scholarly journals EVALUASI KUALITATIF PENGGUNAAN ANTIBIOTIK PADA PASIEN ANAK DENGAN METODE GYSSENS DI RSUD KARAWANG

2019 ◽  
Vol 4 (1) ◽  
pp. 297-302
Author(s):  
Diany Astuti ◽  
Yuli Nurhayati
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Therapy ◽  
Typhoid Fever ◽  
Pediatric Patients ◽  
Descriptive Analysis ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Antibiotics Resistance ◽  
Data Sampling ◽  
Inappropriate Use

ABSTRAK             Peresepan antibiotik untuk pasien anak-anak paling banyak digunakan dalam terapi. Penggunaan Antibiotik untuk anak-anak harus diawasi dan dikendalikan karena penggunaan antibiotik yang tidak terkontrol dan tidak tepat dapat berdampak pada kegagalan efek terapi yang diharapkan dan kemungkinan dapat meyebabkan resistensi antimikroba.  Pemakaian antibiotik harus dianalisis untuk mengendalikan resistensi antibiotik.  Tujuan penelitian ini untuk menilai rasionalitas terapi antibiotik pada pasien anak. Penelitian ini merupakan analisis deskriptif retrospektif dengan pengambilan data purposive sampling. Subjek dari penelitian adalah rekam medis dari bangsal anak RSUD Karawang. Rasionalitas penggunaan antibiotik adalah penilaian melalui metode gyssens. 147 data dianalisis untuk penelitian ini terdiri dari anak laki-laki (54,40%) dan perempuan (45,60%) dengan kasus demam tifoid (53,10), diare (24,5%) dan bronkopneumonia (22,4%). Antibiotik yang digunakan sefotaksim (71,43%), amoksisilin (5,44%) dan kloramfenikol (4,76%). Penilaian antibiotik melalui metode Gyssens adalah skala IVA (93,20%), skala IIB (6,12%) dan skala IIIA (0,68%). Kata Kunci: Antibiotik, Rasionalitas, Metode Gyssens.   ABSTRACT             Antibiotics prescription for pediatric patients is most widely used in therapy. Antibiotic use for pediatric must be watched and controlled because uncontrolled and inappropriate use of antibiotic can impact on failure of expected therapeutic effect and can also cause the possibility of antimicrobial resistance. Antibiotic consumption is must analyzed for controlling the antibiotics resistance. The aim of study The aim of this study was to assess the rationality of antibiotic therapy in pediatric patients. This research is a retrospective descriptive analysis with purposive data sampling. Subject of study are medical record from pediatric ward in RSUD Karawang. Rationality used of antibiotic is asses through Gyssens method. 147 data was analyzed for this study consist of boys (54,40%) and girls (45,60%) with case of typhoid  fever (53,10), diarrhea (24,5%) and bronchopneumonia (22,4%). Antibiotic was use Cefotaxime (71,43%), Amoxicillin (5,44%), Chloramphenicol (4,76%)etc.  Assessment  antibiotic through Gyssens method are IVA scale (93,20%), IIB scale ( 6,12%) and IIIA scale (0,68%). Keyword : Antibiotic, Rationality, Gyssens Method.

scholarly journals Efektifitas Antibiotik Pasien Demam Tifoid RSUP Dr. M. Djamil Padang

2019 ◽  
Vol 2 (2) ◽  
pp. 13-28
Author(s):  
Ayu Rahmawati ◽  
Husni Muchtar ◽  
Hansen Nasif
Keyword(s):  
Typhoid Fever ◽  
Pediatric Patients ◽  
Descriptive Analysis ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Cross Sectional ◽  
Length Of Treatment ◽  
Number Of Patients ◽  
Analysis Design

To find out the effectiveness of antibiotics in typhoid fever patients at the SMF of Pediatric and SMF in Internal Medicine Dr. RSUP M. Djamil Padang. This study was a cross-sectional study with a retrospective type of data during 2012 and prospective from June to September 2013, with a descriptive analysis design. The number of patients who met the inclusion criteria were 11 patients. Percentage of antibiotic use in adult patients for ceftriaxone (60%) and chloramphenicol (40%). The percentage of antibiotic use in pediatric patients for ceftriaxone, chloramphenicol, and cefixim are 60%, 27%, and 13%, respectively. Fever free for ceftriaxone and chloramphenicol in pediatric and adult patients, each of which is 2-3 days and 4-6 days; 3-4 days and 4 days. To be free of cefixime fever in pediatric patients is 2 days. The length of treatment required is ceftriaxone and chloramphenicol (children and adults) antibiotics, 6 - 13 days and 9-13, respectively; 11-14 and 7 days. For the duration of cefixime antibiotic treatment for children is 13 days. The results of this study indicate that antibiotics that are used effectively against typhoid fever patients are seen from the time of free of fever and length of stay.

scholarly journals PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS?

