EVALUATION OF QUANTITATIVE AND QUALITATIVE USE OF ANTIBIOTICS IN COMMUNITY HEALTH CENTERS, BOYOLALI DISTRICT, INDONESIA

HIDAYAH KARUNIAWATI; ROSI HAYYU ANJANI; KHALIFAH UTAMI; WAN ISMAHANISA ISMAIL

doi:10.22159/ijap.2024.v16s6.52787

Authors

HIDAYAH KARUNIAWATI Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy Universitas Muhammadiyah Surakarta, Indonesia
ROSI HAYYU ANJANI Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy Universitas Muhammadiyah Surakarta, Indonesia
KHALIFAH UTAMI Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy Universitas Muhammadiyah Surakarta, Indonesia https://orcid.org/0009-0006-1160-432X
WAN ISMAHANISA ISMAIL Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Pulau Pinang, Kampus Bertam, Penang, Malaysia https://orcid.org/0000-0002-2711-0547

DOI:

https://doi.org/10.22159/ijap.2024.v16s6.52787

Keywords:

Antibiotic, ATC/DDD, Quantitative analysis, Gyssens, Qualitative analysis

Abstract

Objective: This study evaluated the quantity and quality of antibiotic use in hospitalized patients and outpatients at the Boyolali District Health Center.

Methods: This research is a non-experimental study that collects data by purposive sampling. The inclusion criteria were inpatients and outpatients at the two community health centers in the Boyolali district. Data were analyzed quantitatively using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) method and qualitatively using the Gyssens method.

Results: During the study period, 123 hospitalized patients and 338 outpatients met the inclusion and exclusion criteria. The majority of hospitalized patients were women (53.7%) aged 46-65 (30.1%) with a length of stay ≤4 days (56.9%). In comparison, most outpatients were women (61.5%) aged 26-45 (26.9%). The total Defined Daily Dose (DDD)/100 patients-days aged <18 who were hospitalized was 24.3; the most antibiotic was Cefotaxime (36.6%). The total DDD/100 patients days aged ≥ 18 who were hospitalized was 89.7; the most common antibiotic was Thiamphenicol (42.1%). Meanwhile, the most frequently prescribed antibiotic in outpatient was Amoxicillin, 85.3% (age <18 years) and 50.2% (age ≥18 years). Based on Gyssen's analysis, most of the antibiotic administration was in criterion IIIB; namely, the administration of antibiotics was too short.

Conclusion: It is necessary to increase the rationality of the use of antibiotics both in inpatients and outpatients

Downloads

Download data is not yet available.

References

Kemenkes RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 2406/MENKES/PER/XII. Pedoman Umum Penggunaan Antibiotik. 2011;34–44.

Ventola CL. The Antibiotic Resistance Crisis. Pharmacy and Therapeutics. 2015;40:277–83.

WHO. Antibiotic resistance. 2020 [cited 2019 Nov 7]. Available from: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance.

CDC. What Exactly is Antibiotic Resistance?. Centers for Disease Control and Prevention. 2018 [cited 2018 Dec 16]. Available from: https://www.cdc.gov/drugresistance/about.html.

CDC. Antibiotics Resistance Threats in the United States. U.S Department of Health and Human Services Centers for Disease Control and Prevention; 2019.

Friedman ND, Temkin E, Carmeli Y. The negative impact of antibiotic resistance. Clinical Microbiology and Infection. 2016;22:416–22.

Albasanz-Puig A, Gudiol C, Parody R, Tebe C, Akova M, Araos R, et al. Impact of antibiotic resistance on outcomes of neutropenic cancer patients with Pseudomonas aeruginosa bacteraemia (IRONIC study): study protocol of a retrospective multicentre international study. BMJ Open. 2019;9:e025744.

Dadgostar P. Antimicrobial Resistance: Implications and Costs. Infection and Drug Resistance. Dove Press; 2019 [cited 2021 Jan 12]. p. 3903–10. Available from: https://www.dovepress.com/antimicrobial-resistance-implications-and-costs-peer-reviewed-fulltext-article-IDR.

Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Aguilar GR, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022;399:629–55.

Seppälä H. et al. the Effect of Changes in the Consumption of Macrolide. The New England journal of medicine. 1997;337:441–6.

World Health Organization. WHO Methodology for Point Prevalence Survey on Antibiotic Use in Hospitals. World Health Organization. 2018.

Permenkes. Peraturan Menteri Kesehatan Republik Indonesia no 8 tahun 2015 tentang Pengendalian Resistensi Antimikroba di Rumah Sakit [Internet]. 2015 [cited 2018 Nov 15]. Available from: https://ghsaindonesia.files.wordpress.com/2016/02/peraturan-menteri-kesehatan-ri-no-8-tahun-2015-tentang-pengendalian-resistensi-antimikroba-di-rumah-sakit.pdf.

