Drug Utilization Study of Antibiotics in Bacterial Meningitis (A Retrospective Study in Dr. Soetomo General Hospital, Surabaya, Indonesia)

Mareta Rindang Andarsari, Didik Hasmono, Samirah Samirah, Suharjono Suharjono, Dea Ayu Nabilah, Paulus Sugianto

= http://dx.doi.org/10.20473/jfiki.v4i22017.80-83
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Background: Meningitis defined as an inflammation of the meninges, a membrane that surrounds the brain. The inflammation is a result from bacterial infection. Central nervous system infection is a medical emergency because of the progressivity and potentially life-threatening. Antibiotics usage become crucial to reduce morbidity and mortality. Objective: This study was aimed to assess the use of antibiotics, prescribed for patients with bacterial meningitis in Neurology Department of Dr. Soetomo General Hospital Surabaya from January 2010 until June 2015. Methods: Retrospective study using medical record of inpatients obtained from January 1st 2010 until June 30th 2015. The inclusion criteria were inpatients with bacterial meningitis (diagnosed by physician using CT scan data, lumbal puncture and clinical signs and symptoms) and prescribed with antibiotics. Patients with antibiotics therapy less than 3 days and infection other than bacterials were excluded. Results: From 85 patients, male to female ratio was 1.66. Meningitis appear to be mostly occured in productive age, 39 (45.88%) in 15 - 29 years old and 40 (47.06%) in 30 - 60 years old. Number of antibiotics prescribed were 130 prescriptions, as single and combination therapy. The most prescribed antibiotic was cephalosporins (97 prescriptions), dominated by 2 g twice daily ceftriaxone with 86 (66.15%) from overall prescriptions. Followed by metronidazole and fluoroquinolons,11 (8.46%) and 8 (6.15%) respectively. In addition, there were 26 prescriptions of combination therapy, mostly ceftriaxone and metronidazole. Conclusion: Bacterial meningitis are mostly treated using ceftriaxone which is an appropriate drug of choice.


antibiotics, bacterial meningitis, drug utilization study, ceftriaxone

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Goodwin, S. D. & Hartis, C. E. (2008). Central Nervous System Infection. (In: Wells, B. G., Schinghammer, T. L., Malone, P. M., Kolesar, J. M., Rotschafer, J. C., Dipiro, J. T., Pharmacotherapy Principle and Practice). USA: McGraw-Hill.

Heckenberg, S. G., Brouwer, M. C. & Beek, D. V. (2014). Bacterial Meningits (In: J. Biller & J. M. Ferro (ed.) Handbook of Clinical Neurology Volume 121 3rd). Edinburgh: Elsevier.

Libert, C., Dejager, L. & Pinheiro. (2010). The X Chromosomes in Immune Functions: When a Chromosome Makes a Difference. Nature Reviews Immunology; 10; 594-604.

Lofmark, S., Edlund, C. & Nord, C. N. (2010). Metronidazole is Still the Drug of Choice for Treatment of Anaerobic Infections. Clinical Infectious Diseases; 50; 16-23.

Lutsar, I. & Friedland, I. R. (2000). Pharmacokinetics and Pharmacodynamics of Cephalosporin in Cerebrospinal Fluid. Drug Disposition; 39; 335-343.

Mace, S. E. (2008). Acute Bacterial Meningitis. Emergency Medicine Clinics; 26; 281–317.

McGill, F., Heyderman, R. S., Panagiotou, S., Tunkel, A. R. & Solomon, T. (2016). Acute Bacterial Meningitis in Adults. The Lancet; 6736; 1-12.

McIntyre, P. B., O’Brien, K. L., Greenwood, B. & Beek, D. (2012). Effect of Vaccines on Bacterial Meningitis Worildwide. The Lancet; 380; 1703-1711.

Nau, R., Sorgel, F. & Eiffert, H. (2010). Penetration of Drugs through the Blood-Cerebrospinal Fluid/Bood-Brain Barrier for Treatment of Central Nervous System Infections. Clinical Microbiology Reviews; 23; 858-883.

Paolo, A. D., Gori, G., Tascini, C., Danesi, R. & Tacca, M. D. (2013). Clinical Pharmacokinetics of Antibacterials in Cerebrospinal Fluid. Clinical Pharmacokinetics; 52; 511-542.

Prasad, K., Kumar, A. & Singhal, T. (2007). Third Generation Cephalosporins Versus Conventional Antibiotics for Treating Acute Bacterial Meningitis. Hoboken: John Wiley & Sons, Ltd.

Roos, K. L. & Beek, D. V. (2010). Bacterial Meningitis (In: Roos K., Tunkel, A. (ed.), Handbook of Clinical Neurology). Amsterdam: Elsevier.

Shaban, L. & Siam, R. (2009). Prevalence and Antimicrobial Resistance Pattern of Bacterial Meningitis in Egypt. Annals of Clinical Microbiology and Antimicrobials; 8; 1-10.

Tunkel, A. R., Calderwood, S. B. & Thorner, A. R. (2017). Initial Therapy and Prognosis of Bacterial Meningitis in Adults. Amsterdam: Wolters Kluwer.

Tunkel, A. R. (2017). Clinical Features and Diagnosis of Acute Bacterial Meningitis in Adults. Amsterdam: Wolters Kluwer.

Tzanakaki, G. & Mastrantonio, P. (2007). Aetiology of Bacterial Meningitis and Resistance to Antibiotics of Causative Pathogens in Europe and in the Mediterranean Region. International Journal of Antimicrobial Agents; 29; 621-629.


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