Antimicrobial resistance in Indonesia: prevalence and prevention
06 / 2000 - 06 / 2004
Antimicrobial resistance of bacteria is a worldwide and ever growing problem and has been recognized as a major threat to health. Antimicrobial resistance is directly linked to the use of antimicrobial drugs: resistant bacteria emerge under the selective pressure of antibiotics. To reduce the problem of antimicrobial resistance, action should be taken on two fronts: promotion of the prudent use of antibiotics and prevention of the spread of resistant bacteria. Data concerning the prevalence of antimicrobial resistance in Indonesia are limited, but the available data suggest that Indonesia is no exception to other countries in the world. The overall aim of this study is a scientifically based, efficient and standardised programme for the assessment of antimicrobial resistance, antibiotic usage, infection control measures and execution of interventions in Indonesian hospitals. In order to achieve this objective we will investigate the prevalence and genetic basis of antimicrobial resistance in the Indonesian population inside and outside hospitals, the level and quality of antibiotic usage and the application of infection control measures. Interventions to improve antibiotic usage and infection control measures will be developed and implemented and their effects will be evaluated. The programme can be a starting point for a nationwide surveillance of antibiotic resistance, antibiotic usage and infection control measures. The proposed study will investigate the following questions: 1. What is the prevalence and genetic basis of antibiotic resistance among bacteria in the Indonesian population inside and outside hospitals? 2. What is the level and quality of antibiotic usage in the Indonesian population inside and outside hospitals? 3. What is the correlation between antibiotic usage and the development of antibiotic resistance? 4. Does the introduction of guidelines of antimicrobial usage, e.g. prophylaxis, improve the use of antimicrobial drugs in Indonesian hospitals? 5. Which time-proven measures for the prevention of the spread of bacteria and nosocomial infections are implemented in Indonesian hospitals? 6. Which preventive measures should be given priority in order to optimize infection control in Indonesian hospitals and does introduction of preventive measures improve infection control? The results of the study will be a scientifically based, efficient and standardised programme for the assessment of antimicrobial resistance, antibiotic usage patterns, infection control measures and execution of interventions in Indonesian hospitals. The programme should be transferable to other Indonesian hospitals which were not involved in the current research programme. Hospitals which evaluate their situation according to the validated programme will be able to pool and compare their data. By doing so a nationwide surveillance of antibiotic resistance, antibiotic use and infection control measures can be initiated.