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

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.

2021 ◽  
pp. 163-167
Author(s):  
Ika Norcahyanti ◽  
Malikatur Rosyidah ◽  
Abdul Kadir Jaelani ◽  
Antonius N.W. Pratama

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.


2020 ◽  
Vol 6 (1) ◽  
pp. 15-20
Author(s):  
Wirda Anggraini ◽  
◽  
Novia Beta Wiraningtias ◽  
Fidia Rizkiah Inayatilah ◽  
Yen Yen Ari Indrawijaya ◽  
...  

Acute appendicitis is an infection that occurs in vermiform appendix, and because of that it needs to do appendectomy immediately. Appendectomy is included in clean contaminated operation category which allows Surgical Site Infection (SSI). The antibiotics use in post-surgical patients to prevent the infections. The aims of this study to identify profile and determine the quantity and quality of antibiotics use. This study used cross sectional study with retrospective data on patient’s medical records after surgery for acute appendicitis in General Hospital Pasuruan Regency on January-December 2018. Data analysis was performed descriptively. The result of this study showed that the highest profile of the antibiotic use for mono therapy was Cefuroxime (25.81%) and for combination therapy were Phosphomycin + Metronidazole (8.06%) and Ceftriaxone + Metronidazole (8.06%). The quantity of antibiotics use by using Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) method was obtained total DDD value 52.01 DDD/100 patient-days with the highest antibiotic was Metronidazole parenteral route 14.00 DDD/100 patient-days. Antibiotics included in Drug Utilization 90% (DU 90%) segment were (Metronidazole, Ceftriaxone, Phosphomycin, Cefuroxime, Gentamicin) by parenteral route. The quality of antibiotics use based on the Infectious Disease Society of America (IDSA) Guidelines, appropriate indication (11.86%), appropriate dose (52,54%), appropriate interval (22,03%), appropriate route (96.61%) and appropriate duration of treatment (28.81%).


Open Medicine ◽  
2007 ◽  
Vol 2 (2) ◽  
pp. 168-179
Author(s):  
Karin Vasic ◽  
Zorica Jovic ◽  
Gordana Pesic

AbstractThe aim of the study was to test a new model of drug distribution known as unit-dose drug distribution including the effects of implementing this system on total drug consumption, especially in curbing antimicrobial use.The study was carried out in the Department of Surgery at the University Clinical Center in Nis, Serbia. During the first six months of the study (comparative period), drugs were delivered directly from the pharmacy to the urology and orthopedic wards in the traditional way (ward stock system). During the next six months (study period), drugs were delivered directly from the pharmacy to the patients (unit-dose drug distribution system). Drug consumption was measured using the statistical unit defined daily dose (DDD) per 100 bed days according to the anatomical-therapeutic-chemical classification of drugs. Following implementation of the unit-dose drug distribution system, total drug consumption was reduced by 24.34% in the urology ward and by 21.43% in the orthopedic ward. During the comparative period, in the urology and orthopedic wards, systemic antiinfectives (group J) comprised 263.54 and 227.61 DDD/100 bed days or 43.05% and 25.52% of total drug consumption respectively, whereas, during the pilot study period this group of drugs comprised 191.63 and 173.52 DDD/100 bed days or 41.37% and 24.96% of total drug consumption respectively.The unit-dose distribution system of drugs in hospitals leads to a control of drug consumption and substantial savings. Also, the pharmacist-physician interaction began to emerge as an important factor as a direct result of the changes in the drug distribution system.


2019 ◽  
Vol 7 (2) ◽  
pp. 81-87
Author(s):  
Taradharani Wikantiananda ◽  
Adi Imam Tjahjadi ◽  
Reza Widianto Sudjud

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.


2019 ◽  
Vol 5 (3) ◽  
pp. eaau9124 ◽  
Author(s):  
Katariina M. M. Pärnänen ◽  
Carlos Narciso-da-Rocha ◽  
David Kneis ◽  
Thomas U. Berendonk ◽  
Damiano Cacace ◽  
...  

