scholarly journals The ANTIBIOTIC CONSUMPTION AT A PEDIATRIC WARD AT A PUBLIC HOSPITAL IN INDONESIA

2019 ◽  
pp. 64-67
Author(s):  
FAUNA HERAWATI ◽  
MUHAMAD SATRIA MANDALA PUA UPA ◽  
RIKA YULIA ◽  
RETNOSARI ANDRAJATI
Keyword(s):  
Antibiotic Treatment ◽  
Antibiotic Consumption ◽  
Stool Culture ◽  
Second Phase ◽  
Defined Daily Dose ◽  
Pediatric Ward ◽  
Zinc Supplement ◽  
Health Authorities ◽  
Days Of Therapy ◽  
Bed Days

Objective: The aims of the study are to describe how antibiotics were used in a pediatric ward and to observe how they were prescribed for infectious diarrheas of bacterial origin indication. Diarrhea or acute gastroenteritis is one of the most common infection diagnoses observed among the hospitalized children. Rehydration therapy is the key treatment for children with diarrhea. With the zinc supplement, the duration of the hospital stay can be reduced. Thus, the decision whether the local or regional health authorities need to provide an antibiotic treatment depends on the etiology of the disease, the patient’s nutritional history and immunological status, and eventually, the severity of the disease. Good anamneses and diagnoses are essential to decide whether antibiotic treatment is required. Methods: The observation in this study consists of two phases. The first-phase observation was taken from the diagnosis and the number of antibiotics used in 2016 retrospectively calculated from each of the patients’ medical records. Meanwhile, the second phase descriptive observation was prospectively drawn from the stool culture and the number of antibiotics prescribed to 21 inpatient diarrhea children between May 2017 and December 2017. The amount of antibiotic consumption was administered based on defined daily dose (DDD) and days of therapy (DOT). Results: In 2016, 56% (828/1476) of the patients received antibiotic prescriptions. On average, the DDD per 100 bed-days was 45.57. In the prospective study, six of 21 patients with diarrhea were prescribed antibiotics intravenously. The DOT was 3.5 days and the DDD for these patients was 12.10/100 bed-days. Conclusion: There was a high consumption rate of antibiotics which was not indicated in each patient’s etiology of diarrhea in the hospital during the period. Thus, the recommendation is to encourage health authorities to judiciously prescribe antibiotics according to the guidelines.

scholarly journals Lessons Learned from Implementing Clostridium difficile-Focused Antibiotic Stewardship Interventions

2014 ◽  
Vol 35 (S3) ◽  
pp. S86-S95
Author(s):  
B. Ostrowsky ◽  
R. Ruiz ◽  
S. Brown ◽  
P. Chung ◽  
E. Koppelman ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Intervention Group ◽  
Antibiotic Consumption ◽  
Lessons Learned ◽  
Audit And Feedback ◽  
Defined Daily Dose ◽  
Case Control Studies ◽  
Days Of Therapy ◽  
Daily Dose ◽  
Over Time

Objective.To determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates.Design.A multicenter before-and-after intervention comparative study.Setting/Participants.Ten medical centers in the greater New York region. Intervention group comprised of 6 facilities with early antimicrobial stewardship programs (ASPs). The 4 facilities without ASPs made up the nonintervention group.Interventions/Methods.Intervention facilities identified target antibiotics using case-control studies and implemented ASP-based strategies to control their use. Pre- and postintervention hospital-onset CDI rates and antibiotic consumption were compared for a 20-month period from June 2010 to January 2012. Antibiotic usage was compared using defined daily dose, days of therapy, and number of courses prescribed. Comparisons used bivariate and regression techniques.Results.Intervention facilities identified piperacillin/tazobactam, fluoroquinolones, or cefepime (odds ratio, 2.0-9.8 in CDI case patients compared with those without CDI) as intervention targets and selected several interventions (all included a component of audit and feedback). Varying degrees of success were observed in reducing antibiotic consumption over time. Total target antibiotic use significantly decreased (P < .05) when measured by days of therapy and number of courses but not by defined daily dose. Intravenous moxifloxacin and oral ciprofloxacin use showed significant reduction when measured by defined daily dose and days of therapy (P ≤ .01). Number of courses with all forms of these antibiotics was reduced (P ≤ .005). Intervention hospitals reported fewer hospital-onset CDI cases (2.8 rate point difference) compared with nonintervention hospitals; however, we were unable to show statistically significant decreases in aggregate hospital-onset CDI either between intervention and nonintervention groups or within the intervention group over time.Conclusions.Although decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, many valuable lessons (including implementation strategies and antibiotic consumption measures) were learned. The findings can inform potential policy decisions regarding incorporating control of CDI and ASP as healthcare quality measures.

