Ref Number = ASPR0007
Problem of Antibiotic Use And Antimicrobial Resistance in Asia
Irene Ratridewi

Dept of Child Health University of Brawijaya/Saiful Anwar Genera Hospital 
Malang Jawa Timur 
Antibiotic usage have undergone improvements since the first discovery of Penicillin. Over prescription and improper use leads to the spread of multi-resistant pathogenic bacteria and becoming a source of healthcare issues today.
On the year 2014, WHO stated that MDRO flourish in all WHO regions including Asia and is the main cause of healthcare associated infections which is very expensive to treat. The effort taken is the cooperation of all countries driven by their respective governments in controlling and limiting the use of antibiotics in all sectors ranging from human, livestock and agricultural health. This program in Indonesia begins with the issuance of government policies which will be revised in 2019. The items included are guidelines for hospitals to limit antibiotic use, periodic surveillance reports on both qualitative and quantitative analysis on antibiotics and MDRO (ESBL and MRSA). 
In Indonesia the antibiotic resistance problems of ESBL increases from 40% (2013) to 60% (2017) and inappropriate antibiotics usage in teaching hospitals increases from 50-80% (2013) to 60-80% (2017). The national AMR committee started in 2016 involving 14 referral hospitals as pilot project. 
The main issue in handling antimicrobial resistance (AMR) is the obedience of antibiotic users (doctors), inadequate public understanding on the dangers of antibiotics, unavailability of effectively working antibiotics in Indonesia and communications between tiered healthcare centres which still need to be improved (from community health centres to tier 2 hospitals, tier 1 provincial hospitals,  private hospitals and private practices). 
In the end, the goal of AMR control is to achieve a linear graph between the developments of new antibiotics that are stagnant with the development of MDRO so that deaths form MDRO infections can be avoided.
Acknowledgement: Hari Paraton Head of Antimicrobial Resistance Stewardship Program, Ministry of Health, Indonesia
1. World Health Organization. Global Action Plan on Antimicrobial Resistance. Geneva:WHO;2015. 28p.
2. Coyne L, Arief R, Benigno C, Giang VN, Huong LQ, Jeamsripong S, et al. Characterizing Antimicrobial Use in the Livestock Sector in Three South East Asian Countries (Indonesia, Thailand, and Vietnam). 2019 Mar 25;8(33):1-25.
3. Holloway K, et al. Antibiotic use in South East Asia and Policies to promote appropriate use; reports from country situational analyses [Internet]. 2017 Sep [cited: 2019 Jul 05];358(j2291):9-13. Available from: https://www.bmj.com/content/358/bmj.j2291/related DOI: 10.1136/bmj.j2291
4. Kakkar M, Chatterjee P, Chauhan AS, Grace D, Lindahl J, Beeche A, et al. Antimicrobial ressistance in South East Asia: time to ask the right questions. 2018;11(1483637):1-5.
5. Bloom G, Cruickshank M, Shaban R, Oberoi M, Sandoval G. Antimicrobial resistance in the Asia Pacific region: a development agenda [Internet]. Manila, Phillipines; WHO; 2017. 85 p. 
6. Parathon H, et al. Progress towards antimicrobial resistance containment and conrtol in Indonesia [Internet]. 2017 Sep [cited: 2019 Jul 6];358(j808):1-5. Available from: https://www.bmj.com/content/358/bmj.j3808/related DOI: 10.1136/bmj.j3808
7. Podolsky SH. The evolving response to antibiotic resistance (1945-2018) [Internet]. 2018 Oct [cited: 2019 Jul 6];4(124):1-8. Available from: https://www.nature.com/articles/s41599-018-0181-x DOI: 10.1057/s41599-018-0181-x
8. Aslam B, Wang W, Arshad MI, Khurshi M, Muzammil S, Rasool MH, et al. Antibiotic resistance: a rundown of a global crisis. 2018;11:1645-1658
9. Ivanovska V, Muller A, Schweickert B, Sharma P, Tao Wenjing, Castro JL, et al. WHO Report on Surveillance of Antibiotic Consumption 2016-2018 Early implementation. Geneva: WHO; 2018. 127p.
10. Daniel SD, Lee SM, Dykes GA, Rahman S. Public Health Risks of Multiple-Drug-Resistant Enterococcus spp. In Southeast Asia. 2015 Sep;81(18):6090-7.

Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
Journal Office
Mid City Hospital, 3-A Shadman II
Jail Road, Lahore ,Pakistan
Managing Editor
Dr. Digant D Shastri
Support & Help
Associate Editor
Dr. M. Faheem Afzal
Support & Help
e-Journal Administrator
Dr. Khalid Masud