2013 ◽  
Vol 4 (4) ◽  
pp. 5 ◽  
Author(s):  
Usman Hadi ◽  
Kuntaman Kuntaman ◽  
Mariyatul Qiptiyah ◽  
Hari Paraton
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Teaching Hospitals ◽  
Resistant Bacteria ◽  
Prevention Study ◽  
Antibiotic Resistant ◽  
Inappropriate Use ◽  
Government Hospitals ◽  
Inappropriate Antibiotics ◽  
Very High

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.

scholarly journals Exploring gender differences in knowledge and practices related to antibiotic use in Southeast Asia: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259069
Author(s):  
Phuc Pham-Duc ◽  
Kavitha Sriparamananthan
Keyword(s):  
Gender Differences ◽  
Antimicrobial Resistance ◽  
Southeast Asia ◽  
Scoping Review ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Sociodemographic Factors ◽  
Targeted Interventions ◽  
Inappropriate Use ◽  
Males And Females

Inappropriate use of antibiotics has been one of the main contributors to antimicrobial resistance, particularly in Southeast Asia. Different genders are prone to different antibiotic use practices. The objective of this scoping review is to understand the extent and type of evidence available on gender differences in antibiotic use across Southeast Asia. The search strategy for this scoping review involved PubMed, Semantic Scholar, BioMed Central and ProQuest. Two-level screening was applied to identify the final sample of relevant sources. Thematic content analysis was then conducted on the selected final sources to identify recurring themes related to gender differences in antibiotic use and a narrative account was developed based on the themes. Recommendations for next steps regarding reducing inappropriate antibiotic use and gender considerations that need to be made when developing future interventions were also identified. Research on gender and antibiotic use remains scarce. Studies that discuss gender within the context of antibiotic use often mention differences between males and females in knowledge, attitudes and/or behaviour, however, do not explore reasons for these differences. Gender differences in antibiotic use were generally examined in terms of: (i) knowledge of antibiotic use and antimicrobial resistance and (ii) practices related to antibiotic use. Evidence indicated that differences between males and females in knowledge and practices of antibiotic use varied greatly based on setting. This indicates that gender differences in antibiotic use are greatly contextual and intersect with other sociodemographic factors, particularly education and socioeconomic status. Educational interventions that are targeted to meet the specific needs of males and females and delivered through pharmacists and healthcare professionals were the most common recommendations for reducing inappropriate use of antibiotics in the community. Such targeted interventions require further qualitative research on factors influencing differences in knowledge and practices related to antibiotic use among males and females. In addition, there is also a need to strengthen monitoring and regulation practices to ensure accessibility to affordable, quality antibiotics through trusted sources.

scholarly journals Staphylococcus Aureus: Selective Reporting of Antibiogram Results and Its Impact on Antibiotic Use. Interventional Study with a Reference Group on the Effect of Switching from Non-Selective to Selective Antibiotic Reporting

2020 ◽  
Author(s):  
Franka Lestin-Bernstein ◽  
Ramona Harberg ◽  
Ingo Schumacher ◽  
Lutz Briedigkeit ◽  
Oliver Heese ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Selective Reporting ◽  
Care Hospital ◽  
Beta Lactams ◽  
Interventional Study ◽  
Narrow Spectrum ◽  
The Impact

