Antimicrobial resistance (AMR) is a growing concern globally, particularly in third-world countries like the Philippines, where access to healthcare resources may be limited and antimicrobial stewardship practices may be lacking. Understanding the regional antibiograms, which outline the susceptibility of pathogens to specific antibiotics, is crucial for effective treatment strategies. However, there is a lack of comprehensive data on regional antibiograms in the Philippines, hindering the development of targeted antimicrobial therapies.
According to findings from the Global Research on Antimicrobial Resistance (GRAM) Project by the University of Washington, antimicrobial resistance (AMR) poses a significant burden in the Philippines, surpassing deaths from chronic respiratory diseases by 2.9%, totaling 56,700 deaths in 2019. Noteworthy pathogens in the Philippines include Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Mycobacterium tuberculosis, and Acinetobacter baumanii. In contrast, developed countries like China exhibit a lower prevalence of AMR compared to the Philippines by 1.5%. The complexity of AMR in third-world countries stems from various factors such as healthcare practitioners' prescription practices, patients' behavior toward antimicrobial use, limitations in diagnostic resources, unauthorized sales of antimicrobials, deficient regulatory mechanisms, and non-human antimicrobial usage, notably in animal production. Given the unique challenges faced in developing countries, interventions must be tailored to address these specific contextual factors and root causes effectively.
References:
Byarugaba DK. A view on antimicrobial resistance in developing countries and responsible risk factors. Int J Antimicrob Agents. 2004;24:105–10.
Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13:1057–98.
The Philippines has been facing a growing concern over antimicrobial resistance (AMR), similar to the global trend. The overuse and misuse of antibiotics have led to the emergence of multidrug-resistant bacteria, which pose a significant threat to public health.
According to a study published in the Journal of Antimicrobial Chemotherapy in 2020, the Philippines has reported high rates of antibiotic resistance in common bacteria such as Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. The study found that the resistance rates for these bacteria were higher in the Philippines compared to other countries in the Asia-Pacific region.
In particular, the study found that:
E. coli showed high levels of resistance to fluoroquinolones (FQs) and third-generation cephalosporins (3GCs), with resistance rates of 44.8% and 35.1%, respectively.
K. pneumoniae showed high levels of resistance to carbapenems, with a resistance rate of 28.6%.
S. aureus showed high levels of resistance to methicillin (MEC), with a resistance rate of 40.5%.
The high rates of antibiotic resistance in the Philippines are attributed to several factors, including:
Overuse and misuse of antibiotics: The widespread use of antibiotics in the country, particularly in the agriculture and aquaculture industries, has contributed to the development of antibiotic-resistant bacteria.
Poor infection control practices: Inadequate infection control practices in healthcare settings, such as poor hand hygiene and inadequate sterilization and disinfection, have contributed to the spread of antibiotic-resistant bacteria.
Lack of awareness: There is a lack of awareness among healthcare professionals and the general public about the appropriate use of antibiotics and the risks of antibiotic resistance.
To address the issue of antibiotic resistance, the Philippine government has implemented several strategies, including:
Improving antibiotic stewardship: The Department of Health (DOH) has launched various programs aimed at promoting the appropriate use of antibiotics, such as the Antibiotic Stewardship Program and the National Antibiotic Resistance Monitoring System.
Enhancing infection control practices: The DOH has implemented guidelines and standards for infection control in healthcare settings, including proper hand hygiene, sterilization, and disinfection practices.
Promoting antibiotic conservation: The government has launched campaigns to promote the conservation of antibiotics, such as the "Antibiotic Smart Use" campaign, which aims to educate healthcare professionals and the public about the appropriate use of antibiotics.
Encouraging the development of new antibiotics: The government has provided incentives for the development of new antibiotics, such as tax breaks and subsidies for research and development.
Improving surveillance and monitoring: The government has established a national surveillance system to monitor antibiotic resistance patterns and track outbreaks of antibiotic-resistant bacteria.
Overall, the Philippine government has taken steps to address the issue of antibiotic resistance, but continued efforts are needed to ensure the effective implementation of these strategies and to reverse the trend of increasing antibiotic resistance.
Antimicrobial resistance (AMR) is a significant concern globally, including in the Philippines. Key patterns in the Philippines include a high prevalence of multidrug-resistant tuberculosis (MDR-TB), resistance in common pathogens like Escherichia coli and Klebsiella pneumoniae, and challenges with healthcare-associated infections in hospital settings.
Global trends include the rise in extended-spectrum beta-lactamase (ESBL) producing bacteria, the emergence of carbapenem-resistant Enterobacteriaceae (CRE), and the growing threat of antibiotic-resistant gonorrhea.
To address AMR, strategies such as surveillance and monitoring, antibiotic stewardship, infection prevention and control measures, research and development of new antibiotics, and international collaboration are essential. These efforts aim to monitor resistance patterns, promote rational antibiotic use, implement strict infection control practices, invest in research for new treatments, and foster global cooperation to combat AMR effectively.
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