Antimicrobial resistance (AMR) is a significant global health and development threat. The World Health Organization (WHO) has declared that AMR is one of the top 10 global public health threats facing humanity. It is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths. The misuse and overuse of antimicrobials in humans, animals, and plants are the main drivers in the development of drug-resistant pathogens.

Antimicrobial guidelines are designed to improve prescribing practices. There is evidence to suggest that evidence-based guidelines help to standardise care and reduce unnecessary prescriptions. Adherence to guidelines has shown to decrease AMR and reduce mortality rates associated with infections. In addition, Antimicrobial Stewardship (AMS) programs use antimicrobial guidelines to monitor and evaluate antimicrobial use.

This guideline is a product of a year of preparation. It started with a steering committee deciding on the contents or chapters. This was followed by groups of Infectious Diseases physicians, Microbiologists and Pharmacists creating the first draft. This draft was then discussed with representatives from all the Heads of Services of specialties in Ministry of Health. Subsequently the document was displayed for public consultation and externally reviewed. This multi-step process was deemed necessary to create a document that is not only evidence-based but also caters to local needs and peculiarities.

I would like to acknowledge and thank the Editorial Team, Heads of Services, Panels of Expert Groups and Technical Working Groups for their contribution and patience throughout this lengthy but crucial review process in updating our National Antimicrobial Guideline. Additionally, I extend my thanks to our team of external reviewers for their time and constructive input. A special note of appreciation goes to the Pharmaceutical Services Programme and their dedicated pharmacists for their vital role in the development of this essential document.

Together, we need to ensure the effectiveness of our antimicrobial medicines and safeguard our future health. I hope National Antimicrobial Guideline 4th Edition will contribute significantly to this effort.

Dato’ Dr. Suresh Kumar a/l Chidambaram

Head of Services (Infectious Diseases)

Ministry of Health Malaysia

Chairman of National Antimicrobial Guideline Editorial Committee