Abstract Background:Antimicrobial stewardship (AMS) strategies worldwide focus on optimised antibiotic use. Selective susceptibility reporting is recommended as an effective AMS tool, although there is a lack of representative studies investigating the impact of selective susceptibility reporting on antibiotic use.The aim of this study was to investigate the impact of selective susceptibility reporting of Staphylococcus aureus (S. aureus) on antibiotic consumption. Enhancing the use of narrow-spectrum beta-lactam antibiotics such as flucloxacillin/cefazolin/cefalexin is one of the main goals in optimising antibiotic therapy of S. aureus infections.Methods:This interventional study with control group was conducted at a tertiary care hospital in Germany. During the one-year interventional period, susceptibility reports for all methicillin-sensitive S. aureus (MSSA) were restricted to flucloxacillin/cefazolin/oral cefalexin, trimethoprim-sulfamethoxazole, clindamycin, gentamicin and rifampin/fosfomycin; instead of reporting all tested antibiotics during the year before the intervention and in the reference clinic. The impact of the intervention was analysed by monitoring antibiotic consumption (recommended daily dose/100 occupied bed days: RDD/100 BD).Results:MSSA-antibiograms were reported for 2836 patients. Total use of narrow-spectrum beta-lactams more than doubled during the intervention (from 1.2 to 2.8 RDD/100 BD, P<0.001; P<0.001 compared to the reference clinic); the percentage of total antibiotic use increased from 2.6% to 6.2%. A slight, but significant increase in the use of trimethoprim-sulfamethoxazole was also observed (+ 0.37 RDD/100 BD).There was no decrease in antibiotics withdrawn from the antibiogram, probably as a consequence of their wide use for indications other than S. aureus infections.Conclusions:As narrow-spectrum beta-lactams are not widely used for other infections, there is a strong indication that selective reporting guided clinicians to optimised antibiotic therapy of S. aureus infections.As useful AMS tool, we recommend implementing selective reporting rules into the national/international standards for susceptibility reporting.

scholarly journals Overuse of antibiotics in maternity and neonatal wards, a descriptive report from public hospitals in Dar es Salaam, Tanzania

2021 ◽  
Author(s):  
Mwaka Athuman Kakolwa ◽  
Susannah L. Woodd ◽  
Alexander M. Aiken ◽  
Fatuma Manzi ◽  
Giorgia Gon ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Dar Es Salaam ◽  
Prophylactic Antibiotics ◽  
Public Hospitals ◽  
Descriptive Data ◽  
Inappropriate Use ◽  
Control Drug ◽  
Postnatal Women

Abstract Background: Overuse of antibiotics is a major challenge and undermines measures to control drug resistance worldwide. Postnatal women and newborns are at risk of infections and are often prescribed prophylactic antibiotics, although there is no evidence to support their universal use in either group. Methods: We performed point prevalence surveys in three hospitals in Dar es Salaam, Tanzania, in 2018 to collect descriptive data on antibiotic use and infections in maternity and neonatal wards. Results: Prescribing of antibiotics was high in all three hospitals ranging from 90% (43/48) to 100% (34/34) in women after cesarean section, from 1.4% (1/73) to 63%(30/48) in women after vaginal delivery, and from 89%(76/85) to 100%(77/77) in neonates. The most common reason for prescribing antibiotics was medical prophylaxis in both maternity and neonatal wards.Conclusion: We observed substantial overuse of antibiotics in postnatal women and newborns.This calls for urgent antibiotic stewardship programs in Tanzanian hospitals to curb the inappropriate use and limit the spread of antimicrobial resistance.

scholarly journals Evaluating antimicrobial appropriateness in a tertiary care pediatric ICU in Saudi Arabia: a retrospective cohort study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Yasser M. Kazzaz ◽  
Haneen AlTurki ◽  
Lama Aleisa ◽  
Bashaer Alahmadi ◽  
Nora Alfattoh ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Cohort Study ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Antibiotic Utilization ◽  
Antibiotic Courses

Abstract Background Inappropriate antibiotic utilization is associated with the emergence of antimicrobial resistance (AMR) and a decline in antibiotic susceptibility in many pathogenic organisms isolated in intensive care units. Antibiotic stewardship programs (ASPs) have been recommended as a strategy to reduce and delay the impact of AMR. A crucial step in ASPs is understanding antibiotic utilization practices and quantifying the problem of inappropriate antibiotic use to support a targeted solution. We aim to characterize antibiotic utilization and determine the appropriateness of antibiotic prescription in a tertiary care pediatric intensive care unit. Methods A retrospective cohort study was conducted at King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia, over a 6-month period. Days of therapy (DOT) and DOT per 1000 patient-days were used as measures of antibiotic consumption. The appropriateness of antibiotic use was assessed by two independent pediatric infectious disease physicians based on the Centers for Disease Control and Prevention 12-step Campaign to prevent antimicrobial resistance among hospitalized children. Results During the study period, 497 patients were admitted to the PICU, accounting for 3009 patient-days. A total of 274 antibiotic courses were administered over 2553 antibiotic days. Forty-eight percent of antibiotic courses were found to be nonadherent to at least 1 CDC step. The top reasons were inappropriate antibiotic choice (empirical or definitive) and inappropriate prophylaxis durations. Cefazolin and vancomycin contributed to the highest percentage of inappropriate DOTs. Conclusions Antibiotic consumption was high with significant inappropriate utilization. These data could inform decision-making in antimicrobial stewardship programs and strategies. The CDC steps provide a more objective tool and limit biases when assessing antibiotic appropriateness

