Evaluation of Antibiotics Used in Pediatric Outpatients with Acute Respiratory Infection at a Private Hospital in Yogyakarta

Margaretha Wulan Kurniasari(1*), Titien Siwi Hartayu(2),

(1) Faculty of Pharmacy, University Sanata Dharma, Kampus III Paingan Maguwoharjo Depok Sleman Yogyakarta, 55282, Indonesia
(2) Faculty of Pharmacy, University Sanata Dharma, Kampus III Paingan Maguwoharjo Depok Sleman Yogyakarta, 55282, Indonesia
(*) Corresponding Author

Abstract


Ensuring patient safety and optimal health outcomes in the healthcare system requires appropriate and rational use of medicines. One of the prescription issues noted in the pediatric clinic at a private hospital is the high use of antibiotics for acute respiratory infections. This study aimed to improve antibiotics used in outpatient pediatric clinic. This study was a descriptive analysis with a cross-sectional study design, combining quantitative and qualitative methods. The population was all prescriptions in January - March 2023. By using a purposive sampling method, there were 340 prescriptions obtained. The instruments of the study were data collection sheets and in-depth interview guidelines. Data were analyzed using the triangulation method. The antibiotic prescription rate was 64% (n=340). There were patients with Azithromycin and Erythromycin who received antibiotics below the dosing recommendations. Observation of patients’ treatment process showed that prescribers did not always suggest the laboratory examinations. Based on in-depth interviews of prescribers, they prescribed antibiotics based on the patient’s clinical examination. Based on in-depth interviews with the hospital managers, there was a tendency to choose a strategy which was a combination of educational and managerial strategies. The strategies to improve the quality of the antibiotics used include conducting training programs for the prescribers and developing standard treatment guidelines.

Keywords


Educational strategy; In-depth interview; Managerial strategy; Patient safety; Rational use of medicines

References


Angin, M. P., Saputri, G. A. R., Pangestu, D. A. 2021. Pola Penggunaan Antibiotik Infeksi Saluran Pernapasan Atas Akut pada Anak. Journal of Pharmacy and Tropical Issues, 1(3), 53–60.

Chan, Y. Y., Bin Ibrahim, M. A., Wong, C. M., Ooi, C. K., Chow, A. 2019. Determinants of antibiotic prescribing for upper respiratory tract infections in an emergency department with good primary care access: A qualitative analysis. Epidemiology and Infection, 147, 1–7.

Hardin, A. P., Hackell, J. M. 2017. Age limit of pediatrics. Pediatrics, 140(3), 1–3.

Hassan, M. Z., Monjur, M. R., Biswas, M. A. A. J., Chowdhury, F., Kafi, M. A. H., Braithwaite, J., Jaffe, A., Homaira, N. 2021. Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: A population-based survey. BMJ Global Health, 6, 1–13.

Ikatan Dokter Anak Indonesia. 2016. Buku Saku Dosis Obat Pediatri (L. Rundjan, T. T. Sar, A. Alam, & I. Yuniar, Eds.). Ikatan Dokter Anak Indonesia.

Ismail, I. A., Pernadi, N. L., Febriyanti, A. 2022. How to grab and determine the size of the sample for research. International Journal of Academic and Applied Research, 6(9), 88–92.

Karuniawati, H., Yulianti, T., Aini, D. K., Nurwienda, F. I. 2021. Impact of antimicrobial stewardship program on the use of antibiotics in pneumonia patients at teaching hospital in Surakarta Indonesia. International Journal of Applied Pharmaceutics, 13(1), 20–23.

Kaufmann, C. P., Stampfli, D., Hersberger, K. E., Lampert, M. L. 2015. Determination of risk factors for drug- related problems: a multidisciplinary triangulation process. BMJ Open, 5, 1–7.

Lutfiyati, H., Yasin, N. M., Thobari, J. A., Ikawati, Z. 2022. The implementation of antimicrobial stewardship in Indonesia: A regional survey in hospitals. Journal of Advanced Pharmacy Education and Research, 12(4), 19–26.

Mamo, D. B., Alemu, B. K. 2020. Rational drug-use evaluation based on world health organization core drug-use indicators in a tertiary referral hospital, Northeast Ethiopia: A cross-sectional study. Drug, Healthcare and Patient Safety, 12, 15–21.

