Three years of antibacterial consumption in Indonesian Community Health Centers: The application of anatomical therapeutic chemical/defined daily doses and drug utilization 90% method to monitor antibacterial use

Abstract

Context:Irrational use of antibacterial drugs in Community Health-Care Centers (CHCs) may lead to increased resistance, morbidity, and mortality.Aims:The aim of this study was to determine patterns of antibacterial use at CHCs in a district of Indonesia and use this as data for an antibiotic policy.Settings and Design:The observational-descriptive study was conducted in a district of Indonesia to obtain antibacterial use from 2008 to 2010.Subjects and Methods:The data obtained from the report on the use of medicines were classified and processed using the anatomical therapeutic chemical (ATC) and defined daily doses (DDD) method, with DDD/1000 patients as a unit measurement. The number of patients was obtained from attending patients in that research period. The most abundant antibacterial drugs use segment was identified by the drug utilization 90% (DU90%) method.Statistical Analysis Used:Descriptive analysis were performed in this study.Results:Fourteen kinds of antibacterial drugs were used in 61 CHCs. The total of antibacterial drug use during the period 2008–2010 was 871.36 DDD/1000 patients/day. Declining antibacterial use was observed between 2008 and 2010. Six kinds of antibacterial drugs were the most commonly used. The data show that the average use per visit was as high as 24.41 DDD.Conclusions:Amoxicillin, sulfamethoxazole and trimethoprim are antibacterials that have to be reconsidered by physicians for use in the Bandung CHC. The high use of antibacterial drugs, as described in the study, can be used as reference to develop an antimicrobial stewardship program and increase awareness of resistance, adverse drug reaction and drug interaction of antibacterial drugs.

Evaluation of Antibiotic Use in 2018 at the Kebayoran Baru Primary Health Care, Indonesia, Using the Anatomical Therapeutic Chemical/Defined Daily Dose Method

“…Thus, antibiotics that are included in the DU 90% segment must be evaluated for their rational use to minimize the risk of resistance [20]. The identification of an antibiotic in the DU 90% segment can also be used as planning data for providing drugs for the next time period and predicting the side effects of the drugs most frequently used [12].…”

“…The ATC/DDD classification systems for measuring units are tools used to exchange and compare data on drug use at the local, national, and international levels to improve the quality of drug use [11]. This method can also be used to detect the early signs of irrational drug use [12].…”

“…The DU 90% method group drugs fall into categories that indicate that they comprise 90% of the most-used drugs. The two methods can be combined to identify segments of high drug use and can be used to determine the possibility of their irrational use by identifying either their underuse or overuse [12,13].…”

Isolation of Streptococcus thermophilus and Lactobacillus delbrueckii as Starter Culture Candidate Originated from Indonesian Cow��s Milk

“…S. thermophilus 24/S1 and L. delbrueckii 94/L4 showed to be resistant to a range of antibiotics. Both isolates have different antibiotic susceptibility profiles displaying similar susceptibility against the most commonly prescribed antibiotics, amoxicillin and appears to be resistant against sulphonamide ( Table 5, S4−6) [36].…”

Association between Perceived Value and Self-Medication with Antibiotics: An Observational Study Based on Health Belief Model Theory

“…1 Studi di Kota Bandung menunjukkan terdapat potensi tingginya ketidakrasionalan dalam penggunaan antibiotik dan resistensi antibiotik. Beberapa permasalahan yang dapat terjadi dalam penggunaan antibiotik yaitu antara lain penggunaan antibiotik yang tinggi di puskesmas, 2 tingkat resistensi antibiotik yang tinggi, 3,4 dan aksesibitilitas pasien yang tinggi terhadap antibiotik tanpa resep dokter. Hal tersebut semakin diperparah pula dengan minimnya ketersediaan dari tenaga kesehatan serta pelayanan informasi obat di fasilitas kesehatan primer 5,6 sehingga berpotensi dalam mendorong praktik swamedikasi antibiotik.…”