Integrated antibiotic resistance (AR) surveillance is one of the objectives of the World Health Organization global action plan on antimicrobial resistance. Urban wastewater treatment plants (UWTPs) are among the most important receptors and sources of environmental AR. On the basis of the consistent observation of an increasing north-to-south clinical AR prevalence in Europe, this study compared the influent and final effluent of 12 UWTPs located in seven countries (Portugal, Spain, Ireland, Cyprus, Germany, Finland, and Norway). Using highly parallel quantitative polymerase chain reaction, we analyzed 229 resistance genes and 25 mobile genetic elements. This first trans-Europe surveillance showed that UWTP AR profiles mirror the AR gradient observed in clinics. Antibiotic use, environmental temperature, and UWTP size were important factors related with resistance persistence and spread in the environment. These results highlight the need to implement regular surveillance and control measures, which may need to be appropriate for the geographic regions.


2020 ◽  
Vol 41 (S1) ◽  
pp. s500-s501
Author(s):  
Santiago Grau ◽  
Sergi Hernández ◽  
Ariadna Padullés ◽  
Montserrat Gimenez ◽  
Lucía Boix-Palop ◽  
...  

Background: Antimicrobial resistance is a disturbing problem in the health system. A relationship between the use of certain antimicrobials and a resistance increase has been proposed. Since this phenomenon is not usually attributed to specific uses of antimicrobials but preferably to its evolution over the years, the analysis of the antimicrobial consumption over time can justify the epidemiological situation of a given region in terms of resistance and possible increases and decreases for specific microorganisms. The objective of this study was to analyze the evolution of the use of antimicrobials in Catalonia during 2008–2018 through the VINCat program (Infection Control and Antimicrobial Stewardship Catalonian Program). Methods: The number of hospitals participating in the VINCat increased from 46 in 2008 to 63 in 2018 (ie, 68.8% and 85.7% of all adult acute-care hospital beds in Catalonia, respectively). Hospitalization days recorded at the participating hospitals increased from 2,991,053 in 2008 to 3,714,938 in 2018. The Anatomical Therapeutic Chemical Classification (ATC) defined daily dose (DDD) index was used for monitoring antimicrobial consumption. Simple linear regressions were performed, the linear relationship was checked by ANOVA tests, and the Pearson correlation (Pc) coefficients were obtained. Values of P ≤ .05 were considered statistically significant. Results: From 2008 to 2018, there was a statistically significant increase of global antibacterial consumption (65.50 vs 71.73 DDD per 100 bed days; P = .001) and antimycotic consumption (3.09 vs 3.45 DDD per 100 bed days, P = .012) due to an increase of consumption in the surgical units. At the same time, there was a decrease in the consumption of antimycotics in the medical units (4.35 vs 3.90 DDD per 100 bed days; P =.029). Cephalosporins and carbapenem consumption increased both globally (10.88 vs 13.86 DDD per 100 bed days; P < .001) and in medical and surgical units (3.26 vs 5.38 DDD per 100 bed days; P < .001). This increase was mainly associated with ceftriaxone (3.45 vs 5.46 DDD per 100 bed days; P < .001) and meropenem (1.12 vs 3.08 DDD per 100 bed days; P < .001). There was a global decrease in the consumption of penicillins (26.10 vs 24.24 DDD per 100 bed days; P = .012) and quinolones (11.63 vs 9.61 DDD per 100 bed days; P = .004). This trend was observed also in ICUs and medical units but not in surgical units, for which only quinolones showed a significant decrease. Decreases in the use of amoxicillin/clavulanate acid (17.80 vs 14.24 DDD per 100 bed days; P < .001) and ciprofloxacin (5.68 vs 4.01 DDD per 100 bed days; P < .001) were observed. Conclusions: The increase in the use of antimicrobials in Catalonia is concerning. This increase is attributable to the use of these drugs in surgical units. Antibiotic stewardship measures should be aimed primarily at these units. The increasing use of carbapenems should be analyzed.Funding: NoneDisclosures: Juan Pablo Horcajada reports consulting fees from MSD, Pfizer, and Menarini as well as speaker honoraria from MSD, Pfizer, and Zambon.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S894-S895
Author(s):  
Belén Hervera ◽  
Lisette Irarrázabal ◽  
Lilian Ferrer ◽  
Rosina Cianelli

