In 2019, the World Health Organization (WHO) grimly reported 700,000 deaths attributed to microbial resistance, with respiratory infections, sexually transmitted diseases, and urinary tract infections standing out as the primary culprits.
Alarming projections by researchers hint at a substantial increase in such deaths by 2050 unless decisive action is taken against microbial resistance to antimicrobials.
Professor Ika Puspita Sari, a distinguished UGM Faculty of Pharmacy professor, asserts that a crucial key to curbing microbial resistance lies in implementing the One Health initiative.
This approach, she explains, entails a collaborative, multidisciplinary effort at local and global levels, addressing human health in tandem with animal health and the environment.
During her inaugural speech as a professor of pharmacology and toxicology at the UGM Senate Hall on Thursday (Dec. 7), she emphasized, “The indiscriminate use of antimicrobials in livestock can lead to the emergence of microbes resistant to antimicrobials, which can enter humans through food.”
“Antimicrobial residues in livestock meat, not destroyed by cooking methods, can enter the human body. On the human side, judicious use of antimicrobials is key to slowing down resistance.”
Professor Sari underscores that wise use of antimicrobials involves strict adherence to indications, narrow-spectrum antimicrobials, and ensuring proper dosage, intervals, and duration of administration.
This wise approach aligns with the principles of limiting antimicrobial use—Access, Watch, and Reserve (AWaRe)—integrated with applying pharmacokinetics and pharmacodynamics.
In the national effort to combat antimicrobial resistance and improve the quality of antimicrobial use, the antimicrobial stewardship program, a translation of WHO’s program, plays a central role.
“The knowledge that pharmacists must possess in implementing antimicrobial stewardship is an understanding of pharmacokinetics and pharmacodynamics, applied depending on the source of infection, which will have consequences for the optimal selection of antimicrobials,” she explained.
Professor Sari delved into antimicrobials’ physical and chemical properties, emphasizing their impact on the drug’s ability to penetrate membranes and reach infection sites. The patient’s condition, she added, dictates the route of antimicrobial administration.
For critically ill patients, prioritizing the rapid entry of antimicrobials becomes crucial, given that delays can increase patient mortality. Notably, high-risk sepsis patients not promptly receiving antimicrobials face a threefold risk of death.
Her insights shed light on the challenges of optimizing antimicrobials, underscoring the pivotal role of pharmacokinetics and pharmacodynamics.
“The role of pharmacology, especially pharmacokinetics and pharmacodynamics, must be continually improved, considering the optimization of antimicrobials and other drugs requires pharmacokinetic and pharmacodynamic considerations,” she concluded.
Author: Gloria
Photographer: Firsto