Abstract
High levels of antimicrobial resistance (AMR) in Indonesia are caused by the use of inappropriate antimicrobials (AM) in healthcare services and the livestock and fisheries sector. The available data and information about overused antibiotics and the AMR threat in Indonesia are limited. The aim of the study is to describe the AMR situation in Indonesia based on perceptions of government officials, health professionals, and the community to determine actions needed to develop AMR-related strategy and policy. The study was done in eight provinces in Indonesia and included reviewing AMR-related policy, collecting antibiotic use reports in primary health care from health offices and hospitals, and conducting in-depth interviews and focus group discussions with informants from health and nonhealth sectors. The results of the study show that AM misuse happens not only in healthcare facilities but also in communities. Medical officers are unfamiliar with AMR-related policy, as are officers in the livestock and fisheries sectors. There is limited coordination between sectors regarding the AMR situation in Indonesia. The government has to take stronger measures to oversee better implementation of AMR policies.
Highlights
Antimicrobial resistance (AMR) is a global public health concern. e World Health Organization (WHO) reports that AMR constitutes a serious threat to public health worldwide [1]
According to WHO, the world has ran out of effective ways to treat common infections such as urinary tract infections or some form of diarrhea. is situation is indicated by the high levels of antimicrobial resistance to drugs that are often used to treat such infections. e WHO further noted that the level of resistance to ciprofloxacin, an antimicrobial that is often used to treat urinary tract infections, ranged from 8.4% to 92.9% in 33 countries
E data for Global Antimicrobial Resistance and Use Surveillance System (GLASS) collection was limited to 20 selected hospitals spread in Indonesia. ese hospitals act as sentinel sites for AMR data. e result from GLASS reported in 2019 for Indonesia was an increase in the percentage of antimicrobial resistances for some bacteria such as E.coli and K. pneumonia. ose include Carbapenems, Fluoroquinolones, and third generation Cephalosporins [3]
Summary
Antimicrobial resistance (AMR) is a global public health concern. e World Health Organization (WHO) reports that AMR constitutes a serious threat to public health worldwide [1]. National data regarding AMR in Indonesia refers to Global Antimicrobial Resistance and Use Surveillance System (GLASS). E result from GLASS reported in 2019 for Indonesia was an increase in the percentage of antimicrobial resistances for some bacteria such as E.coli and K. pneumonia. A surveillance study conducted in 2017 on Escherichia coli and Klebsiella pneumoniae, which caused UTIs, revealed that the resistance to commonly available treatments was quite high in Indonesia [4]. All of this indicated that Indonesia has a quite high level of AMR as other Southeast Asian countries such as India and Bangladesh [1]. E WHO states that, to overcome the current AMR situation, participation and collaboration are required from all stakeholders; governments and people have to work together comprehensively [1]. is study aims to describe the AMR situation in Indonesia based on the perceptions of government officials, health professionals, and the community
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