scholarly journals Responsible antibiotic therapy simplified

2020 ◽  
Vol 35 ◽  
pp. 29-38
Author(s):  
Abhay K. Shah ◽  
Aashay Abhay Shah
Keyword(s):  
Developing Countries ◽  
Antibiotic Therapy ◽  
Disease Burden ◽  
Critical Role ◽  
Antibiotic Use ◽  
Developed Countries ◽  
Bacterial Disease ◽  
Antibiotic Prescribing ◽  
Inappropriate Use ◽  
Current Article

Antimicrobial resistance is a global problem and is particularly pressing in developing countries where the infectious disease burden is very high. In developing countries, where relatively easy availability and higher consumption of medicines have led to disproportionately higher incidence of inappropriate use of antibiotics and greater levels of resistance compared to developed countries. The bacterial disease burden in India is among the highest in the world; consequently, antibiotics will play a critical role in limiting morbidity and mortality in the country. Improving antibiotic prescribing and use is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance. Responsible antibiotic therapy is one of the most important components of antibiotic stewardship. The current article is an attempt to provide a set of key principles to guide efforts to improve responsible and rational antibiotic use.

scholarly journals Prevalence and antimicrobial resistance phenotypes of Salmonella species recovered at various stages of broiler operations in Hathazari, Bangladesh

2021 ◽  
pp. 158-164
Author(s):  
Ferdausi Ali ◽  
Tazriyan Noor Silvy ◽  
Tanim Jabid Hossain ◽  
Md. Kamal Uddin ◽  
Mohammad Seraj Uddin
Keyword(s):  
Antimicrobial Resistance ◽  
Clavulanic Acid ◽  
Nalidixic Acid ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Antibiotics Resistance ◽  
Broiler Meat ◽  
Resistance Patterns ◽  
Meat Samples

Background and Aim: Dissemination of multidrug-resistant (MDR) Salmonella through food chains has serious health implications, with higher rates of morbidity and mortality. Broiler meat remains a major reservoir of Salmonella contamination. The lack of proper hygiene in local broiler operations has, therefore, prompted this research into the assessment of Salmonella contamination in local shops and associated antimicrobial resistance (AMR) phenotypes. Materials and Methods: A total of 55 broiler samples including skin, meat, and swab samples from chopping and dressing sites were included in the study. The samples were collected from broiler shops in Hathazari, Bangladesh, and screened for the presence of Salmonella strains using culture-based methods. The isolates were biochemically characterized and further tested for AMR to eight common antibiotics using the disk diffusion technique. Results: Salmonella contaminations were identified in 29% (16/55) of the broiler samples. Swab samples collected from the chopping sites appeared to be contaminated in higher proportions (33%) than those collected from the dressing areas (25%). On the other hand, the skin samples (50%) were detected with a higher percentage of contamination than the meat samples (25%). All Salmonella isolates showed resistance toward at least one of the eight antibiotics used. Although none of the isolates was resistant to all antibiotics, 18.75% showed resistance to a maximum of seven antibiotics. Resistance to nalidixic acid was most prevalent (87.5%), followed by sulfamethoxazole-trimethoprim (81.25%), erythromycin (81.25%), tetracycline (75%), streptomycin (56.25%), ampicillin-clavulanic acid (50%), chloramphenicol (43.75%), and cefotaxime (18.75%). The resistance patterns of the isolates were found to be highly diverse. The most frequently observed pattern was the following: Ampicillin-clavulanic acid-sulfamethoxazole-trimethoprim-nalidixic acid-tetracycline-chloramphenicol-streptomycin-erythromycin. Conclusion: The relatively high prevalence of MDR strains in the samples underlies an urgent need for surveillance and control measures concerning hygiene and antibiotic use in local broiler operations.

scholarly journals Inappropriate Use of Antibiotics and Their Predictors in Pediatric Patients Admitted at the Hospital Central De Nampula, Mozambique

