Antimicrobial resistance is one of the global health challenges that can reduce the quality of health services, increase the burden of financing, and hinder the achievement of SDGs..
The resolution at the 68th World Health Assembly (WHA) meeting in 2015 resulted in the Global Action Plan on Antimcrobial Resistance (GAP AMR) as an effort to control antimicrobial resistance and become one of the priority programs in the health sector, both nationally and globally.
As a follow-up, Indonesia's National Action Plan for Antimicrobial Resistance Control (RAN PRA) 2020-2024 was developed through the One Health approach by involving cross-sectors and cross-ministries in Indonesia through the Coordinating Minister for PMK Regulation Number 7 of 2021, which aims to minimize the emergence and spread of resistant microbes, ensure the availability of safe, effective, quality, and affordable antimicrobials, and the wise and responsible use of antimicrobials.
Antimicrobial consumption (AMC) is aggregate data on the type and amount of antimicrobial drugs consumed by a population. WHO has defined the main antimicrobial groups monitored in AMC, including: J01 (antibacterials for systemic use), A07AA (antibiotics for alimentary tract) and P01AB (nitroimidazole derivatives for protozoal diseases).

AMC reporting is based on import, production, distribution, prescription, or service data from the pharmaceutical industry, PBF, hospital pharmaceutical installations, and health centers using the Anatomy Therapeutic Chemical (ATC)/Defined Daily Dose (DDD) system, which has been recommended by WHO since 1996.
The use of ATC/DDD has several benefits, which are
- This classification allows for international comparisons of drug use between countries;
- Drugs in the ATC structure are grouped by active substance in several groups according to the organ/system where the drug works, the purpose of therapy, pharmacological and chemical properties of the drug so that all drug dosage forms can be grouped in one ATC code.
In accordance with this, the Directorate General of Pharmaceuticals and Medical Devices through the Directorate of Pharmaceutical Management and Services held a Capacity Building activity on Antimicrobial Consumption which focused on Data Assessment on Antimicrobial Consumption on May 24-26, 2023 at the Savero Style Hotel Bogor.
The activity was opened by the Head of the Public Health and Clinical Pharmacy Working Team Dra. Hidayati Masud, Apt. by involving offline participants consisting of WHO SEARO, WHO Country Office Indonesia, BPOM, BPJS Health, KPRA, IQVIA, Digital Transformation Officer, BRIN, Project Manager Officer (PMO) and other main units related to AMS within the Ministry of Health.
"The purpose of this activity is to increase the knowledge and capacity of the AMC surveillance team in collecting and evaluating drug consumption using the ATC/DDD methodology and providing drug consumption data, especially antimicrobials, from the health service facility level," said Hidayati.
WHO SEARO representative Terence Fusire said that at the global level, antimicrobial consumption (AMC) rose 65 percent from 2000-2015. Based on WHO study data, Indonesia is one of the countries with high consumption of antibiotics.
Terence further said that the measurement of antimicrobial consumption data is an important component in controlling antimicrobial resistance. Analysis of antimicrobial consumption data can contribute to strengthening the pharmaceutical system (policy, procurement and supply, Rational Drug Use, Famacovigilance), improving clinical services (AMR epidemiology, improving guidelines, antimicrobial management, infection prevention control) and one health (policy and epidemiology).

Chairman of the Antimicrobial Resistance Control Committee (KPRA), dr. Harry Parathon, Sp.OG said, Permenko PMK Number 7 of 2021 is the legal legitimacy of Indonesia's second National Action Plan for Antimicrobial Resistance Control (RAN PRA) 2020-2024, it is hoped that all Ministries / Institutions and related agencies can implement these regulations to realize a healthy Indonesia and free from the impact of antimicrobial resistance.
"The trend of antimicrobial resistance continues to rise, let's reduce antimicrobial consumption," said Dr. Harry.
One of the training participants, Patri from BPOM said, "After attending this training, we get a lot of benefits, namely being able to understand the mechanism of calculation to reporting and presentation of AMC data and an overview of antimicrobial use (AMU) which will have an impact on antibiotic resistance interventions, get an overview of the form of data available in the public sector used for AMC, can develop an action plan to follow up on the preparation of AMC, prepare appropriate countermeasure policies in the prevention and control of antibiotic resistance based on AMC data and initial steps in synchronizing AMR handling policies."
"In the future, we hope to strengthen coordination between relevant Ministries / Institutions in terms of managing AMC data and create a special AMC team to focus on managing the data needed, so that globally Indonesia can play an active role in AMC reporting in accordance with WHO standard methodology." Patri concluded.
