Philippines: Antimicrobial resistance is on the rise – but we are fighting back in Bacolod

Philippines: Antimicrobial resistance is on the rise – but we are fighting back in Bacolod

Bacolod City, Negros Occidental – Antimicrobial resistance is increasingly becoming a problem in the Philippines. Drug-resistant organisms have been on the rise as evidenced by the antimicrobial tests in our institution, the Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH).

We have observed an increase in drug-resistant bacteria – a significant clinical and public health concern. This means that there’s a possibility that available last-resort antibiotics would be rendered useless if resistance to these bacteria continues to surge.

To help fight antimicrobial resistance in our region, CLMMRH began a programme on antimicrobial stewardship (AMS) so that antimicrobials will continue to be useful for human health. With the support of our Medical Centre Chief, Dr. Julius Drilon, as well as the team of dedicated doctors, nurses, and pharmacists in the hospital, we were able to launch the antimicrobial stewardship programme back in 2015. It is important to have this programme in our region so that we can put policies in place and give awareness to the people of Negros to use antimicrobials judiciously.

The World Health Organization also provided additional learnings for our institution when they sent me and a fellow pharmacist, Christine Joy Barredo, to an antimicrobial stewardship clinical observership programme at the Singapore General Hospital last year.

The author (rightmost), together with the Singapore General Hospital Antimicrobial Stewardship Pharmacists, during the observership programme in 2016.
Photo courtesy of Jenny Rose Castel

Through the fellowship training programme, we were able to fully understand the relationship of antimicrobial use and resistance and learn how to optimize antimicrobial prescribing to improve individual patient care, reduce hospital cost, and slow the spread of antimicrobial resistance. We were also able to impart our knowledge back in the Philippines to our fellow pharmacists by working together with the Department of Health in training new antimicrobial stewardship pharmacists in government and private institutions.

Participants in an antimicrobial stewardship workshop for hospitals, supported by the Department of Health and Corazon Loscin Montelibano Memorial Regional Hospital.
Photo courtesy of Jenny Rose Castel

It took time to establish the programme and we had initial challenges of low compliance and resistance to change. However, with continuous education, monitoring, measuring and managing of the antimicrobial stewardship policies, we were able to overcome these challenges.

We have seen a number of transformations in the few years that we have been doing antimicrobial stewardship. Through education, hospital staff members now understand the goals and policies of antimicrobial stewardship programme. They are now aware of their role in ensuring that the policies are being implemented across the hospital. The behaviour of antimicrobial prescribing amongst the doctors has also changed.

Antimicrobials, particularly, antibiotics, have always been one step ahead of resistance. Through the relentless efforts of health practitioners in antimicrobial stewardship programmes, I hope that we will be able to combat antimicrobial resistance. Let us all do our part to be antibiotic guardians, and stop overuse and misuse of antibiotics.Together, let us win the war against antimicrobial resistance!

The author doing antimicrobial stewardship rounds which includes reviewing of the appropriateness of antimicrobial use, checking if doctors are following protocols in antimicrobial stewardship policies, monitoring of antimicrobials given to patient from day one to seven, and monitoring of surgical prophylaxis.
Photo courtesy of Jenny Rose Castel

Jenny Rose Castel is a senior clinical pharmacist and antimicrobial stewardship (AMS) pharmacist at the Corazon Loscin Montelibano Memorial Regional Hospital in Bacolod City, Negros Occidental. She participated in a three-week antimicrobial stewardship clinical observership programme in Singapore supported by WHO.

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