Background: Collaborative practice in healthcare has been recommended to improve the quality of antimicrobial stewardship interventions, a behavioral change in antimicrobial use. Insufficient knowledge regarding antibiotic resistance, the fear of complications from infections, and how providers perceive antibiotic use and resistance are likely to influence prescribing behavior. This study's objective was to identify the knowledge and belief healthcare professionals' differences about antibiotic stewardship. Methods: This cross-sectional survey study of three hospitals in the East Java province, Indonesia utilized a 43item questionnaire to assess antimicrobial stewardship knowledge and belief. There were 12 knowledge questions (total possible score: 12) and 31 belief questions (total possible score: 155). The Kuder Richardson 20 and Cronbach alpha values of the questionnaire were 0.54 and 0.92, respectively. Results: Out of the 257 respondents, 19% (48/257) had a low scores of knowledge, and 39% (101/257) had low scores on belief about antibiotic stewardship (101/257). Most midwives had a low scores on knowledge (25/61) and low scores on belief (46/61). Respondents with high scores on belief were 17% (10/59) physicians, 15% (4/ 27) pharmacists, 8% (5/65) nurses, and 3% (2/61) midwives. Conclusion: Among healthcare professionals, knowledge and belief differences concerning antibiotic stewardship vary widely. These differences will affect their capability, behavior, and contribution to the healthcare team collaboration and performance. Further studies are needed to evaluate the correlation between the level of interprofessional collaboration and the quality of the antibiotic stewardship implementation.

Background Providing proper antibiotics is undoubtedly crucial to prevent infections during surgery. Objective This study set out to evaluate the medication administration in antibiotic prophylaxis using both quantitative and qualitative methods. Setting The study employed a retrospective design and observed patients who underwent surgical procedures during hospitalization at a private hospital in Indonesia within the period of January-June 2019. Methods The data obtained were evaluated quantitatively and qualitatively; and analyzed descriptively. The quantitative evaluation used the defined daily dose (DDD) per 100 bed-days. The qualitative evaluation was expressed as the percentage of antibiotic suitability based on antibiotic administration, i.e. (1) type; (2) timing; (3) dosage; (4) duration; and (5) route. Main outcome measure Suitability of antibiotic prophylaxis in a hospital setting. Results There were 164 prescriptions recorded from 20 types of surgical procedures, of which the most common was cholecystectomy (23 patients, 14%). Most antibiotics were administered 61-120 min before the incision time (55 patients, 37%), and had a duration of more than 24 h (119 patients, 80%). The total DDD per 100 bed-days for pre-, on-, and post-surgery antibiotic use were 44.2, 33.3, and 66.7 respectively. The suitability profiles of the antibiotics used according to the Antibiotic Use Guideline for Hospital (2018) were as follows: 26.3% right type, 52.9% right time, 24.8% right dosage, 19.1% right duration, 91.8% right route, while according to American Society of Health-System Pharmacists Therapeutic Guidelines (2014) there were 17.6% right type, 53.4% right time, 16.4% right dosage, 19.1% right duration, and 96.6% right route. Conclusion Ceftriaxone was the first-choice prophylactic antibiotic administered in this Indonesian hospital. The data indicate a considerable non-compliance with local and international guidelines. Keywords Antibiotic prophylaxis • DDD per 100 bed-days • Inappropriate prescriptions • Surgery Impacts on practice• Evaluating antibiotic prophylaxis is useful for assessing the possibility of inappropriate antibiotic use. • Surgeons tend to prescribe prophylactic antibiotics for all types of surgery despite the absence of prerequisites for some of them.• Frequent inappropriate use of antibiotics can increase the cost of treatment and antibiotic resistance in patients. • Increasing adherence to guidelines and the use of appropriate prophylactic antibiotics are important points in prevention of surgical site infection and control of microbial resistance. • To increase adherence, training is needed to normalize antibiotic selection in accordance with international and local guidelines.

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Asians often consume foods high in carbohydrates with the addition of MSG as a flavor enhancer. Foods with high carbohydrates and MSG are predicted to be obesogen. This study aims to explore the effects of high carbohydrate (HC), high MSG (HMSG), and a combination of high carbohydrate and MSG (HCHMSG) intake with the onset of obesity. Seven-week-old male Swiss Webster strain mice (Mus musculus) (n = 40) were divided into four groups. The control group consisted of 57% carbohydrates, 9% fiber, and 6.11% fat. The HC group was given food intake consisting of 71% carbohydrate, 4.62% fiber, and 1.81% fat for 14 weeks; the HMSG group's diet consisted of 57% carbohydrates, 9% fiber, 6.11% fat with an additional 10% MSG and group HCHMSG diet consisted of 71% carbohydrates, 4.62% fiber and 1.81% fat with an additional 10% MSG. Significant weight gain (p < 0.05) began at the fourth week in HC and HCHMSG groups and the HMSG group in the sixth week. After 14 weeks of study the HC group (BW 45.07 ± 4.41; p < 0.05) and the HCHMSG group were obese (42,817 ± 7,149; p > 0.05). WAT increases significantly in both HC and HCHMSG groups.

The clinical manifestations associated with COVID-19 disease is mainly due to a dysregulated host response related to the overexpression of inflammatory markers. Until recently, only remdesivir had gained FDA approval for COVID-19 hospitalized patients and there are currently no evidence-based therapeutic options or options for prevention of complications that have been established. Some medical treatments such as antivirals, antibacterials, antithrombotics, antipyretics, corticosteroids, interleukin inhibitors, monoclonal antibodies, convalescent plasma, immunostimulants, and vitamin supplements have been utilized. However, there are limited data to support their effectiveness. Hence, this study was attempted to identify and evaluate the effectiveness of antibacterials and antivirals used for COVID-19 using a retrospective cross-sectional approach based on the medical records of adult patients in four hospitals. The number of antibacterials was calculated in defined daily dose (DDD) per 100 bed-days unit. Both mixed-logit regression and analysis of covariance were used to determine the effectiveness of the aforementioned agents in relation to COVID-19 outcome and patients’ length of stay. The model was weighed accordingly and covariates (e.g., age) were considered in the model. Heart disease was found to be the most common pre-existing condition of COVID-19 hospitalized patients in this study. Azithromycin, an antibacterial in the Watch category list, was used extensively (33–65 DDD per 100 bed-days). Oseltamivir, an antiviral approved by the FDA for influenza was the most prescribed antiviral. In addition, favipiravir was found to be a significant factor in improving patients’ COVID-19 outcomes and decreasing their length of stay. This study strongly suggests that COVID-19 patients’ received polypharmacy for their treatment. However, most of the drugs used did not reach statistical significance in improving the patients’ condition or decreasing the length of stay. Further studies to support drug use are needed.