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

  • FAUNA HERAWATI Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Jalan Raya Kalirungkut, Surabaya 60293, Indonesia. http://orcid.org/0000-0002-8355-955X
  • MUHAMAD SATRIA MANDALA PUA UPA Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Jalan Raya Kalirungkut, Surabaya 60293, Indonesia.
  • RIKA YULIA Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Jalan Raya Kalirungkut, Surabaya 60293, Indonesia.
  • RETNOSARI ANDRAJATI Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.

Abstract

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.

Keywords: Antibiotic, prescription, Days of therapy, Defined daily dose, Diarrhea, Pediatrics

Author Biography

FAUNA HERAWATI, Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Jalan Raya Kalirungkut, Surabaya 60293, Indonesia.

Clinical and Community Pharmacy

References

1. Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care associated infections. N Engl J Med 2014;370:1198-208.
2. Ling ML, Apisarnthanarak A, Madriaga G. The burden of healthcare-associated infections in Southeast Asia: A systematic literature review and meta-analysis. Clin Infect Dis 2015;60:1690-9.
3. Duerink DO, Roeshadi D, Wahjono H, Lestari ES, Hadi U, Wille JC, et al. Surveillance of healthcare-associated infections in Indonesian hospitals. J Hosp Infect 2006;62:219-29.
4. Herawati F, Hartono ID, Pranajaya D, Narindra IP. Antibiotic use at primary healthcare centers in Surabaya: A surveillance study. Int J Pharm Pharm Sci 2017;9:41-4.
5. Muslim Z. Antibiotic prescription to pediatric in hospital Bengkulu, Indonesia: ATC/DDD index. Int J Pharm Pharm Sci 2018;10:31-4.
6. Hanafi EM, Danial EN. Natural antimicrobials in the pipeline and possible synergism with antibiotics to overcome microbial resistance. Asian J Pharm Clin Res 2019;12:15-21.
7. Suman RK, Ray IM, Mohanty NC, Mukhia RK, Deshmukh YA. Assessment of usage of antibiotic and their pattern of antibiotic sensitivity test among childhood fever. Int J Pharm Pharm Sci 2014;6:296-9. Available from: https://www.innovareacademics.in/journals/index.php/ijpps/article/view/1790.
8. Niranjana ES, Sambath KR, Sudha M, Venkateswaramurthy N. Review on clinically developing antibiotics. Int J App Pharm 2018;10:13-8.
9. National Action Plan on antibiotics in human healthcare: Three measurable goals for a reduction of antibiotic consumption towards 2020. Denmark: The Danish Ministry of Health; 2017.
10. Murni IK, Duke T, Kinney S, Daley AJ, Soenarto Y. Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: An effectiveness study. Arch Dis Child 2015;100:454-9.
11. World Health Organization. Antimicrobial resistance: Global report on surveillance. Geneva: World Health Organization; 2014 . Available from: http://www.who.int/iris/handle/10665/112642.
12. Fridkin SK, Srinivasan A. Implementing a strategy for monitoring inpatient antimicrobial use among hospitals in the United States. Clin Infect Dis 2014;58:401-6.
13. Centers for Disease Control and Prevention. Antimicrobial Use and Resistance (AUR) Module. Available from: https://www.cdc.gov/nhsn/PDFs/pscManual/11pscAURcurrent.pdf. [Last accessed on 2015 Jan 28].
14. Indonesian Ministry of Health (IMOH). Pedoman Umum Penggunaan Antibiotik. Jakarta, Indonesia: Indonesian Ministry of Health; 2011. Available from: http://www.binfar.depkes.go.id/dat/Permenkes_Antibiotik.pdf. [Last accessed on 2018 Jul 26].
15. ATC/DDD Index 2017. Date Unknown. Available from: https://www.whocc.no/atc_ddd_index. [Last accessed on 2018 Jul 26].
16. WHO International Working Group for Drug Statistics Methodology, WHO Collaborating Centre for Drug Statistics Methodology and WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacological Services. Introduction to Drug Utilization Research. Geneva: World Health Organization; 2003.
17. Sidik NA, Lazuardi L, Agung FH, Pritasari K, Roespandi H, Setiawan T, et al. Assessment of the quality of hospital care for children in Indonesia. Trop Med Int Health 2013;18:407-15.
18. Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP). Kids’ Inpatient Database (KID), 2012. Available from: https://www.hcup-us.ahrq.gov/kidoverview.jsp. [Last accessed on 2015 Jan 28].
19. Leyenaar JK, Shieh MS, Lagu T, Pekow PS, Lindenauer PK. Direct admission to hospitals among children in the United States. JAMA Pediatr 2015;169:500-2.