scholarly journals Antibiotic use on paediatric inpatients in a public hospital in Bangil, Indonesia

2021 ◽  
pp. 163-167
Author(s):  
Ika Norcahyanti ◽  
Malikatur Rosyidah ◽  
Abdul Kadir Jaelani ◽  
Antonius N.W. Pratama
Keyword(s):  
Public Hospital ◽  
Anatomical Therapeutic Chemical ◽  
Action Plan ◽  
Antibiotic Use ◽  
Defined Daily Dose ◽  
Cross Sectional ◽  
Pediatric Ward ◽  
Global Action ◽  
Bed Days ◽  
Cross Sectional Design

Introduction: The importance of antibiotic use in a clinical setting was evaluated in order to support the global action plan to decelerate the spreading speed of antimicrobial resistance. Objective: This study aimed to evaluate antibiotic use among pediatric inpatients in Bangil public hospital, East Java, Indonesia. Methods: This study used a cross-sectional design. The data were obtained from medical records of pediatric patients admitted to a pediatric ward in 2017. Data were analysed using the anatomical therapeutic chemical classification system (ATC)/defined daily dose (DDD) method in conjunction with data sources from a locally developed bacterial map. Results: The results showed the paediatric patients were dominantly male (n=218; 54.2%) and mostly diagnosed with diarrhoea (n=87; 15.3%). Ampicillin-sulbactam was the most commonly used antibiotic (16.3%). The total DDD value was 66.1 DDD/100 bed-days, and ceftriaxone demonstrated the highest DDD value (10.3 DDD/100 bed-days). Conclusion: In conclusion, the use of antibiotics in the pediatric ward in Bangil public hospital was comparable to other studies conducted in Indonesia.

Measuring antibiotic consumption and outcomes

2016 ◽  
Author(s):  
Hayley Wickens
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Consumption ◽  
Electronic Prescribing ◽  
Defined Daily Dose ◽  
Antimicrobial Usage ◽  
Monitoring Process ◽  
Days Of Therapy ◽  
Daily Dose ◽  
Information Management Systems ◽  
The Uk

Understanding how antimicrobial usage is monitored and reported is crucial when reading the literature on antimicrobial stewardship and assessing outcomes of local programmes. This chapter covers the methods used to monitor antimicrobial usage and the associated terminology, such as defined daily dose (DDD), average daily quantities (ADQs), and days of therapy (DOT), and gives and overview of usage monitoring in primary and secondary healthcare in the UK and beyond. This chapter also covers potential roles for electronic prescribing and information management systems in the monitoring of antimicrobial usage, and highlights some issues in the monitoring process and the outcome of antimicrobial stewardship initiatives.

Bacterial Profile and Antibiotic Use in Pneumonia Patients at Dr. Soetomo General Hospital

2020 ◽  
Vol 16 (1) ◽  
pp. 21-27
Author(s):  
Rika Yulia ◽  
Josephine Witha Mariza ◽  
Soedarsono ◽  
Fauna Herawati
Keyword(s):  
General Hospital ◽  
Antibiotic Treatment ◽  
Antibiotic Sensitivity ◽  
Severe Pneumonia ◽  
Antibiotic Use ◽  
Common Species ◽  
Defined Daily Dose ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Bed Days

Background: Pneumonia is one of the causes of morbidity and mortality in children and adults worldwide. WHO report in 1999 stated that the main cause of death due to infectious disease is pneumonia. The rising mortality rate among severe pneumonia patients is because they do not receive empirical antibiotic treatment according to the infecting pathogens. Objective: The purpose of this study is to identify the bacterial profile and the use of antibiotic treatment on pneumonia patients admitted to the pulmonology ward of Dr. Soetomo General Hospital in Surabaya, Indonesia. Methods: This descriptive observational study used the data from pneumonia patients admitted to the pulmonology ward of Dr. Soetomo General Hospital, Surabaya, from February to April 2018. The data was collected from the patients’ medical records, antibiotic use notes, and culture results of bacterial antibiotic sensitivity test. The total of antibiotic use was calculated using a defined daily dose (DDD) per 100 bed days. The quality of antibiotics was assessed using Gyssens method. The microbial mapping was acquired from a sputum culture test result. Results: The most prevalent bacteria in pneumonia patients were the Gram-negative bacteria and the most common species was Acinetobacter baumannii followed by Klebsiella pneumoniae. In contrast, the most common Gram-positive bacteria species was Streptococcus viridans. The total antibiotic use was 35.53 DDD/100 bed days, and ceftriaxone was the most commonly used antibiotic with 9.23 DDD/100 bed days. Fifty percent of the antibiotic use was in category wise use of antibiotic. Conclusion: The Gram-negative bacteria were the most common cause of pneumonia and ceftriaxone was the most commonly used antibiotic for its cure. Fifty percent of the patients received ceftriaxone appropriately.

