Antimicrobial resistance (AMR) is now a significant public health threat that causes major health and economic consequences both in human and veterinary health. It claims lives, prolongs illnesses, increases healthcare costs and financial burden, and affects trade and global security. The global health community has identified irrational use/ misuse of antimicrobial medicines as a major driver of AMR which is associated with a variety of management and healthcare provider practices.
With the support of the World Health Organization (WHO), the Department of Health (DOH) conducted the Antimicrobial Stewardship (AMS) Training for Level III hospitals last 6-9 December 2016 in Talisay City, Negros Occidental as a continuation of a series of AMS training-of-trainers workshops which have been initiated since 2015. The training serves to prepare the hospitals in implementing AMS programs in their setting as part of the hospital licensing requirement by 2018.
The activity was participated in by infectious disease physicians, medical technologists, clinical pharmacists, and infection control nurses from 16 tertiary hospitals. The National AMS program is one of the DOH strategies to address the AMR problem in this setting wherein the antimicrobial use is rampant. It is the concerted implementation of systematic, multi-disciplinary, multi-pronged interventions in both public and private hospitals to ensure the appropriate use of antimicrobials, which is essential for preventing the emergence and spread of AMR.
Lectures and interactive sessions were conducted which focused on the six AMS core pillars, namely: leadership, policies guidelines pathway, AMR surveillance, antibiotic restriction and pre-authorization, educational strategies, and performance and evaluation.
The varying capacities of the hospitals in setting up their own AMS program became evident during the discussions and interactive sessions. Concerns on the hospital management to support and sustain the program, expand laboratory facilities, and strengthen the skills of the healthcare personnel were raised as important issues that need to be addressed by the participants. The vital role of the pharmacists in performing the legwork of the program and the importance of having strong coordination among the hospital staff were highlighted as well. A demonstration on how to navigate the WHONET which is an information system for global surveillance of bacterial resistance to antimicrobial agents and the excel-based tool that can determine the antimicrobial use within the facility was led by the Research Institute for Tropical Medicine (RITM) and the University of the Philippines College of Pharmacy (UPCP), respectively.
The last day of training was spent in a tour around Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH), one of the lead AMS pilot sites in the country, to observe how the institution is implementing AMS in the hospital’s daily operations. Existing reporting forms and feedback mechanisms of CLMMRH were shown to the participants from other hospitals who also offered their suggestions in improving processes.
Although there are numerous challenges in establishing AMS in hospitals, the participants committed to champion this DOH initiative once they are back in their respective facilities which in turn, will serve as AMS training hubs for other healthcare institutions across the country.