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Analysis Antimicrobial Resistance in South East Asia

New chapter in tackling antimicrobial resistance in Thailand

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j2423 (Published 05 September 2017) Cite this as: BMJ 2017;358:j3415

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  1. Nithima Sumpradit, senior pharmacist1,
  2. Suriya Wongkongkathep, senior consultant in public health and health systems2,
  3. Sitanan Poonpolsup, head of the international affairs office1,
  4. Noppavan Janejai, deputy director of the National Institute of Health3,
  5. Wantana Paveenkittiporn, head of the National Antimicrobial Resistance Surveillance Center, 3,
  6. Phairam Boonyarit, senior pharmacist4,
  7. Sasi Jaroenpoj, head of veterinary medicinal products and AMR containment5,
  8. Niyada Kiatying-Angsulee, manager6,
  9. Wantanee Kalpravidh, regional manager of the emergency centre for transboundary animal disease7,
  10. Angkana Sommanustweechai, health systems and, policy research fellow8,
  11. Viroj Tangcharoensathien, senior researcher8
  1. 1Food and Drug Administration, Ministry of Public Health, Bangkok, Thailand
  2. 2Ministry of Public Health, Bangkok, Thailand
  3. 3Department of Medical Sciences, Ministry of Public Health, Bangkok, Thailand
  4. 4Office of Permanent Secretary, Ministry of Public Health, Bangkok, Thailand
  5. 5Department of Livestock Development, Ministry of Agriculture and Cooperatives, Bangkok, Thailand
  6. 6Drug System Monitoring and Development Center, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
  7. 7Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific, Bangkok, Thailand
  8. 8International Health Policy Program, Ministry of Public Health, Bangkok, Thailand
  1. Correspondence to: N Sumpradit nithima{at}fda.moph.go.th

Nithima Sumpradit and colleagues describe the experience of Thailand in developing its national strategic plan on antimicrobial resistance and highlight the need for sustained political commitment and multisectoral collaboration

Antimicrobial resistance (AMR) is a serious global health threat which can cross borders and human and animal species. Concerted action is required at global, regional and national levels to tackle it. The World Health Assembly adopted the global action plan on AMR in 2015, which called on member states of the World Health Organization to develop national action plans by May 2017.1 To date, 67 member states have finalised their national action plans.

AMR places a high burden on health and the economy in Thailand,2 and the government has shown strong political commitment to tackle AMR over the past decade. Box 1 summarises the effect of AMR and antimicrobial consumption in Thailand.

Box 1: Burden and prevalence of antimicrobial resistance in Thailand2

AMR burden*

  • •About 88 000 infections were attributed to antimicrobial resistance (AMR), resulting in at least 3.24 million additional days in hospital and 38 000 deaths

  • •Direct costs of antibiotics to treat AMR infection were about $70-$170m (£54-£132m; €62-€150m; 2400-5800m baht)

  • •Indirect costs of morbidity and premature deaths related to AMR were at least $1100m

AMR prevalence†

  • Important resistant pathogens include imipenem resistant Acinetobacter spp, imipenem resistant Pseudomonas aeruginosa, vancomycin resistant enterococci, carbapenem resistant Enterobacteriaceae, extended spectrum β-lactamase producing Enterobacteriaceae, and multidrug resistant and extensive drug resistant tuberculosis

  • Between 2000 and 2014, the prevalence of imipenem resistant P aeruginosa and Acinetobacter spp increased from 10% to 22% and from 14% to 65%, respectively

Antimicrobial consumption‡

  • More than 5200 antimicrobial products are registered with the Thai Food and Drug Administration, of which two thirds are for humans and the remainder for animals

  • Antimicrobials account for 15-20% of the total human drug costs, and 50% of antimicrobial consumption is antibiotics; the other 50% are antiviral, antifungal, …

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