Five Years Outpatients Antibiotics Consumption at Public Tertiary Hospital in Bengkulu According to Access, Watch and Reserve Classification
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Background: Access, Watch, and Reserve (AWaRe) antibiotics classification was released in 2019 by the World Health Organization (WHO) to enhance antimicrobial stewardship programs in all healthcare facilities. As a result, WHO advises global action to increase the availability of antibiotics from the Access group by more than 60%.Objective: to determine antibiotics consumption for outpatients at a public tertiary hospital in Bengkulu, Sumatera-Indonesia, from 2018 to 2022, focusing on antibiotics from Access class according to the AWaRe classification from WHO and Ministry of Health Republic of Indonesia (MoHRI). Methods: This is a cross-sectional survey analyzing aggregate data on antibiotics use for outpatients at the hospital during the study period. Data on antibiotics were collected from the hospital pharmacy department, while data on patient visits were collected from the medical records department. The quantity of antibiotics used was calculated using the ATC/DDD method and expressed in DDD/1000 patient-day (PD), which was then converted into a percentage. Results: During the study period, 50-60% and 65-73% out of 14-19 antibiotic agents are from Access class according to WHO and MoHRI AWaRe classification, respectively. Quantitatively, according to the WHO and MoHRI AWaRe classification, the consumption of antibiotics from the Access class was 25-50% and 33-71% of total consumption, respectively. In addition, the segment of drug utilization 90% (DU90%) of antibiotics was dominated by antibiotics from Watch class. Conclusion: The hospital has not yet met the WHO target for antibiotic consumption from the Access class, highlighting the need for some effective efforts from Watch class to limit the usage of antibiotics.
Apriyanti, Y. F. & Saepudin. (2023). Review: Application of The ATC/DDD Method for Antibiotic Evaluation in Indonesia. Medical Sains: Jurnal Ilmiah Kefarmasian; 8; 1323–1344. doi: 10.37874/ms.v8i3.888.
Assis, D., Madalosso, G., Boszczowski, I. & Piastrelli, F. (2022). 1792. Different Patterns of Antibiotic Use in Different Administrative Categories: An Overview of 10 years (2009/2018) of a Statewide Surveillance Program in Sao Paulo, Brazil. In Open Forum Infectious Diseases; 9; 1-10. doi: 10.1093/ofid/ofac492.1422.
Azyenela, L., Tobat, S. R. & Selvia, L. (2022). Evaluasi Penggunaan Antibiotik di Instalasi Rawat Inap Bedah RSUD M. Natsir Kota Solok Tahun 2020. Jurnal Mandala Pharmacon Indonesia; 8; 1–10.
Alves, P., Rijo, P., Bravo, C., M. M. Antunes, A. & André, V. (2020). Bioactivity of Isostructural Hydrogen Bonding Frameworks Built from Pipemidic Acid Metal Complexes. Molecules; 25; 1-14. doi: 10.3390/molecules25102374.
Dadgostar, P. (2019). Antimicrobial Resistance: Implications and Costs. Infection and Drug Resistance; 12; 3903–3910. doi: 10.2147/IDR.S234610.
Daneman, N., Fridman, D., Johnstone, J., Langford, B. J., Lee, S. M., MacFadden, D. M., Mponponsuo, K., Patel, S. N., Schwartz, K. L. & Brown, K. A. (2023). Antimicrobial Resistance and Mortality Following E. coli Bacteremia. E-Clinical Medicine; 56; 101781. doi: 10.1016/j.eclinm.2022.101781
Diah, F. (2022). Rationality of Antibiotics Use with Quantitative and Qualitative Methods at Hospital In Indonesia. Pharmacology, Medical Reports, Orthopedic, and Illness Details (COMORBID); 1; 73–82.
Dobbyn, D., Zeggil, T., Kudrowich, B. & Beahm, N. P. (2022). Ciprofloxacin Resistances Rates in Escherichia coli Across Canada (CREAC): a Longitudinal Analysis 2015–2019. International Journal of Antimicrobial Agents; 59; 1-6. doi: 10.1016/j.ijantimicag.2022.106532.
Feroche, A. T. & Alemu, B. M. (2021). Drug Use Evaluation of Ciprofloxacin at Inpatient and Outpatient Departments of Hiwot Fana Specialized University Hospital, Harar General Hospital and Jagol Hospital in Harar City Advances in Pharmacoepidemiology & Drug Safety. Population; 5; 1–5.
Hollingworth, S. & Kairuz, T. (2021). Measuring Medicine Use: Applying ATC/DDD Methodology to Real-World Data. Pharmacy; 9; 1-8. doi: 10.3390/pharmacy9010060.
