Evaluasi Penggunaan Antibiotik Pada Pasien Anak Rawat Inap di RSD Dr. Soebandi Jember

Infection is one of the health problems. It is mostly caused by bacteria. The increased incidence of bacterial infection results in higher antibiotic use. It can lead to antibiotic resistance risk. Antibiotic resistance may occur in pediatric patients. Morbidity, mortality, and high cost of medication are impact of this condition. Evaluation of antibiotic use needs to be done to ensure responsible use of antibiotics. ATCD/DDD (Anatomical Therapeutic Chemical/ Defined Daily Dose) method can be used to evaluate antibiotic use quantitatively. ATC classification is a system of grouping active substances according to their location of action and DDD is a measurement system that is connected to the ATC code.The purpose of this study was determining the profile of antibiotic use and measuring quantitative evaluation with ATC/DDD method in pediatric patients. The data was collected by observing the hospital medical record. The results of this study showed that cephalosporin (46,22%) was the most used group and cefotaxime (31,15%) was the most used type of antibiotic. While, the quantitative evaluation with ATC/DDD method indicated that the highest of antibiotic use was ceftriaxone (11,30 DDD/100 patient days) and the lowest was amikacin (0,03 DDD/100 patient days)

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Evaluasi Penggunaan Antibiotik pada Pasien Anak Rawat Inap di RSD Dr. Soebandi Jember

Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) ◽

10.22487/j24428744.2020.v6.i2.14976 ◽

2020 ◽

Vol 6 (2) ◽

Author(s):

Sinta Rachmawati ◽

Dewi Khurmi Masito ◽

Ema Rachmawati

Keyword(s):

Antibiotic Resistance ◽

Quantitative Evaluation ◽

Pediatric Patients ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Resistance Risk ◽

Condition Evaluation ◽

Daily Dose ◽

Active Substances

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ANALISIS PENGGUNAAN ANTIBIOTIK PADA PASIEN ANAK DI RUANG THERESIA RUMAH SAKIT ST. ELISABETH SEMARANG DENGAN METODE ATC/DDD

Jurnal Riset Kefarmasian Indonesia ◽

10.33759/jrki.v3i1.110 ◽

2021 ◽

Vol 3 (1) ◽

pp. 26-34

Author(s):

Fef Rukminingsih ◽

Apriliyani Apriliyani

Keyword(s):

Infectious Diseases ◽

Pediatric Patients ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Inappropriate Use ◽

Number Of Patients ◽

High Incidence ◽

Daily Dose ◽

Record Data

The high incidence of infectious diseases causes the use of antibiotics to increase. Inappropriate use of antibiotics will lead to resistance. Infectious diseases are included in the top 10 diseases in pediatric patients at St. Elisabeth Hospital.Semarang. This study aims to evaluate the use of antibiotics in pediatric patients in the Theresia ward of St. Elisabeth Hospital Semarang. This research is a descriptive observational study using retrospective data. Data were taken from medical records of pediatric patients in the Theresia ward at St. Elisabeth Hospital Semarang, aged 6 months - 14 years, the use of antibiotic therapy during the period October - December 2019. The data obtained were analyzed by calculating the quantity of antibiotic use using the Anatomical Therapeutic Chemical (ATC) and Defined Daily Dose (DDD)) / 100 patient-days methods. Based on the results of tracing medical record data, it was found that the number of pediatric patients in the Theresia room at St. Elisabeth Semarang for the period October - December 2019 is 385. The number of patients who received a single antibiotic was 162. The total value of DDD / 100 patient-days in the Theresia ward of St. Elisabeth Hospital Semarang for the period October - December 2019 is 18.17 with a total length of stay of 1117 days. The antibiotic with the highest DDD / 100 patient-days was ceftriaxone, namely 15.10. While the antibiotics that enter the DU 90% segment are ceftriaxone and cefotaxime.

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STUDI PENGGUNAAN ANTIBIOTIK PASIEN PNEUMONIA ANAK DENGAN METODE DDD DAN DU 90%

Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan ◽

10.36387/jiis.v6i1.644 ◽

2021 ◽

Vol 6 (1) ◽

pp. 108-115

Author(s):

Farah Bidara ◽

◽

Mumfasiroh Saputri ◽

Dyah Aryani Perwitasari ◽

Intan Fatah Kumara ◽

...

