An Integrated Approach to Combating Antibiotic Resistance

Antibiotics have revolutionised the medical world since their discovery the in 1920’s. Designed to prevent and treat bacterial infections, when used properly, they save lives.

Antibiotic resistance is a phenomenon that occurs when bacteria change in response to the use of these medicines. Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria.

Antibiotic resistance is a major global health issue – as it means that common illnesses and diseases will no longer respond to antibiotic treatment, resulting in longer bouts of illness, more serious illnesses and more deaths.

“Belief and free medical markets are the main causes for incorrect usage of antibiotics in Cambodia,” says Dr Miliya Thyl, Angkor Hospital for Children’s (AHC) Lead Clinical Microbiologist. “It is not easy to change this stereotype, so we have to do all we can to raise awareness of antibiotic resistance – from medical professionals to government and ordinary people.”

Dr. Thyl has observed that in Cambodia, everyday people and even nurses and doctors overuse this kind of medicine through misunderstanding.

“Some Cambodian parents don’t go to the hospital or clinic – they take their kids directly to the pharmacy and ask for antibiotics, no matter whether the child has the flu, fever or diarrhea,” says Dr Thyl. “The pharmacists just sell their products without requiring a prescription. It is very hard to change this habit.”

Dr. Thyl suggests parents talk with doctors first before allowing their kids to take antibiotics. Antibiotics are effective for bacterial infections only, but if you try to use them to treat a viral infection, it could result in prolonged sickness and wastage of money and time.

“You must bring your child to the hospital or clinic. DO NOT buy antibiotic medicines from a pharmacy without prescription,” says Dr Thyl.

In partnership with COMRU, AHC takes an integrated approach to combating antimicrobial resistance – from within our hospital walls to rural villages – working alongside the government and other healthcare partners. AHC-COMRU’s microbiology laboratory and surveillance systems allow the team to observe different types of bacteria present in patient samples and in the hospital environment, monitor clinicians use of antibiotics, and reduce incorrect usage.

AHC-COMRU’s combined expertise in clinical microbiology and antibiotic resistance further enables the organisation to lead the way in antibiotic stewardship, as representatives in the Ministry of Health’s (MOH) AMR Technical Working Group.

The AMR Working Group was formalised in 2012 to develop and implement an antibiotic resistance national action plan and surveillance system. Today, the group meets monthly at the MOH Department of Communicable Disease Control to discuss common problems, solutions, and other activities around antibiotic resistance.

AHC brings expertise to the group, through years of building clinical and laboratory proficiency, along with conducting in-house infectious disease and AMR surveillance.

By subscribing to the MicroGuide app platform, AHC-COMRU have also have also made freely available the hospital’s infection and antibiotic treatment guidelines. The MicroGuide App has been designed for doctors to make better choices about what types of medications to prescribe. In addition, AHC has its own microbiology laboratory and surveillance systems to observe different types of bacteria present in patient samples and in the hospital environment, monitor clinicians use of antibiotics and reduce incorrect usage.

To help engage the local community and get their support, AHC-COMRU conducts Science Café sessions with community members focusing on antibiotic resistance.

Learn more about AHC’s Antibiotic Stewardship initiatives.