Antibiotic resistance: A present and future challenge

In anticipation of the World Antimicrobial Awareness Week (November 18-24), the Viet Nam Respiratory Society in collaboration with GSK Viet Nam organized the symposium "Antibiotic resistance and multidisciplinary strategies for treating infections" to promote action, raise awareness, and urging the rational use of antibiotics – for a sustainable future of treatment in Ha Noi on November 20.

Antibiotic resistance – A threat no longer silent

Antimicrobial resistance (AMR) is an urgent threat to global public health, with a sharply increasing risk that could cause at least 10 million deaths annually and reach a mortality level comparable to cancer by 2050 if timely and effective action is not taken.

The World Health Organization (WHO) reported that besides death and morbidity, AMR also imposes significant economic costs.

Viet Nam is among the countries facing the growing threat of antimicrobial resistance (AMR), stemming from unnecessary antibiotic use in non-bacterial cases or inappropriate use for specific bacterial species over many years.

Particularly in the treatment of community-acquired respiratory infections, some cases require high-dose antibiotics for children.

According to a study by Torumkuney and colleagues, the resistance rates of of Streptococcus pneumoniae and Haemophilus influenzae – the two main pathogens causing pneumonia, otitis media, and sinusitis – are currently at alarming levels

The healthcare professionals emphasized the need for coordinated multidisciplinary action to control AMR, especially in the context of widespread antibiotic overuse for mild respiratory conditions.

Prof. Dinh Xuan Anh Tuan – Former President of the University of Corsica, France updated: "In 2019, one in five deaths among children under five years old was attributed to antimicrobial resistance. The consequence of unnecessary antibiotic use is that it destroys beneficial bacteria that protect the body, creating conditions for resistant bacteria to increase, thrive, and dominate, while also transferring resistance mechanisms to other bacteria. Antibiotic overuse is accelerating this process, turning resistance into a global issue that threatens public health, hampers economic development, increases poverty rates, and creates social inequities. Even more concerning, the growing prevalence of antimicrobial resistance is rendering antibiotics ineffective, increasing the risk of death from infectious diseases and pushing human medicine back to the 19th century, when infections were considered incurable."

Assoc. Prof. Dr. Tran Minh Dien, President of the Viet Nam Pediatric Association, provided an example: "According to data from the National Children's Hospital, respiratory diseases have accounted for the highest hospitalization rates from 2020 to 2024 and show an annual upward trend. Pediatric antibiotic stewardship strategies should be based on the WHO classification framework, which includes three antibiotic groups: Access, Watch, and Reserve, aiming for accurate and rational prescribing. In addition to adhering to antibiotic stewardship strategies, it is essential to promote diagnostic approaches to identify the causative pathogens, enabling correct and sufficient antibiotic use and reducing unnecessary prescriptions for viral infections."

Assoc. Prof. Dr. Pham Tuan Canh – Vice President of the Viet Nam Otorhinolaryngology Association updated: "Ear, nose and throat (ENT) infections and community-acquired pneumonia are common respiratory conditions in adults, contributing significantly to hospitalizations and mortality, particularly among older individuals and those with underlying diseases. Current data indicate that pneumococcal strains causing respiratory infections have markedly reduced susceptibility to second-generation cephalosporins and macrolides. This is a warning sign of increasingly complex antibiotic resistance, requiring close coordination between microbiological testing and rational antibiotic selection in clinical practice."

Citing the antibiotic use regulations issued by the Ministry of Health, Assoc. Prof. Dr. Nguyen Hoang Anh, Director of the National Center for drug information and adverse drug reaction monitoring, emphasized: "Understanding antibiotic classification, pharmacokinetics, and pharmacodynamics is fundamental to selecting the right antibiotic, with accurate and sufficient dosing to overcome bacterial resistance and ensure effective treatment from the initiation phase. The role of community pharmacists and pharmacies is to provide proper counseling, helping patients adhere to the full course of antibiotic therapy, thereby contributing to reducing antimicrobial resistance."

Prof. Dr. Ngo Quy Chau – President of the Viet Nam Respiratory Society concluded: "I believe that controlling antimicrobial resistance (AMR) requires a comprehensive approach, especially in three areas: respiratory, otorhinolaryngology, and pediatrics – where antibiotics are most commonly used. 

To build an effective infection management strategy, it is essential to rely on updated microbiological data from hospitals, studies such as SOAR (the antibiotic surveillance research program), and surveys on medication usage behavior. 

At the same time, harmonizing treatment guidelines and implementing education and training programs for healthcare professionals at all levels are crucial factors to ensure long-term efficacy of antibiotics"./.