WHO. Global Antimicrobial Resistance Surveillance System (GLASS) Report Early Implementation 2016-2017. 2017 [cited 2018 Sep 8]. Available from: http://apps.who.int/iris/bitstream/handle/10665/259744/9789241513449-eng.pdf;jsessionid=7861782D4C6EEBFAD5298635401473C7?sequence=1

Khabbaz R, Cars O, Kumar S, Perovic O, Song J-H, Thamlikitkul V, et al. Implementation of the global action plan on antimicrobial resistance. WHO GAP AMR Newsletter N°32. 2017;1–4.

Kemenkes RI. Pedoman Pelayanan Kefarmasian Untuk Terapi Antibiotika Kementrian Kesehatan Republik Indonesia, Jakarta. 2011.

Gould IM, Van Der Meer JWM. Antibiotic policies: Theory and practice. Antibiotic Policies: Theory and Practice. 2005.

Newman. Carranza’s Clinical Periodontology 11th Ed. Google Docs. 2012. Available from: https://drive.google.com/file/u/1/d/1ipDKc9mmtrbZYAcUwcAgWMldHu9-B3xW/view?usp=embed_facebook

WHO. Guidelines for ATC classification and DDD assignment 2018. 2017 [cited 2019 Dec 4]. Available from: https://www.drugsandalcohol.ie/29364/

WHO. WHOCC - Use of ATC/DDD [Internet]. 2018 [cited 2019 Dec 4]. Available from: https://www.whocc.no/use_of_atc_ddd/

WHO. WHO ‎AWaRe classification‎. 2021 [cited 2023 Mar 21]. Available from: https://www.who.int/publications-detail-redirect/2021-aware-classification

Kemenkes. Peraturan Menteri Kesehatan No 28 tahun 2021 tentang Pedoman Penggunaan Antibitik. Kementerian Kesehatan Republik Indonesia, Jakarta; 2021 [cited 2022 Sep 29]. Available from: https://yankes.kemkes.go.id/unduhan/fileunduhan_1658480966_921055.pdf

Kepmenkes. Keputusan Menteri Kesehatan Republik Indonesia tentang Formularium Nasional. Kementerian Kesehatan Republik Indonesia, Jakarta. 2021.

Pani S, Barliana M, Halimah E, Pradipta I, Annisa N. Monitoring the Use of Antibiotics by the ATC/DDD Method and DU 90%: Observational Studies in Community Health Service Centers in North Gorontalo District. Indonesian Journal of Clinical Pharmacy. 2015;4.

Antoro TZ, Mutmainah N. The Evaluation of Antibiotics Using to Pediatric Acute Upper Respiratory Tract Infection Patients at Health Centers in Kunduran Blora 2013. Pharmacon: Jurnal Farmasi Indonesia. 2018;14:27–33.

Bestari MP, Karuniawati H. Evaluasi Rasionalitas dan Efektifitas Penggunaan Antibiotik pada Pasien Pneumonia Pediatrik di Instalasi Rawat Inap Rumah Sakit Pusat Jawa Tengah. Pharmacon: Jurnal Farmasi Indonesia. 2019;14:62-71–71.

Kemenkes. Keputusan Menteri Kesehatan Republik Indonesia Nomor 364/MENKES/SK/V/2006 tentang Pedoman Pengendalian Demam Tifoid. Kementerian Kesehatan Republik Indonesia, Jakarta; 2006.

Nisa RYC, Yulianti T. Evaluasi Penggunaan Antibiotik Pada Pasien Community-Acquired Pneumonia (CAP) Dengan Metode Gyssens Di Instalasi Rawat Inap RSUD Ir Soekarno Sukoharjo Tahun 2017 [Thesis]. Universitas Muhammadiyah Surakarta; 2020.

WHO. Keep antibiotics working – limit their use this flu season. 2019 [cited 2023 Mar 23]. Available from: https://www.who.int/europe/news/item/05-02-2019-keep-antibiotics-working-limit-their-use-this-flu-season

Carrat F, Schwarzinger M, Housset B, Valleron A-J. Antibiotic treatment for influenza does not affect resolution of illness, secondary visits or lost workdays. Eur J Epidemiol. 2004;19:703–5.

Lim JK, Kim TH, Kilgore PE, Aiello AE, Choi BM, Lee KC, et al. The Association between Influenza Treatment and Hospitalization-Associated Outcomes among Korean Children with Laboratory-Confirmed Influenza. Journal of Korean Medical Science. 2014;29:485–93.

Karuniawati H, Hassali MAA, Suryawati S, Ismail WI, Taufik T, Hossain MS. Assessment of Knowledge, Attitude, and Practice of Antibiotic Use among the Population of Boyolali, Indonesia: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2021;18:8258.

Karuniawati H, Hassali MAA, Suryawati S, Ismail WI, Taufik T, Wiladatika A. Public practices towards antibiotics: A qualitative study. Clinical Epidemiology and Global Health. 2020 [cited 2020 Sep 16]; Available from: http://www.sciencedirect.com/science/article/pii/S2213398420301238.

Karuniawati H, Yulianti T, Aini DK, Nurwienda FI. Impact of Antimicrobial Stewardship Program on the Use of Antibiotics in Pneumonia Patients at Teaching Hospital in Surakarta Indonesia. International Journal of Applied Pharmaceutics. 2021;20–3.