Development of the Papua New Guinea Antimicrobial Guidelines

Antimicrobial resistance (AMR) is a major threat to human medicine, veterinary medicine and food security. Antimicrobials play a crucial role in the treatment and prevention of infectious diseases. However, overuse and misuse can lead to increased AMR and significant public health risk. Working in Papua New Guinea (PNG), this project aims to develop the first national antimicrobial guidelines with broad stakeholder consultation and local engagement.

In August 2019, in line with the Global Action Plan on AMR, the Government of Papua New Guinea endorsed their National Action Plan on AMR 2019–2023.

The plan contains Strategic Objective 5, which strengthens access to antimicrobial medicines. It includes the development of antimicrobial guidelines for human use, aligning antimicrobial use with best evidence. The development of an antimicrobial prescribing guideline is another critical component.

These guidelines will address gaps and complement other investments in AMR and antimicrobial stewardship in PNG.

The new guidelines will:

• be evidence-based, transparent and implementable
• align with the principles of antimicrobial stewardship, giving prescribers an easy access reference point for rational antimicrobial prescribing
• improve patient-centred care by facilitating the best antimicrobial for indication at the correct dose, route and duration
• minimise toxicity, unnecessary cost and antimicrobial resistance.

Objective

The project aims to:

• develop separate national human health antimicrobial prescribing (standard treatment) guidelines, based on best evidence and opinion regarding antimicrobial treatment and prophylaxis in PNG
• provide guidance for prescribers of antimicrobial treatment and prophylaxis on the optimal choice, route of administration, dose, frequency and duration
• recommend antimicrobial treatment and prophylaxis based on local antimicrobial resistance and use information
• update the national Essential Medicines List, ensuring access to antimicrobials recommended in the new prescribing guidelines
• disseminate the antimicrobial prescribing guidelines across public and private sectors, in co-ordination with the provincial health authorities
• train health care workers at the central and provincial level on implementation of the guidelines and the principles of antimicrobial stewardship.

Timeline 

1 July 2022–31 December 2024.

Approach

To develop the guidelines, Burnet partnered with the Australian Therapeutics Guidelines. Born from broad stakeholder consultation and engagement, the guidelines will be locally relevant and locally owned.

The project brings together experts from PNG and Australia. This expertise covers:

• clinical infectious diseases
• antimicrobial stewardship AMR data surveillance
• clinical microbiology
• clinical pharmacy
• One Health
• paediatrics
• critical care medicine
• hospital acquired infections.

The project also consults and works with representatives from:

• PNG National Department of Health
• AMR Secretariat 
• Port Moresby Hospital 
• Paradise Private Hospital 
• provincial hospitals 
• civil society and other key organisations.

Community impact 

National antimicrobial guidelines can have a significant impact on the community.  

They provide healthcare professionals with clear guidance on the appropriate use of antibiotics. This includes when to prescribe them, as well as which antibiotics to use and for how long.

They provide evidence-based recommendations on the most effective antibiotics treatment for different infections. This reduces the risk of treatment failure, helping to improve patient and public health outcomes.

Promoting judicious, targeted antibiotics use, the guidelines help reduce the risk of antibiotic resistance, a growing public health concern.