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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia
Clinical Microbiology and Infection, Volume 14, No. 7, Year 2008
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Description
This article estimates the magnitude and quality of antibiotic prescribing in Indonesian hospitals and aims to identify demographic, socio-economic, disease-related and healthcare-related determinants of use. An audit on antibiotic use of patients hospitalized for 5days or more was conducted in two teaching hospitals (A and B) in Java. Data were collected by review of records on the day of discharge. The method was validated through concurrent data collection in Hospital A. Multivariate logistic regression analysis was performed to determine variables to explain antibiotic prescribing. Prescriptions were assessed by three reviewers using standardized criteria. A high proportion (84%) of 999 patients (499 in Hospital A and 500 in Hospital B) received an antibiotic. Prescriptions could be categorized as therapeutic (53%) or prophylactic (15%), but for 32% the indication was unclear. Aminopenicillins accounted for 54%, and cephalosporins (mostly third generation) for 17%. The average level of antibiotic use amounted to 39DDD/100patient-days. Validation revealed that 30% of the volume could be underestimated due to incompleteness of the records. Predictors of antibiotic use were diagnosis of infection, stay in surgical or paediatric departments, low-cost nursing care, and urban residence. Only 21% of prescriptions were considered to be definitely appropriate; 15% were inappropriate regarding choice, dosage or duration, and 42% of prescriptions, many for surgical prophylaxis and fever without diagnosis of infection, were deemed to be unnecessary. Agreement among assessors was low (kappa coefficients 0.13 - 0.14). Despite methodological limitations, recommendations could be made to address the need for improving diagnosis, treatment and drug delivery processes in this setting. © 2008 European Society of Clinical Microbiology and Infectious Diseases.
Authors & Co-Authors
Hadi, Usman
Indonesia, Surabaya
Universitas Airlangga
Duerink, D. Offra
Netherlands, Leiden
Leids Universitair Medisch Centrum
Lestari, Endang Sri
Indonesia, Semarang
Universitas Diponegoro
Nagelkerke, Nico J.D.
United Arab Emirates, Al Ain
United Arab Emirates University
Keuter, Monique M.
Netherlands, Nijmegen
Radboud University Medical Center
Huis In't Veld, D.
Netherlands, Nijmegen
Radboud University Medical Center
Suwandojo, E.
Indonesia, Surabaya
Universitas Airlangga
Rahardjo, E.
Indonesia, Surabaya
Universitas Airlangga
van den Broek, Peterhans J.
Netherlands, Leiden
Leids Universitair Medisch Centrum
Gyssens, I. C.
Netherlands, Rotterdam
Erasmus Mc
Netherlands, Nijmegen
Radboud University Medical Center
Statistics
Citations: 75
Authors: 10
Affiliations: 7
Identifiers
Doi:
10.1111/j.1469-0691.2008.02014.x
ISSN:
1198743X
e-ISSN:
14690691
Research Areas
Health System And Policy
Study Design
Grounded Theory
Study Approach
Quantitative