20. Barwise-Munro R, Al-Mahtot M, Turner S. Mortality and other outcomes after paediatric hospital admission on the weekend compared to weekday. PLoS One 2018;13:e0197494.
21. Chaw PS, Schlinkmann KM, Raupach-Rosin H, Karch A, Pletz MW,Huebner J, et al. Antibiotic use on paediatric inpatients in a teaching hospital in the Gambia, a retrospective study. Antimicrob Resist Infect Control 2018;7:82.
22. Momattin H, Al-Ali AY, Mohammed K, Al-Tawfiq JA. Benchmarking of antibiotic usage: An adjustment to reflect antibiotic stewardship program outcome in a hospital in Saudi Arabia. J Infect Public Health 2018;11:310-3.
23. Ergül AB, Gökçek ?, Çelik T, Torun YA. Assessment of inappropriate antibiotic use in pediatric patients: Point-prevalence study. Turk Pediatri Ars 2018;53:17-23.
24. Hadi U, Duerink DO, Lestari ES, Nagelkerke NJ, Keuter M, Huis In’t Veld D, et al. Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia. Clin Microbiol Infect 2008;14:698 707.
25. Herawati F, Yulia R, Hak E, Hartono AH, Michiels T, Woerdenbag HJ, et al. A retrospective surveillance of the antibiotics prophylactic use of surgical procedures in private hospitals in Indonesia. Hospital Pharmacy, SAGE; 2018. p. 1-7.
26. Yulia R, Giovanny BE, Khansa AA, Utami SP, Alkindi FF, Herawati F, et al. The third-generation cephalosporin use in a regional general hospital in Indonesia. Int Res J Pharm 2018;9:41-5.
27. Herawati F, Rahem A, Handayani D, Yulia R. Antibiotic prophylactics on curettage for preventing pelvic inflammatory disease events: Is it necessary? Asian J Pharm Clin Res 2018;11:267-9.
28. Indonesian Ministry of Health (IMOH). Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.02.02/MENKES/514/2015 Tentang Panduan Praktik Klinis Bagi Dokter Di Fasilitas Pelayanan Kesehatan Tingkat Pertama. Jakarta, Indonesia: Indonesian Ministry of Health; 2015. Available from: https://www.draguscn.com/wp-content/uploads/2018/02/kmk-514-2015-ppk-faskes-primer1.pdf.
29. World Health Organization. World Health Report 2013: Research for Universal Health Coverage. Geneva: World Health Organization; 2013 . Available from: http://www.who.int/iris/handle/10665/85761. [Last accessed on 2015 Jan 28].
30. Centers for Disease Control and Prevention Office of Infectious Disease. Antibiotic Resistance Threats in the United States, 2013. Available from: http://www.cdc.gov/drugresistance/threat-report-2013. [Last accessed on 2015 Jan 28].
31. Ventola CL. The antibiotic resistance crisis: Part 1: Causes and threats. P T 2015;40:277-83.
32. Chaudhry N, Mukherjee TK. Differential effects of temperature and ph on the antibiotic resistance of pathogenic and non-pathogenic strains of Escherichia coli. Int J Pharm Pharm Sci 2016;8:146-9.
33. Okoye NV, Oyawole MR, Uzochukwu PU, Oyetunde OO. Review of ciprofloxacin use in children. Nig Q J Hosp Med 2013;23:43-7.
34. Makvana S, Krilov LR. Escherichia coli infections. Pediatr Rev 2015;36:167-71.
35. Zhou Y, Zhu X, Hou H, Lu Y, Yu J, Mao L, et al. Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: A hospital based study. BMC Infect Dis 2018;18:63-72.
36. Amaya E, Reyes D, Vilchez S, Paniagua M, Möllby R, Nord CE, et al. Antibiotic resistance patterns of intestinal Escherichia coli isolates from Nicaraguan children. J Med Microbiol 2011;60:216-22.
37. Doron S, Davidson LE. Antimicrobial stewardship. Mayo Clin Proc 2011;86:1113-23.
38. Indonesian Ministry of Health (IMOH). Peraturan Menteri Kesehatan Republik Indonesia Nomor 8 tahun 2015 Tentang Program Pengendalian Resistensi Antimikroba Di Rumah Sakit. Jakarta, Indonesia: Indonesian Ministry of Health; 2015. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8& ved=2ahUKEwjQu6eWl63dAhUKuo8KHXM2COYQFjABegQICBA B&url=http%3A%2F%2Fperaturango.id%2Fpermen%2Fkemenkes- nomor-8-tahun-2015. html&usg=AOvVaw3Je9LBJhw8zJiBC1es7TNO.
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FAUNA HERAWATI, MUHAMAD SATRIA MANDALA PUA UPA, RIKA YULIA, and RETNOSARI ANDRAJATI. “The ANTIBIOTIC CONSUMPTION AT A PEDIATRIC WARD AT A PUBLIC HOSPITAL IN INDONESIA”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 12, no. 8, June 2019, pp. 64-67, https://innovareacademics.in/journals/index.php/ajpcr/article/view/33339.
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