Abstract Hospitalization is a good opportunity to offer smoking cessation programs to smokers. Healthcare providers′ (HCP) tobacco consumption and cessation attitudes are known to affect the provision of cessation interventions. Lesser known are Latino HCP’s tobacco intervention attitudes. This study aimed to examine the associations between tobacco cessation attitudes (TCA), levels of consumption, and demographics among Latino HCP’s. A quantitative, correlational, cross-sectional design was used. 66 HCP’s working in a public hospital in Santiago, Chile self-reported demographics (age, gender, profession), tobacco consumption, and TCA. TCA’s include questions regarding Acceptability of Brief Counseling (ABC), belief whether smoking is harmful for patients, and duty to aid patients quit smoking. Majority of HCP’s (34 years old, 83% female, 58.5% technical nurses, 38.5% nurses, 3.1% Kinesiologists) did not consume tobacco (67%). Pearson’s correlation revealed that greater HCP age was significantly associated with less belief that smoking is harmful for their patients (r = -.36, p. = .004). ABC (M = 22, SD = 5.5) was positively associated with the belief that smoking is harmful for patients (r = .306, p = .016) and duty to help patients quit smoking (r = .574, p = .000). Findings provide evidence that HCP’s TCA’s are important factors to consider during implementation of a brief counseling for tobacco cessation. Further research should focus on increasing HCP’s acceptability of providing cessation care to their patients. Specifically, tailoring education and interventions by age might serve useful to address the differences in TCA’s which may subsequently influence their tobacco cessation practices.


Author(s):  
Sinta Rachmawati ◽  
Dewi Khurmi Masito ◽  
Ema Rachmawati

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)


2021 ◽  
Vol 3 (1) ◽  
pp. 9-21
Author(s):  
Wirda Anggraini

Abstract—Pneumonia was an inflammation that occurs in the lungs accompanied by exudation and consolidation of microorganisms. In Indonesia, the prevalence of pneumonia continues to increase. Treatment of pneumonia uses antibiotic therapy. The use of antibiotics needs to be controlled by evaluating the quality of antibiotic use to prevent negative effects that can occur on patients, such as antibiotic resistance. The purpose of this study was to determine the quality of antibiotic use in pneumonia patients. This study did with observational method with cross-sectional design. The study was conducted in August-September 2019. Qualitative evaluations did with Gyssen method. The results of 35 medical record samples that fulfill the criteria showed that 21.43% of cases category 0; 16.67% of cases category I; 0% of cases category II C; 33.34% of cases in category II B; 4.76% of cases category II A; 0% of cases category III B; 0% of cases category III A; 0% of cases category IV D; 19.05% of cases category IV C; 4.76% of cases category IV B; 61.90% of cases category IV A; 0% of cases category V; 0% of cases category VI. Thus, rational cases (category I) were 21,43% and irrational cases (categories I-IV) were 78,57%.


2021 ◽  
Author(s):  
Noha Alaa Hamdy ◽  
Nahla Hesham Kandil ◽  
Ahmed Noby Amer

Abstract Background: Antimicrobial stewardship (ASP) aims to stopping or slowing emergence of antimicrobial resistant strains. After initiation of National action plan on antimicrobial resistance (AMR) in Egypt, there were several initiatives by hospitals to implement ASP but no formal assessment was performed.Objective & setting: This study attempts to assess the extent of ASP application in different Egyptian hospitals; stewardship knowledge & implementation in selected hospitals. Method: A cross-sectional study was conducted to assess stewardship knowledge & implementation in selected hospitals in Egypt. Main outcome measure: Core elements of the survey included Hospital Description, ASP committee, ASP Activities (including training, restriction methods and outcome measurement), reporting antibiotic use, antibiogram, information technology (IT) support, ASP restriction methods and ASP Future ApplicationResults: The study included many aspects regarding hospital description; all types of hospitals were involved. Most of hospitals (61.8%) implemented an ASP program while 38.2% did not; 71.4 % of the later are planning for future Antimicrobial stewardship application. 22 hospitals (48.5%) reported having facility-specific antibiogram on regular basis. 13 hospitals (37.1%) reported receiving antimicrobial reports on regular basis. 15 hospitals (42.9%) reported having one or more computer programs already in use. The monitoring activities included resistance patterns, infection rates, length of stay, mortality rate & reported adverse drug reactions. Only 20% of the hospitals included in this study reported having an ASP training program. Conclusion: Egyptian hospitals have a fairly good implementation, improvements need to include IT support programs, healthcare members cooperation, monitoring outcomes & infectious disease (ID) consultations.


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