scholarly journals ANTIBIOTIC USE IN SLOVENIAN HOSPITALS

2020 ◽  
Vol 7 (11) ◽  
pp. 249-258
Author(s):  
Tatjana Pokrajac ◽  
Milan Čižman ◽  
Bojana Beovič
Keyword(s):  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Total Consumption ◽  
Test Analysis ◽  
Weighted Linear Regression ◽  
Case Mix Index ◽  
Regression Test ◽  
Daily Dose ◽  
Bed Days

Abstract: Motivation/Background: Antibiotics are commonly overused and misused what increase the emergence of resistant organisms, side- effects and costs. To assess the appropriate use of antibiotics many methods are available. The aim of the present study is to find correlation between antibiotic use and case mix index (CMI) in Slovenian hospitals. Method: In retrospective study (in the years between 2004 and 2013) we correlated the total consumption of antibiotics for systemic use and CMI. Weighted linear regression test analysis was performed to determine correlation between defined daily dose (DDD) / 100 admissions and DDD / 100 bed-days and CMI. Results: The total antibiotic consumption in all included hospitals was in mean 317.69 DDD / 100 admissions and 58.88 DDD / 100 bed days, respectively. CMI range were from 1.25 to 3.55. A significant correlation between consumption expressed in DDD / 100 admissions and CMI (p = 0.028) and DDD / 100 bed days and CMI (p =0.008) was found. Conclusions: Thus, detailed analysis of correlations between DDD of antibiotics and CMI may constitutes a proper use of antibiotics.

scholarly journals Antibiotic Consumption and Stewardship at a Hospital outside of an Early Coronavirus Disease 2019 Epicenter

2020 ◽  
Vol 64 (11) ◽  
Author(s):  
Deanna J. Buehrle ◽  
Brooke K. Decker ◽  
Marilyn M. Wagener ◽  
Amesh Adalja ◽  
Nina Singh ◽  
...  
Keyword(s):  
Antibiotic Consumption ◽  
Days Of Therapy ◽  
Hospital Antibiotic Consumption ◽  
Bed Days ◽  
The Impact

ABSTRACT There are scant data on the impact of coronavirus disease 2019 (COVID-19) on hospital antibiotic consumption, and no data from outside epicenters. At our nonepicenter hospital, antibiotic days of therapy (DOT) and bed days of care (BDOC) were reduced by 151.5/month and 285/month, respectively, for March to June 2020 compared to 2018–2019 (P = 0.001 and P < 0.001). DOT per 1,000 BDOC was increased (8.1/month; P = 0.001). COVID-19 will impact antibiotic consumption, stewardship, and resistance in ways that will likely differ temporally and by region.

scholarly journals Measurement of antibiotic consumption in surgical ward of a tertiary care hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1565
Author(s):  
Rashmi R. Pujari ◽  
Bhabagrahi Rath ◽  
Tapan Kumar Nayak
Keyword(s):  
Antibiotic Resistance ◽  
Average Length ◽  
Tertiary Care ◽  
Medical Science ◽  
Antibiotic Consumption ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Number Of Patients ◽  
Improper Use ◽  
Bed Days

Background: Antibiotic resistance is a global health problem. Improper use of antibiotics leads to development of antibiotic resistance, side effects, superinfections and increase in treatment costs. There are few publications on antibiotic consumption. Serious morbidity and mortality are associated with postoperative wound infections. The use of peri or pre-operative antibiotics has resulted in a reduced risk of postoperative infection when appropriate principles of prophylaxis are applied.Methods: An observational study during a 2-month period was carried out in the department of surgery of Veer Surendra Sai Institute of Medical Science and Research, Burla. We utilized the administrative data for expression of antibiotic consumption using anatomical therapeutic classification (ATC) / defined daily dose (DDDs) methodology. The information included were drug names, strength, pharmaceutical form, quantity dispensed, total number of patients admitted during the study period and average length of stay. Each drug was then given a code according to the ATC classification. The number of DDDs and DDDs/100 bed days was calculated.Results: The most frequent antibiotic used was cephalosporin group with DDDs 62.70 DDDs/100 bed days (44.34%) followed by metronidazole with 23.10 DDDs/100 bed days (16.34%). Among cephalosporin group most common antibiotic used was ceftriaxone with 24.46 DDDs/100 bed days. The mean duration of stay was 7.2 days.Conclusions: The results of this study are similar to previous studies and it showed that there is irrational use of antibiotics as there is no antibiotic policy in our hospital. Drug utilization research should be carried out at frequent intervals to improve rational use of antibiotics.

