Antimicrobial Resistance Becomes a Silent Pandemic

The prevalence of microbes that are resistant to antimicrobials in Indonesia reaches 67 percent. This condition makes hospitals no longer safe for treatment and surgery.

The following article was translated using both Microsoft Azure Open AI and Google Translation AI. The original article can be found in Resistensi Antimikroba Menjadi Pandemi Sunyi

KOMPAS/ADHITYA RAMADHAN

Image of several bacteria that are resistant to antibiotics when seen under a modified microscope.

JAKARTA, KOMPAS - The prevalence of microbes resistant to antimicrobials in Indonesia continues to increase, reaching 67 percent. It requires commitment from all parties to prevent the spread of antimicrobial resistance which has now become a silent pandemic.

"The prevalence of two types of bacteria (Escherichia coli andKlebsiella pneumoniae) which cannot be killed by cephalosporin antibiotics, which are quite high, continues to rise. "The latest data is 67 percent," said Chairman of the Antimicrobial Resistance Control Committee Harry Parathon in a seminar at the Coordinating Ministry for Human Development and Culture, Monday (20/11/2023), in Jakarta.

This data was obtained from 11 hospitals that were sampling for research in Indonesia. "This is actually terrible because hospitals are no longer safe as places for treatment, surgery and emergency procedures," he said.

According to Harry, in Singapore the prevalence of antimicrobial resistance is only 24-26 percent. "That's why many Indonesians seek treatment abroad," he said.

The cost incurred in handling drug-resistant bacterial infections can be three to four times higher than that of non-resistant bacteria.

Harry said that there was further evidence from mapping carried out by the Association of Indonesian Clinical Microbiology Specialists (PAMKI) regarding the increasing number of bacteria that have levels of antibiotic resistance. "If you have an Acinetobacter infection, it will be very difficult to treat and very expensive," he said.

Antimicrobials, including antibiotics, antivirals, antifungals, and antiparasitics, are drugs used to prevent and treat infections in humans, animals, and plants. Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites no longer respond to drugs. This makes infections harder to treat and increases the risk of disease spread, severe illness, and death.

THE LANCET (2022)

Klebsiella pneumoniae resistance to third generation cephalosporins in Indonesia is in the range of 70-80 percent.

According to Harry, the cost involved in dealing with antibiotic-resistant bacterial infections can be three to four times higher than dealing with non-resistant bacteria. Data shows that the higher the consumption of antibiotics in a country, the higher the prevalence of resistant bacteria. Antibiotic consumption can be for humans, animals, or even plants.

Globally, according to Harry, research in the journalThe Lancetalso shows that with 33 bacteria that cause death in humans, it is assumed that antimicrobial resistance could cause the death of 7.7 million people per year.

"This is still the researcher's assumption. In another journal, it is said that the victims are 4.9 million people per year. Still, this death rate is higher than the Covid-19 pandemic which killed 2 million people a year. However, many people have not been moved by this. "That is why antimicrobial resistance is called a silent pandemic," he said.

According to Harry, regulations in Indonesia regarding antimicrobial resistance are already complete, including the existence of the Ministerial Regulation on Human Development and Culture Coordination (PMK) No. 7 of 2021 concerning the National Action Plan for Antimicrobial Resistance Control for the Year 2020-2024 as the highest legal umbrella.

"Throughout this time, the most difficult thing to regulate is the world of medicine. It is most difficult to regulate doctors. They are the ones who write the prescriptions. This is not only in Indonesia, but also in the world, how doctors use antibiotics properly," he said.

Also read: Many Antibiotics for Common Infections in Children Are No Longer Effective

Harry stated that antibiotics have two sides. On one hand, it can cure, but on the other hand, it can trigger dangerous resistance.

Prevention

When opening this seminar, Deputy for Improvement of Health Quality and Population Development of Coordinating Ministry for Human Development and Culture, Satya Sananugraha, stated that besides causing mortality and longer treatment duration, antimicrobial resistance has also triggered significant social and economic losses. "We hope all parties can utilize antimicrobials responsibly to prevent further resistance," he said.

At the event, a declaration was also read about the serious threat of antimicrobial resistance to human health and the economy, requiring a commitment from representatives of related professional organizations as the forefront of further prevention efforts.

The declaration was read by the chairman of the Indonesian Hospital Association (Persi) and the Indonesian Veterinary Association (PDHI), followed by several other human and animal health professional organizations.

There are five declaration points that were read, which prioritize preventing infection and only using antimicrobials when necessary, ensuring the administration of antimicrobials is based on prescriptions from appropriate medical professionals such as doctors, dentists, and veterinarians, based on accurate diagnosis results.

Also read: Use Antibiotics Only for Diseases Due to Bacterial Infections

In addition, professional organizations will provide continuous education to patients, livestock farmers, farmers, human health workers, animal health workers, and the general public on the dangers of antimicrobial resistance and prevention. They also pledge to enhance the capacity and commitment of members towards responsible antimicrobial use, as well as support efforts to improve the quality of public and animal health, and safe food and environment for the public.