Rika Yulia

THE THIRD-GENERATION CEPHALOSPORIN USE IN A REGIONAL GENERAL HOSPITAL IN INDONESIA

Antibiotic is used abundantly over time. This study aimed to determine the profile of the use of antibiotics in units of DDD/100 bed-days, types of bacteria as well as the sensitivity of bacteria in the Surgery, Obstetrics and Gynecology, and Medical Ward of Bangil Regional General Hospital, Pasuruan in 2016. The study was conducted using a descriptive, cross-sectional study design and data collection was done retrospectively. The results showed that the most-used antibiotics in surgery and medical wards are the third-generation cephalosporins, whereas in Obstetrics and Gynecology is the first-generation cephalosporins. The total DDD per bed-days of the medical ward (53.76 DDD per bed-days) is higher than surgery ward (45.83 DDD per bed-days) and Obstetrics and Gynecology ward (28.78 DDD per 100 bed-days). Only limited microbial culture perform during the study period. The most bacteria came from the isolates were Staphylococcus aureus and Escherichia coli. Antibiotic stewardship programme is urgently needed due to a high antibiotic use in the hospital.

A Retrospective Surveillance of the Antibiotics Prophylactic Use of Surgical Procedures in Private Hospitals in Indonesia

Background: According to international guidelines, prophylactic antibiotics in elective surgery should be given as a single dose 30 to 60 minutes before the operation is conducted. Postoperative administration of antibiotics should be discontinued 24 hours after surgery to minimize bacterial resistance and to keep control over hospitalization costs. There is a lack of data on the actual antibiotic use around surgical procedures in Indonesia. Objective: This retrospective surveillance study aimed to obtain defined daily doses (DDD) and DDDs per 100 bed days (DDD-100BD) for prophylactically used antibiotics in two private hospitals in Surabaya, East Java. These hospitals are considered to be representative for the current situation in Indonesia. Method: Data from a total of 693 patients over a nearly 1-year period (2016) were collected and evaluated. Results: The overall DDD per patient was 1.5 for hospital A and 1.7 for hospital B. The overall DDD-100BD was 30 for hospital B. Of the 24 antibiotics given prophylactically, ceftriaxone was the most commonly used in both hospitals. Conclusion: There was a clear discrepancy between daily practice in both hospitals and the recommendations in the guidelines. This study shows that better adherence to antibiotic stewardship is needed in Indonesia. Substantial improvements need to be made toward guided precision therapy regarding quantity (dose and frequency), route of administration (prolonged intravenous), and choice of the type of antibiotic.