In the past year, IQVIA (a company that provides services to advance the health information technology industry and clinical research) recorded sales of antibiotics in Indonesia reaching more than IDR 10 trillion. According to Professor at the Faculty of Pharmacy (FF) Universitas Indonesia (UI) Prof. apt. Rani Sauriasari, M.Med.Sci., Ph.D., said that the increase in antibiotic sales is understandable if it is commensurate with the increase in infectious disease outbreaks. Unfair sales are most likely caused by a lack of understanding and negligence of patients and health workers, resulting in irrational antibiotic use.
Uncontrolled use of antibiotics, both in quantity and type, can cause bacteria to become resistant to antibiotics. If antibiotics are inappropriate and uncontrolled, bacteria will continue to adapt and become increasingly resistant. This can endanger the patient because antibiotics become ineffective. The government and society need to work together to reduce the sale and use of antibiotics in Indonesia.
Moreover, Prof. Rani also said that it was necessary to analyze where the antibiotics were obtained. Suppose hospitals are the largest source of expenditure. In that case, doctors’ prescribing control must be in accordance with indicators of rationality for antibiotic prescribing with a clear diagnosis based on existing disease patterns. On the other hand, the role of the Antimicrobial Resistance Control Program (ARCP) and pharmacists in hospitals must be optimized.
If the biggest shopping source comes from pharmacies, it is necessary to ensure that antibiotics are delivered with or without a doctor’s prescription. Pharmacists, as an extension of doctors, have an important role in assessing the suitability of prescriptions, providing drug information, education services to patients, and monitoring the effectiveness and safety of patients.
Furthermore, Prof. Rani said that the public must be aware of the threat of antibiotic resistance. Based on a World Health Organization (WHO) study, the death rate due to antibiotic resistance until 2014 was recorded at around 700,000 people per year. With the rapid development and spread of infections caused by resistant microorganisms, it is estimated that deaths due to antimicrobial resistance will be greater than deaths due to cancer by 2050.
Meanwhile, research to find new antibiotics for more than 60 years has not succeeded in finding antibiotics that can overcome multi-resistant bacteria. “Imagine if there is a pandemic of multi-resistant bacterial infections in the future. The situation will be similar to the last COVID-19 pandemic, with no effective antibiotics. It will be a very serious health disaster,” said Prof. Rani.
Therefore, Prof. Rani recommended that education and warnings against doctors who violate must be improved to control antibiotic prescribing behavior. The role of ARCP in hospitals is also presented. Besides, pharmacists in charge of pharmacies must comply with government regulations and need strict warnings if violations occur.
These steps must align with monitoring the distribution chain of distributor antibiotic supplies, which can only be distributed to pharmacies and hospitals. According to Prof. Rani, research into the discovery of new antibiotics, especially for multi-resistant bacteria, can also be prioritized in responding to the challenge of antibiotic resistance