Management Sciences for Health. 2012a. Investigating medicine use. In M. Embrey (Ed.), MDS-3: Managing Access to Medicines and Health Technologies (pp. 28.1-28.23). Management Sciences for Health.

Management Sciences for Health. 2012b. Managing for rational medicine use. In M. Embrey (Ed.), MDS-3: Managing Access to Medicines and Health Technologies (pp. 27.1-27.16).

Management Sciences for Health. 2012c. Promoting Rational Prescribing. In MDS-3: Managing Access to Medicines and Health Technologies (pp. 29.1-29.24). Management Sciences for Health.

Maxwell, S.R. 2016. Rational prescribing: the principles of drug selection. CME CLINICAL PHARMACOLOGY, 16(5), 459–464.

Menteri Kesehatan Republik Indonesia. 2015. Peraturan Menteri Kesehatan Republik Indonesia Nomor 8 Tahun 2015 (pp. 1–32).

Mirino, R., Dary, Tampubolon, R. 2022. Identification of factors causing Acute Respiratory Infection (ARI) of under-fives in community health center work area in North Jayapura Sub-District. Journal of Tropical Pharmacy and Chemistry, 6(1), 15–20.

Muliana, H. 2017. Rasionalitas pola pemberian antibiotik pada pasien balita penyakit demam dan batuk Rawat Jalan Di RSUD Tuan Rondahaim Pematang Raya Kabupaten Simalungun tahun 2017. 2-TRIK: Tunas-Tunas Riset Kesehatan, 7, 87–90.

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., Doorn, H. R. Van, 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(100611), 1–12.

Nyabuti, A. O., Okalebo, F. A., Guantai, E. M. 2020. Examination of WHO/INRUD core drug use indicators at public primary healthcare centers in Kisii County, Kenya. Advances in Pharmacological and Pharmaceutical Sciences, 2020.

Paul, S.P., Wilkinson, R., Routley, C. 2014. Management of respiratory tract infections in children. Nursing: Research and Reviews, 4, 135–148.

Rahajoe, N. N., Supriyatno, B., Setyanto, D.B. 2010. Buku Ajar Respirologi Anak (N. N. Rahajoe, B. Supriyanto, & D. B. Setyanto, Eds.; Pertama). Ikatan Dokter Anak Indonesia.

Setiawan, E., Cotta, M. O., Abdul-Aziz, M. H., Sosilya, H., Widjanarko, D., Wardhani, D. K., Roberts, J.A. 2022. Indonesian healthcare providers’ perceptions and attitude on antimicrobial resistance, prescription and stewardship programs. Future Microbiology, 17(5), 351–362.

Shahbaz, K. 2017. Cephalosporins: Pharmacology and chemistry. Pharmaceutical and Biological Evaluations, 4(6), 234–238.

Sutriyati Tuloli, T., Abdulkadir, W. S., Rasdianah, N. 2021. Evaluasi mutu pelayanan kefarmasian berdasarkan Standar Pelayanan Minimal (Spm) di Instalasi Farmasi. Journal Syifa Sciences and Clinical Research, 3(2), 87–97.

Tandi, J., Penno, M., Ruterlin, V., Panggeso, A. 2018. Kajian peseperan obat antibiotik penyakit ISPA pada anak di RSU Anutapura Palu tahun 2017. Pharmacon: Jurnal Ilmiah Farmasi, 7(4), 126–135.

Titami, A., Mende, J., Dian K, N. 2022. Drug-related problems of antibiotic therapy used for pediatric: A review. Indonesian Journal of Pharmacology and Therapy, 3(2), 61–69.

Zanichelli, V., Tebano, G., Gyssens, I. C., Vlahović-Palčevski, V., Monnier, A. A., Stanic Benic, M., Harbarth, S., Hulscher, M., Pulcini, C., Huttner, B.D. 2019. Patient-related determinants of antibiotic use: a systematic review. Clinical Microbiology and Infection, 25(1), 48–53




DOI: https://doi.org/10.24071/jpsc.007707

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Published by Faculty of Pharmacy, Universitas Sanata Dharma Yogyakarta

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