Keyword(s):

Antibiotic Resistance ◽

Respiratory Infections ◽

Demographic Data ◽

Antibiotic Use ◽

Defined Daily Dose ◽

Inpatient Ward ◽

Daily Dose ◽

Patient Demographic Data ◽

Antibiotic Duration ◽

Empirical Antibiotics

Pneumonia is one of the most common respiratory infections. The treatment of pneumonia mostly uses broad-spectrum empirical antibiotics that are susceptible to resistance. One of the efforts to reduce antibiotic resistance is to use antibiotics wisely which can be done by regularly evaluating the quantitative and qualitative use of antibiotics. The purpose of this study was to determine the quantity of consumption and the type of antibiotic used in patients pneumonia child inpatient ward at Hospital Mitra Paramedika Yogyakarta (MPY) and Yadika Pondok Bambu Jakarta (YPBJ) by DDD (Defined Daily Dose) and DU (Drug utility) 90%. This is a descriptive study period June 2017 - April 2020 in pediatric patients aged 1 - 18 years with a diagnosis of pneumonia. Sampling was performed at the Medical Record Installation. The Data taken were antibiotic type, dosage regimen, medication route, antibiotic duration (day), and hospital stay (day) as well as patient demographic data (age, type sex) .There are differences in the pattern of antibiotic use between YPBJ and MPY. Comparison of DDD and DU 90% may be due to differences in standard of therapy used by physicians, antibiotic resistance, differences in germ maps and hospital formularies.

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Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

Antibiotics ◽

10.3390/antibiotics10040397 ◽

2021 ◽

Vol 10 (4) ◽

pp. 397

Author(s):

Ana Tomas ◽

Nebojša Pavlović ◽

Nebojša Stilinović ◽

Olga Horvat ◽

Milica Paut-Kusturica ◽

...

Keyword(s):

Broad Spectrum ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Annual Reports ◽

Antibiotic Prescribing ◽

Defined Daily Dose ◽

Increasing Trend ◽

Daily Dose ◽

Total Utilization ◽

Third Generation Cephalosporins

The aim of this study was to determine and describe trends in antibiotics utilization in Serbia over a ten-year period. Data were retrieved from publicly available annual reports (2010–2019). The results were expressed as Defined Daily Dose (DDD) per 1000 inhabitants per day (DID). All calculations were performed using the DDD values for the 2020 Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) version for each year of the study, to account for the DDD changes during the study period. Antibiotics were classified using the WHO Access, Watch, Reserve (AWaRe) classification. Total utilization of antibacterials for systemic use increased from 17.25 DID in 2010 to 28.65 DID in 2019. A statistically significant increasing trend in the use of the Watch category antibiotics was observed. A tendency towards use of broad-spectrum antibiotics, apparent by a statistically significant increase in the rate of utilization of broad-spectrum macrolides, quinolones and third-generation cephalosporins vs. narrow-spectrum ones, as well as a significant increasing trend in the use of quinolones was identified. Total antibiotic utilization was found to be well above the European average. Several specific problem areas were identified, which requires further efforts to improve antibiotic prescribing. The present study provides the information needed to facilitate antibiotic stewardship in Serbia further and proposes specific interventions to optimize antibiotic use in Serbia.

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Hazai kórházi antibiotikum-alkalmazás az elmúlt két évtizedben (1996–2015)

Orvosi Hetilap ◽

10.1556/650.2016.30523 ◽

2016 ◽

Vol 157 (46) ◽

pp. 1839-1846 ◽

Cited By ~ 5

Author(s):

Ria Benkő ◽

Mária Matuz ◽

Edit Hajdú ◽

Andrea Bor ◽

Péter Doró ◽

...

Keyword(s):

Bacterial Resistance ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Generation Cephalosporin ◽

Defined Daily Dose ◽

Future Studies ◽

International Benchmarking ◽

Consumption Data ◽

Daily Dose ◽

Parenteral Products

Introduction: Growing bacterial resistance threatens public health, which can be tempered by prudent antibiotic use. Aim: To quantify systemic antibacterial use in Hungarian hospitals. Method: Consumption data were analysed using the Anatomical-Therapeutic-Chemical – Defined Daily Dose (ATC/DDD) methodology. Data were standardized for patient turnover and also for population to enable international benchmarking. Results: Hospital antibiotic use was quite constant (22.4 ± 1.5 DDD/100 patient-days), but its composition changed substantially. The use of parenteral products rose gradually (in 1996 26.4% and in 2015 41.6%). The pattern of use was homogenised due to the headway of co-amoxiclav use. A substantial increase of fluoroquinolone (2.3 vs. 4.2 DDD/100 patient-days) and third generation cephalosporin (1.0 vs. 2.9 DDD/100 patient-days) use was detected. In parallel the use of narrow spectra penicillins diminished. Conclusion: Hungarian hospital antibiotic use is low. The causes and the justification of this low use together with the internationally outstanding use of certain antibacterials should be addressed in future studies. Orv. Hetil., 2016, 157(46), 1839–1846.