Limato, R., Nelwan, E. J., Mudia, M., de Brabander, J., Guterres, H., Enty, E., Mauleti, I. Y., Mayasari, M., Firmansyah, I., Hizrani, M. & Hamers, R. L. (2021). A Multicentre Point Prevalence Survey of Patterns and Quality of Antibiotic Prescribing in Indonesian Hospitals. JAC-Antimicrobial Resistance; 3; 1-10. doi: 10.1093/jacamr/dlab047.
Ministry of Health Republic of Indonesia (MoHRI). (2021). Guidelines for the Use of Antibiotics. Regulation of the Minister of Health of the Republic of Indonesia No 28 of 2021. Jakarta: Ministry of Health Republic of Indonesia.
Nguyen, N. V., Do, N. T. T., Vu, D. T. V., Greer, R. C., Dittrich, S., Vandendorpe, M., Pham, T. N., Ta, N. T. D., Pham, T. Q., Khuong, V. T., Le, T. T. B., Anh, L. T., Cao, T. H., Trinh, T. S., Nguyen, H. T., Ngo, L. N., Vu, T. T., van Doorn, H. R., Lubell, Y. & Lewycka, S. O. (2023). Outpatient Antibiotic Prescribing for Acute Respiratory Infections in Vietnamese Primary Care Settings by the WHO AWaRe (Access, Watch and Reserve) Classification: An Analysis Using Routinely Collected Electronic Prescription Data. The Lancet Regional Health - Western Pacific; 30; 1-12. doi: 10.1016/j.lanwpc.2022.100611.
Nwobodo, C., Ugwu, D. M. C. O. A., Al-Ouqaili, M. T. S., Chinedu Ikem, J., Victor Chigozie, U. & Saki, M. (2022). Antibiotic Resistance: The Challenges and Some Emerging Strategies for Tackling a Global Menace. J Clin Lab Anal, 36; 1-10. doi: 10.1002/jcla.24655.
Oldenburg, C. E. & Doan, T. (2020). Azithromycin for Severe COVID-19. The Lancet; 396; 936–937. doi: 10.1016/S0140-6736(20)31863-8.
Oldenburg, C. E., Pinsky, B. A., Brogdon, J., Chen, C., Ruder, K., Zhong, L., Nyatigo, F., Cook, C. A., Hinterwirth, A., Lebas, E., Redd, T., Porco, T. C., Lietman, T. M., Arnold, B. F. & Doan, T. (2021). Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection. JAMA; 326; 490-498. doi: 10.1001/jama.2021.11517.
Ranjbar, R., Alam, M. & Antimicrobial Resistance Collaborators. (2022). Global Burden of Bacterial Antimicrobial Resistance in 2019: a Systematic Analysis. Evidence-Based Nursing (2023); 399; 629–655. doi: 10.1016/s0140-6736(21)02724-0.
Rehman, A., Patrick, W. M. & Lamont, I. L. (2019). Mechanisms of Ciprofloxacin Resistance in Pseudomonas aeruginosa: New Approaches to An Old Problem. Journal of Medical Microbiology; 68; 1–10. doi: 10.1099/jmm.0.000873.
Sinto, R. (2020). Peran Penting Pengendalian Resistensi Antibiotik pada Pandemi COVID-19. Jurnal Penyakit Dalam Indonesia; 7; 7–9.
Tomas, A., Pavlovíc, N., Stilinovíc, N., Horvat, O., Paut-Kusturica, M., Dugandžija, T., Tomíc, Z. & Sabo, A. (2021). Increase and Change in the Pattern of Antibiotic Use in Serbia (2010-2019). Antibiotics; 10; 1–13. doi: 10.3390/antibiotics10040397.
WHO. (2020). GLASS Methodology for Surveillance of National Antimicrobial Consumption. WHO: Geneva. https://iris.who.int/bitstream/handle/10665/336215/9789240012639-eng.pdf?sequence=1
WHO. (2022). ATC/DDD Index 2022. https://www.whocc.no/atc_ddd_index/.
Wilson, A., Mair, T., Williams, N., McGowan, C. & Pinchbeck, G. (2022). Antimicrobial Prescribing and Antimicrobial Resistance Surveillance in Equine Practice. Equine Veterinary Journal; 2022; 494–505. doi: 10.1111/evj.13587.
Xiao, Z. (2023). Antimicrobial Resistance Mechanisms: Using Examples from Gram-Positive and Gram-Negative Bacteria. In G. Royle & S. M. Lipkin (Eds.). Second International Conference on Biological Engineering and Medical Science (ICBioMed 2022) SPIE. doi: 10.1117/12.2669646.
Zhussupova, G., Utepova, D., Orazova, G., Zhaldybayeva, S. & Skvirskaya, G. (2021). Evaluation of Antibiotic Use in Kazakhstan for the Period 2017 – 2019 Based on WHO Access, Watch and Reserve. Antibiotics; 10; 1-13. doi: 10.3390/antibiotics10010058
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