Antibiotic Resistance: Crisis of Thai Peoples Health Situations - Consequences- Measures Presented at the National Seminar on Antibiotic Resistance:

Crisis of Thai Peoples Health 28 - 29 May 2012, at Siam City Hotel, Bangkok, Thailand Antibiotic Resistance Situations Antibiotic resistant infections are emerging infectious diseases, which pose an increasing threat to human health around the world. The National Antimicrobial Resistance Surveillance Center, Department of Medical Sciences, Ministry of Public Health reported that there has been a continuing increase of antibiotic resistance rates among many bacteria causing infections in humans. In Thailand, the important antibiotic resistant bacteria are Enterobacteriaceae (such as E.coli), Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumanni. The prevalence of antibiotic resistance among the aforementioned bacteria has been increasing. Acinetobacter baumannii is a major cause of hospital-acquired infections. Most of Acinetobacter baumannii isolates are resistant to carbapenems which are the most potent and the last option for therapy of infections caused by gram negative bacteria. Therefore, we need to return to use colistin which is an old antibiotic developed 50 years ago which is rather toxic agent. Consequences of Antibiotic Resistance The rapid emergence of antibiotic resistance is mainly due to the irrational use of antibiotics, particularly the excessive use of antibiotics in humans and nonhumans. According to the report on manufacture and import of medicines in 2009, it revealed that there was an excessive use of antibiotics among Thai people, accounting for more than 10,000 million baht. The top three most commonly used antibiotics manufactured and imported are penicillins, cephalosporins, and carbapenems. There are more than 100,000 Thai people infected with antibiotic resistant bacteria, 1 million days of extra hospital stay, and 30,000 deaths annually, leading to economic loss of more than 10,000 million baht, excluding losses due to premature deaths.

Measures for Antibiotic Resistance Major measures for containment of antibiotic resistance in Thailand are: 1. All health care facilities must implement strict infection control and prevention measures (such as hand hygiene, isolation precaution) especially for hospitalized patients. 2. All health care facilities must have antibiotic stewardship program to promote rational use of antibiotics. 3. The public should be aware of antibiotic resistance problems and avoid using unnecessary antibiotics especially for minor ailments such as common cold, diarrhea, simple fresh wound. 4. Limit dispensing of antibiotics at pharmacies. 5. Prohibition the use of antibiotics and chemicals either as antimicrobials or growth promoters in feedstuff. .