(NAR) VOL. 29 NO. 2/ APRIL - JUNE 18
A. Antimicrobial Resistance (AMR) - is the ability of organisms that cause disease to withstand attack by antimicrobials.V. GENERAL GUIDELINES
B. Antimicrobial Resistance Surveillance Program (ARSP) - is a program of the DOH which aims to provide critical inputs to the DOH’s effort to promote rational drug use by determining the status and trends of antimicrobial resistance of selected bacteria to specific antibiotics.
C. Tertiary clinical laboratory - A clinical laboratory, regardless of its classification by ownership, function, and institutional character which provides minimum service capabilities for the following: routine and special hematology including coagulation procedures, qualitative and quantitative platelet determination, routine urinalysis and fecalysis, routine clinical and special chemistry, cross matching*, KOH*, blood typing*, immunology, and microbiology-culture and sensitivity. (* for hospital based only)
D. AMS program - Antimicrobial Stewardship program is the program of the DOH tasked with concerted implementation of systematic, multi-disciplinary, multi-pronged interventions in both public and private hospitals in the Philippines to improve appropriate use of antimicrobials, which is essential for preventing the emergence and spread of AMR.
E. Adverse Monitoring Findings - performance of health care providers that show deviations from PhilHealth policies and treatment protocols which may result to abuse or compromise the National Health Insurance Program (NHIP). These are identified during conduct of the monitoring activities prescribed by the Corporation. (source: PhilHealth Circular No. 2016-0026)
A. Restricted antimicrobials shall only be utilized by institutions with tertiary clinical laboratories which have ARSP laboratory accreditation.
B. The restricted antimicrobials as stated in the Philippine National Formulary
8th edition 2017 are listed in ANNEX A*.
C. All future DOH issuances identifying restricted antimicrobials shall automatically be adopted by PhilHealth. ANNEX A shall be updated accordingly through an Advisory posted in the PhilHealth website.
D. Transition period for hospitals to attain ARSP Laboratory Accreditation as a requirement for utilization of restricted antimicrobials:
1. Compliance period until June 2019 will be implemented. The list of hospitals with provisional ARSP accreditation shall be provided by RITM-DOH to PhilHealth and shall be regularly updated. Use of restricted antimicrobials by facilities with no ARSP accredited laboratory shall not be an “adverse monitoring finding” during post-audit or monitoring activities if:a. They will present either of the following documents issued by Antimicrobial Resistance Surveillance Reference Laboratory (ARSL) of Research Institute for Tropical Medicine: “Acknowledgment letter for Phase 1 ARSP Accreditation” (ANNEX-B*) or the Notification for compliance to Phase 2 ARSP accreditation (ANNEX-C*) containing the list of requirements for compliance identified during inspection; AND2. By July 2019, as imposed by the DOH issued Administrative Order No. 2016-0034 “The New Implementing Guidelines of the Philippine National Formulary System (PNFS)”, aside from the requirement for the microbiology laboratory to be ARSP accredited, all secondary and tertiary hospitals should have any of the following:
b. Relevant cultures are taken from patients for whom restricted antimicrobials are used with the results attached to medical charts and should be readily available during PhilHealth’s validation or post-audit activities.
a. A DOH AMS trained chairperson of either the hospital’s Infection Control Committee (ICC) or Antimicrobial Stewardship (AMS) Committee. The hospital shall provide a copy of the Certificate of Training on AMS of current personnel to their respective PhilHealth Regional Office (PRO); or use of the restricted antimicrobials per patient.
c. For hospitals which will not attain ARSP accreditation after July 2019, may outsource with an ARSP Accredited Laboratory. A copy of a valid Memorandum of Agreement (MOA) shall be provided to the respective PRO.
E. Inappropriate or unauthorized use of restricted antimicrobials shall not result in denial of a claim but shall be considered as an “Adverse Monitoring Findings” during claims post-audit or any monitoring activity wherein cumulated offenses shall have bearing on a provider's accreditation renewal.
F. For queries and accreditation applications on ARSP, the HCI may refer to the details below:
VI. REPEALING CLAUSEAntimicrobial Resistance Surveillance Program
Research Institute for Tropical Medicine - Department of Health
9002 Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City 1781
Direct Line: (02) 809-9763 Trunk Line: (02) 807-2631 to 32 loc. 243
Email: secretariat@arsp.com.ph Website: www.arsp.com.ph