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抗菌药物耐药性问题:实践和开展审计的能力问题。

Antimicrobial Resistance Issue: A Matter of Practice and Capacity to Conduct an Audit.

机构信息

Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

出版信息

Acta Med Indones. 2024 Apr;56(2):135-136.

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. 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.

摘要

世界卫生组织于 2019 年发布了适用于中低收入国家医疗保健机构的抗菌药物管理实用工具包,原因是抗菌药物耐药率(AMR)不断上升,导致治疗选择减少,而可用的抗生素似乎不再有效。引入这个工具包表明,需要更加务实,解决抗菌药物耐药问题。这种情况的发生是因为我们长期以来一直认为抗生素是理所当然的,对其认识不足,导致其潜在用途和益处丧失。另一方面,尽管有药物可用,但在世界许多地方,仍然报告了抗生素获取有限的主要问题。抗菌药物耐药问题已经延伸到社区;在社区中,人群难以评估。在医院环境中,预计会对患者进行监测,这样可以方便地获取数据。印度尼西亚政府通过在每个医院设立国家抗生素委员会(Permenkes no. 8(2015)中提到)来对抗耐药性的承诺,以及将抗菌药物耐药问题提升为国家优先事项和计划之一,表明了对抗耐药性的承诺。在这个问题上,Fadrian 等人进行了一项研究,以衡量印度尼西亚西部地区抗生素使用的质量。每年 11 月 18 日至 24 日,我们都在庆祝世界抗菌药物耐药性认识周,强烈希望减少死亡人数,据估计,2019 年因耐药而死亡的人数为 127 万。这种希望必须伴随着对抗生素过度处方风险的强烈承诺和认识,如果我们忽视这一点,死亡率可能会增加 9 倍,这意味着到 2050 年,每年可能会有多达 1000 万人死亡。

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