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Indicators for the monitoring of antibiotic use

Journal of Infection Prevention ◽

10.1177/1757177410363357 ◽

2010 ◽

Vol 11 (4) ◽

pp. 124-126

Author(s):

CE Curtis

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Use ◽

Antibiotic Prescribing ◽

Defined Daily Dose ◽

Daily Dose ◽

Prescribing Practice

Increasing rates of antibiotic resistance have been related to increased rates of antibiotic prescribing. This paper describes the use of indicators to measure and compare antibiotic use and enable hospitals to benchmark their practice. The Defined Daily Dose measure may be combined with a number of denominators that quantify patient activity in order to correct for workload variations between hospitals. This may be combined with data from mandatory surveillance schemes for various infections to inform prescribing practice.

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Measurement of Antibiotic Consumption: A Practical Guide to the Use of the Anatomical Therapeutic Chemical Classification and Defined Daily Dose System Methodology in Canada

Canadian Journal of Infectious Diseases ◽

10.1155/2004/389092 ◽

2004 ◽

Vol 15 (1) ◽

pp. 29-35 ◽

Cited By ~ 35

Author(s):

James M Hutchinson ◽

David M Patrick ◽

Fawziah Marra ◽

Helen Ng ◽

William R Bowie ◽

...

Keyword(s):

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Antibiotic Consumption ◽

Defined Daily Dose ◽

Global Public Health ◽

Anatomical Therapeutic Chemical Classification ◽

Public Health Importance ◽

Chemical Classification ◽

Daily Dose ◽

Relationship Of

Despite the global public health importance of resistance of microorganisms to the effects of antibiotics, and the direct relationship of consumption to resistance, little information is available concerning levels of consumption in Canadian hospitals and out-patient settings. The present paper provides practical advice on the use of administrative pharmacy data to address this need. Focus is made on the use of the Anatomical Therapeutic Chemical classification and Defined Daily Dose system. Examples of consumption data from Canadian community and hospital settings, with comparisons to international data, are used to incite interest and to propose uses of this information. It is hoped that all persons responsible for policy decisions regarding licensing, reimbursement, prescribing guidelines, formulary controls or any other structure pertaining to antimicrobial use become conversant with the concepts of population antibiotic consumption and that this paper provides them with the impetus and direction to begin accurately measuring and comparing antibiotic use in their jurisdictions.

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Defined Daily Dose and Cost of Therapy of Empirical Ceftriaxone Pre- and Post-Antimicrobial Stewardship Program Model Implementation in Sepsis Patients in A Tertiary Hospital in Indonesia

International Journal of Integrated Health Sciences ◽

10.15850/ijihs.v7n2.1693 ◽

2019 ◽

Vol 7 (2) ◽

pp. 96-101

Author(s):

Uun Sumardi ◽

Anggra Filani ◽

Evan Susandi ◽

Ida Parwati

Keyword(s):

Antibiotic Resistance ◽

General Hospital ◽

Antibiotic Use ◽

Tertiary Hospital ◽

Defined Daily Dose ◽

Post Intervention ◽

Antibiotic Development ◽

Stewardship Program ◽

Daily Dose ◽

Quasi Experimental

Objective: Antibiotic resistance requires substantial responses through two mechanisms: new antibiotic development and smart antibiotic use. Antibiotic Stewardship Program (ASP) is one of the responses that reduce the overall antibiotics use and prevent the overuse of antibiotics to avoid antibiotic resistance. The purpose of this study was to assess the difference in defined daily dose (DDD) and the cost of therapy (COT) for empirical ceftriaxone therapy in sepsis patients pre- and post-ASP model implementation in Dr. Hasan Sadikin General Hospital, Bandung. Methods: A pre- and post-intervention quasi-experimental study on ASP model implementation in empirical ceftriaxone therapy provided to sepsis patients treated in the intensive or semi-intensive care units was performed from December 2015 to July 2016 using the Mann Whitney test and t-test. The DDD was calculated as DDD/100 patient-days, while the COT was calculated as the COT/patient-day. The ASP model intervention implemented in these units applied 2 main strategies: ceftriaxone use restriction and ceftriaxone therapy duration audit. Results: Participants of this study consisted of 112 sepsis subjects (n=112) with 55 subjects in the pre-ASP group and 57 subjects in the post-ASP group. The mean DDD/100 patient-days in the post-ASP subject was lower than that of the pre-ASP (16.3±4.3 and 45.8±16.8; p=0.018). The median COT/patient-days in post-ASP subject was IDR 42,000 (IDR 14.000–42.000), which was lower than that of the pre-ASP group of IDR 84.000 (IDR 28.000–420.000, p=0.001). Conclusion: The differences in the DDD/100 patient-day and COT/patient-day values between the pre-ASP and post-ASP are significant. The ASP model applied in Dr. Hasan Sadikin General Hospital, Bandung leads to a smart use of ceftriaxone and reduces costs for the empiric ceftriaxone therapy in sepsis patients

