Southeast Asia (SEA) can be considered a hotspot of antimicrobial resistance (AMR) worldwide. As recent surveillance efforts in the region reported the emergence of multidrug-resistant (MDR) pathogens, the pursuit of therapeutic alternatives against AMR becomes a matter of utmost importance. Phage therapy, or the use of bacterial viruses called bacteriophages to kill bacterial pathogens, is among the standout therapeutic prospects. This narrative review highlights the current understanding of phages and strategies for a phage revolution in SEA. We define phage revolution as the radical use of phage therapy in infectious disease treatment against MDR infections, considering the scientific and regulatory standpoints of the region. We present a three-phase strategy to encourage a phage revolution in the SEA clinical setting, which involves: (1) enhancing phage discovery and characterization efforts, (2) creating and implementing laboratory protocols and clinical guidelines for the evaluation of phage activity, and (3) adapting regulatory standards for therapeutic phage formulations. We hope that this review will open avenues for scientific and policy-based discussions on phage therapy in SEA and eventually lead the way to its fullest potential in countering the threat of MDR pathogens in the region and worldwide.

Objectives. This study aimed to analyze if the indicator 72-hours Unplanned Return Visits after EmergencyDepartment (ED) index discharge was influenced by the patient’s age, triage severity, month, payment methods,and length of stay. Likewise, it aimed to determine if the 72-hour Unplanned Return Visits was a robust indicator inassessing the quality of Emergency Department services. Methods. This was a retrospective single-center study from January to December 2017. Data were retrievedfrom a tertiary hospital in the Philippines. All Emergency Department patients discharged on their index visitwere monitored for Unplanned Return Visits within 72 hours in the hospital. A univariate and multivariate logisticregression model was used to assess the variables associated with the 72-hour Unplanned Return Visits. Results. The 72-hour Unplanned Return Visits rate was measured at 2.67%, with the highest occurrence on thefirst 24 hours, and with predominance on third-party payer (p.<.0001), pediatrics (p.<0001), January (p<.0001),February (p<.0001), November (p<.0001), December (p<0001), and shorter length of stay (p<.0001) dischargedafter ED index visit. Conclusions. Strong association of Unplanned Return Visits during the first 72 hours after Emergency Departmentindex discharge was found for patients financed through third party-payers, with seasonal variations andinclination to the younger population with shorter length of stay. These findings warrant exploratory studies todetermine the reasons for the 72-hour Unplanned Return Visits after Emergency Department index discharge andinvestigation on the association of premature discharge, socio-economic, health structure, and illness progression.

Flu, a viral infection caused by the influenza virus, is still a global public health concern with potential to cause seasonal epidemics and pandemics. Vaccination is considered the most effective protective strategy against the infection. However, given the high plasticity of the virus and the suboptimal immunogenicity of existing influenza vaccines, scientists are moving toward the development of universal vaccines. An important property of universal vaccines is their ability to induce heterosubtypic immunity, i.e., a wide immune response coverage toward different influenza subtypes. With the increasing number of studies and mounting evidence on the safety and efficacy of recombinant influenza vaccines (RIVs), they have been proposed as promising platforms for the development of universal vaccines. This review highlights the current progress and advances in the development of RIVs in the context of heterosubtypic immunity induction toward universal vaccine production. In particular, this review discussed existing knowledge on influenza and vaccine development, current hemagglutinin-based RIVs in the market and in the pipeline, other potential vaccine targets for RIVs (neuraminidase, matrix 1 and 2, nucleoprotein, polymerase acidic, and basic 1 and 2 antigens), and deantigenization process. This review also provided discussion points and future perspectives in looking at RIVs as potential universal vaccine candidates for influenza.

Objectives The non‐standard emergency medicine services and the limited utilisation of primary care providers in the Philippines may contribute towards the ED being a preferred area for patients with non‐urgent conditions. Our study aims to determine the factors associated with non‐urgent consultations in the ED of a tertiary hospital in the Philippines. Methods From 7 January to 15 February 2020, we surveyed non‐urgent ED patients (n = 757) presenting to a tertiary hospital in the Philippines. We evaluated the data using descriptive statistics, while chi‐squared and multivariate analyses versus urgent ED patients (n = 281) were used to show the association of factors. Results Our recruited non‐urgent patients were mostly 21–40 years old (n = 576 [76%]), single (n = 437 [58%]), with full‐time employment (n = 654 [86%]), have Health Maintenance Organization coverage (n = 684 [90%]), self‐referred (n = 498 [66%]), and have private means of getting to ED (n = 414 [55%]). They had moderate scores of social support‐seeking behaviours (mean 3.92/5; 95% confidence interval [CI] 3.88–3.96), health literacy (mean 3.58/5; 95% CI 3.56–3.61), self‐efficacy (mean 3.09/5; 95% CI 3.56–3.61), whereas their ED access score (mean 4.10/5; 95% CI 4.06–4.14) was high. They had moderate self‐assessed severity (mean 3.75/6; 95% CI 3.70–3.80), urgency (mean 3.83/6; 95% CI 3.78–3.88), and anxiety (mean 3.88/6; 95% CI 3.83–3.93) scores and high ED satisfaction rating (mean 4.73/6; 95% CI 4.69–4.77). They mostly had digestive (n = 203 [26.8%]) and infection‐related (n = 172 [22.7%]) chief complaints and final diagnoses (n = 198 [26.2%] and n = 145 [19.2%], respectively), without previous consultations (n = 577 [76%]), and eventually discharged (n = 755 [99%]). Our urgent patients had similar characteristics, but with higher assessed patient severity, urgency, anxiety and satisfaction with ED services (P < 0.001). Conclusion Non‐urgent consultations in ED are attributed to multiple factors encompassing socio‐demographic, socio‐economic and psychosocial dimensions. These factors must be considered in improving the current healthcare management system for the appropriate utilisation of ED in the Philippines.