2021 ◽  
Author(s):  
Sancho Pedro Xavier ◽  
Audêncio Victor ◽  
Graciano Cumaquela ◽  
Melsequisete Daniel Vasco ◽  
Osiyallê Rodrigues ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pediatric Patients ◽  
Treatment Time ◽  
Binary Logistic Regression ◽  
Antibiotic Use ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Inappropriate Use

Abstract Background Antibiotics are synthetic or natural substances used to treat diseases of infectious origin. When used incorrectly, they can be a factor in the development of antimicrobial resistance, increased treatment time, costs, and mortality. The present study aimed to assess the pattern inappropriate use of antibiotics and their predictors in pediatric patients admitted to the Hospital Central de Nampula, Mozambique Methods A cross-sectional, retrospective study with a quantitative approach was conducted between January and July 2019. The population consisted of children aged 0 to 10 years hospitalized in the pediatric ward I. Binary logistic regression was used to determine risk factors for inappropriate use of antibiotics with 95% CI. Results The prevalence of antibiotic use among pediatric patients was 97.5%. Of the 464 antibiotics prescribed, 39.9% were for patients suffering from gastroenteritis, 21.8% and 9.1% Affected with pneumonia and malaria. Most antibiotics were for systemic use (95.9%, 445/464). Most (36.5%) of prescriptions had errors. Duration of treatment (74.6%) and dosage (25.4%) were the most frequent errors. Binary logistic regression analysis revealed that patients were prescribed with ≥ 3 antibiotics (OR = 2.920, 95% CI = 1.283–6.646, p–value = 0.011) and with a short hospitalization time (OR = 1.726, 95% CI = 1.040–2.864, p–value = 0.035) were more likely to experience some inappropriate use of antibiotics. Conclusion The study showed a higher prevalence of antibiotic use, however, a greater number of prescriptions contained errors. Errors related to dose and duration of treatment were the most common among pediatric patients. These results reveal a concern, since inappropriate and excessive use of antibiotics is a major factor for the development of antibiotic resistant microorganisms. Therefore, strategies concerning the use of antibiotics in order to reduce their inappropriate and excessive use are necessary.

scholarly journals Impact of an antimicrobial resistance control program: pre- and post-training antibiotic use in children with typhoid fever

2016 ◽  
Vol 56 (4) ◽  
pp. 205 ◽  
Author(s):  
Elfrida A. Rachmah ◽  
Maftuchah Rochmanti ◽  
Dwiyanti Puspitasari
Keyword(s):  
Antimicrobial Resistance ◽  
Typhoid Fever ◽  
Bacterial Infections ◽  
Good Condition ◽  
Antibiotic Use ◽  
Appropriate Use ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
The Impact

Inappropriate use of antibiotics may lead to antimicrobial resistance. In 2012, Dr. Soetomo Hospital conducted training for pediatric residents on the proper use of antibiotics to limit antimicrobial resistance.Objective To evaluate the impact of a rational, antibiotic-use training program for pediatric residents on their antibiotic prescriptions for patients with typhoid fever.Methods A cross-sectional, analytic study was conducted. We collected data from children with typhoid fever who were hospitalized in Dr. Soetomo Hospital, pre- and post-training on antibiotic prescriptions. Children with other known bacterial infections or who were discharged on request were excluded. Antibiotic prescriptions were evaluated using Gyssens algorithm based on the local protocol. Chi-square test was used to compare the quality of antibiotic prescriptions, before (year 2012) and after (year 2013) the training.Results Forty-nine patients with 67 prescriptions in 2012 and 34 patients with 48 prescriptions in 2013 fulfilled the inclusion criteria. Patients’ ages ranged from 1-18 years. Diagnoses of uncomplicated and complicated typhoid were found in 74% and 26% of subjects, respectively. First line (chloramphenicol, thiamphenicol, ampicillin, trimetroprim and sulfametoxazol) and second line (ceftriaxone and cefixime) use were 72% and 28%, respectively. All patients were discharged in good condition. Appropriate use of antibiotics was noted in 61% of subjects in 2012 and in 81% of subjects in 2013 (P=0.036). The most common type of error in 2012 and 2013 was dosage imprecision (25% and 17%, respectively).Conclusion Training on appropriate use of antibiotics significantly improved the quality of antibiotics prescribed in children with typhoid fever in Dr. Soetomo Hospital.

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