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Antibiotic Utilization Pattern in the Intensive Care Unit of Tertiary Hospital in West Java, Indonesia

International Journal of Integrated Health Sciences ◽

10.15850/ijihs.v7n2.1633 ◽

2019 ◽

Vol 7 (2) ◽

pp. 81-87

Author(s):

Taradharani Wikantiananda ◽

Adi Imam Tjahjadi ◽

Reza Widianto Sudjud

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

Tertiary Hospital ◽

Defined Daily Dose ◽

Antibiotic Utilization ◽

Daily Dose ◽

Bed Days ◽

International Measurement

Objective: To find out the pattern of antibiotic utilization in intensive care unit (ICU). The high use of antibiotics in intensive care may increase antibiotic resistance. Methods: This was a retrospective study with total sampling method from patients who were treated in ICU in the period of January to June 2016. Selected data is processed using the Anatomical Therapeutic Chemical (ATC) Classification/Defined Daily Dose (DDD) system as an international measurement standard for analyzing and comparing usage applied by the WHO. Results: The results showed that of the 57 medical records collected, the total antibiotic use was 295.72 DDD/100 bed-days. Levofloxacin, meropenem, ceftriaxone, ceftazidime, and metronidazole were the five maximally utilized antibiotics with 143.18, 49.88, 30.62, 19.74, dan 16.99 DDD/100 bed-days respectively. Conclusion: The most frequently used of antibiotics is ceftriaxone, used in 54.39% of patients. Whereas in number, the most widely used antibiotic is levofloxacin with a total of 143.18 DDD/100 bed-days.

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EVALUATION OF ANTIBIOTIC USE IN 2018 AT THE KEBAYORAN BARU PRIMARY HEALTH CARE, INDONESIA, USING THE ANATOMICAL THERAPEUTIC CHEMICAL/DEFINED DAILY DOSE METHOD

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2020.v12s1.ff011 ◽

2020 ◽

pp. 78-82

Author(s):

LARASATI ARRUM KUSUMAWARDANI ◽

ATIKA WAHYU PUSPITASARI ◽

VANNISA NABILLA WIDYANTARI

Keyword(s):

Health Care ◽

Primary Health Care ◽

Anatomical Therapeutic Chemical ◽

Antibiotic Use ◽

World Health ◽

Defined Daily Dose ◽

Oral Antibiotics ◽

Design Data ◽

Primary Health ◽

Daily Dose

Objective: The abnormally high use of antibiotics can indicate irrational prescribing. One of the ways by which to support rationally prescribingantibiotics is by evaluating their frequency of use. This study aimed to evaluate the use of antibiotics in 2018 by outpatients at the Kebayoran BaruPrimary Health Care of Indonesia.Methods: The study was a cross-sectional and descriptive design. Data were collected retrospectively from sampling outpatient records. The data wereon oral antibiotics prescribed in 2018 at Kebayoran Baru Primary Health Care. There were 10,553 prescriptions for oral antibiotics used as the studysamples. Both quantitative and qualitative evaluations were conducted. The quantitative evaluations were conducted using the method recommendedby the World Health Organization, namely, the anatomical therapeutic chemical/defined daily dose (DDD), and the qualitative evaluations wereconducted using the 90% drug utilization (DU 90%) method and the suitability of antibiotic use with the list of drugs in the Indonesian nationalformulary for the first-level health facilities (FKTP).Results: Three of the antibiotics used most often were amoxicillin at 0.9358 DDD/1000 inhabitants/d, ciprofloxacin at 0.4940 DDD/1000inhabitants/d, and cefadroxil at 0.1983 DDD/1000 inhabitants/d. The drugs within the DU 90% segment were amoxicillin, ciprofloxacin, cefadroxil,and thiamphenicol. There was 70% compatibility of antibiotic use with Indonesian national formulary for the FKTP.Conclusion: We suggest that the use of antibiotics at Kebayoran Baru Primary Health Care tended to be on the high side and not in accordance withnational guidelines.

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