having these guidelines in place. Dr. Panaligan stated that physicians tend to “overprescribe” antibiotics, which is an “important trigger to why there is a increase of AMR in the Philippines.” In support of this, Dr. Ferdinand De Guzman of Philippine Academy of Family Physicians (PAFP) stressed the importance of “primary care physicians” in the fight against AMR.
According to Dr. De Guzman, since physicians are the first in line in treating people, controlling AMR has to start with them. He stated that developing a good foundation in medical schools in the rational use of antibiotics is very important. Through this, along with refresher courses for doctors on antibiotics and communicable diseases, people will now be more informed about the risks of taking too many antibiotics.
Even if medical professionals observe antimicrobial stewardship, the challenge is changing people’s perspectives. According to former Philippine Pharmacists Association (PPhA) president Leonila Ocampo, patients and some pharmacy owners lack knowledge on the effects of antibiotics. They see them as “ordinary commodities”. Because of this the association had lobbied for a new pharmacy law in the Philippines. Under Republic Act 10918, a person who wants to sell antibiotics must first have the proper educational background to do so. They also cannot sell antibiotics to anyone without a prescription. Anyone caught doing so would be fined between P250,000 to P500,000. However, these laws can only reach mostly urban areas of the country. Dr. Ocampo stated that in rural areas, antibiotics can be sold in sari-sari stores. While the PPhA has been working on that situation by expanding the implementation of the stewardship program, she stated that they have plenty of work to do before everyone is aware of the dangers of AMR.
As a parting message, the panel encouraged their fellow doctors to properly listen to their patients before administering a prescription. According to Global Respiratory Infection Partnership (GRIP) representative Adrian Shephard, the root cause of people’s overdependence on antibiotics is because they are looking for immediate relief from common illnesses. According to him, the best thing doctors can do is have conversations with their patients and find out what is really bothering them and what they want. He also mentioned about educating their patients about AMR, so they know that they do not need antibiotics every time they get sick. Through these efforts, perhaps AMR can be addressed.
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