scholarly journals Antibiotic use on paediatric inpatients in a public hospital in Bangil, Indonesia

2021 ◽  
pp. 163-167
Author(s):  
Ika Norcahyanti ◽  
Malikatur Rosyidah ◽  
Abdul Kadir Jaelani ◽  
Antonius N.W Pratama
Keyword(s):  
Public Hospital ◽  
Anatomical Therapeutic Chemical ◽  
Action Plan ◽  
Antibiotic Use ◽  
Defined Daily Dose ◽  
Cross Sectional ◽  
Pediatric Ward ◽  
Global Action ◽  
Bed Days ◽  
Cross Sectional Design

Introduction: The importance of antibiotic use in a clinical setting was evaluated in order to support the global action plan to decelerate the spreading speed of antimicrobial resistance. Aim: This study aimed to evaluate antibiotic use among pediatric inpatients in Bangil public hospital, East Java, Indonesia. Methods: This study used a cross-sectional design. The data were obtained from medical records of pediatric patients admitted to a pediatric ward in 2017. Data were analysed using the anatomical therapeutic chemical classification system (ATC)/defined daily dose (DDD) method in conjunction with data sources from a locally developed bacterial map. Results: The results showed the paediatric patients were dominantly male (n=218; 54.2%) and mostly diagnosed with diarrhoea (n=87; 15.3%). Ampicillin-sulbactam was the most commonly used antibiotic (16.3%). The total DDD value was 66.1 DDD/100 bed-days, and ceftriaxone demonstrated the highest DDD value (10.3 DDD/100 bed-days). Conclusion: In conclusion, the use of antibiotics in the pediatric ward in Bangil public hospital was comparable to other studies conducted in Indonesia.

scholarly journals National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): A Cross-Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 77
Author(s):  
Joseph Sam Kanu ◽  
Mohammed Khogali ◽  
Katrina Hann ◽  
Wenjing Tao ◽  
Shuwary Barlatt ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Defined Daily Dose ◽  
Oral Antibiotics ◽  
Sectional Study ◽  
Beta Lactam ◽  
Total Consumption ◽  
Cross Sectional ◽  
Procaine Penicillin

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.

scholarly journals Infectious Disease Team Review Using Antibiotic Switch and Discharge Criteria Shortens the Duration of Intravenous Antibiotic: A Single-Center Cluster-Randomized Controlled Trial in Thailand

2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Thanyarak Wongkamhla ◽  
Buddharat Khan-asa ◽  
Sasima Tongsai ◽  
Nasikarn Angkasekwinai
Keyword(s):  
Infectious Disease ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Cluster Randomized Controlled Trial ◽  
Defined Daily Dose ◽  
Randomized Controlled ◽  
Days Of Therapy ◽  
Significant Difference ◽  
Cluster Randomized ◽  
Discharge Criteria

Abstract Background Strategies have been recommended to optimize early antibiotic (ATB) switching from intravenous (IV) to oral ATB. This study aimed to determine whether infectious disease (ID) team review using ATB switch and discharge criteria would shorten the duration of IV ATB and length of hospital stay (LOS). Methods This cluster-randomized controlled trial was conducted in 8 general medical wards as cluster units at Siriraj Hospital during January–October 2019. The ID team review with checklist criteria was performed on the third, fifth, and seventh day of IV-ATB treatment to determine (1) the suitability of switching to oral ATB or outpatient parenteral ATB therapy and (2) early discharge for patients receiving IV-ATB versus control. The primary outcomes were LOS and the duration or days of therapy (DOT) or defined daily dose (DDD) of IV-ATB therapy. Results Four wards each were randomly assigned to the intervention and control groups (46 patients/cluster, 184 patients/arm). No significant difference was observed between intervention and controls for median duration of IV-ATB therapy (7 vs 7 days) and LOS (9 vs 10 days). A significantly shorter duration of IV ATB was observed in patients without sepsis in the intervention group when measured by DOT (7 vs 8 days, P = .027) and DDD (7 vs 9, P = .017) in post hoc analysis. Conclusions Infectious disease team review using checklist criteria did not result in a shorter duration of IV-ATB and LOS in overall patients. Further study is needed to determine whether faster culture turnaround time or advanced testing will reduce the duration of IV-ATB therapy.

Sign in / Sign up

Export Citation Format

Share Document