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All Journal Pharmaciana: Jurnal Kefarmasian Jurnal Ilmiah Medicamento Borneo Journal of Pharmacy
Meriyani, Herleeyana
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Health Professions Medicine & Pharmacology Public Health

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Penggunaan Antibiotik dan Resistensi Escherichia coli and Klebsiella pneumoniae: Studi Ekologikal Lima Tahun di Sebuah Rumah Sakit Umum Daerah Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana; Juanita, Rr. Asih; Siada, Nyoman Budiartha; Mahaputra, Yudistira; Kamalia, Made Gek Adisti
Jurnal Ilmiah Medicamento Vol 11 No 2 (2025): Jurnal Ilmiah Medicamento (In progress)
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v11i2.11156

Abstract

Antibiotic resistance is a growing global health threat, partly driven by high antibiotic consumption. The World Health Organization (WHO) has identified critical-priority bacteria, including Escherichia coli and Klebsiella pneumoniae, due to their increasing resistance to multiple antibiotics. This study aimed to evaluate the correlation between antibiotic consumption and resistance rates in Escherichia coli and Klebsiella pneumoniae. This ecological study was conducted at a Regional Hospital in Indonesia based on retrospective inpatient data from January 2019 to December 2023. The population in this study is all data on systemic antibiotic consumption based on the J01 category of the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) classification system and antibiogram from inpatient databases. Pearson and Spearman’s rank correlation analyses were performed to examine the associations between systemic antibiotic consumption levels and the percentage of Escherichia coli and Klebsiella pneumoniae resistance to other antibiotics. The most frequently used antibiotics were cefixime (305.664 DDD/100 bed-days), levofloxacin (139.552 DDD/100 bed-days), and ceftriaxone (109.805 DDD/100 bed-days). A strong and statistically significant correlation was observed between doxycycline consumption and Escherichia coli resistance to meropenem (r=0.894; p=0.041). Moreover, consumption levels of cefazolin, ceftazidime, cefepime, and ciprofloxacin were correlated with Escherichia coli resistance to ceftriaxone (p<0.05), while cefoperazone use demonstrated a very strong and statistically significant correlation with Escherichia coli resistance to ampicillin-sulbactam (r=0.952; p=0.012). Conversely, no significant correlation was found between antibiotic consumption and resistance in Klebsiella pneumoniae, suggesting that alternative factors such as intrinsic resistance mechanisms, mobile genetic elements, and environmental reservoirs may influence resistance development.
Antibiotic consumption and resistance: a 3-years ecological study for four critical groups of bacteria in a general regional hospital Sanjaya, Dwi Arymbhi; Siada, Nyoman Budiartha; Juanita, Rr Asih; Mahaputra, I Putu Yudistira; Kamalia, Made Gek Adisti; Meriyani, Herleeyana
Pharmaciana Vol. 14 No. 1 (2024): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v14i1.27321

Abstract

Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae are the most critical groups of multi-drug resistant (MDR) bacteria that cause a threat in hospitals. This study identified the trend of antibiotic consumption, antibiotic resistance pattern, and the relationship between antibiotic consumption and antibiotic resistance in a critical group of bacteria in a general regional hospital. This ecological study was based on retrospective data from inpatient databases in a general regional hospital over three years (2017-2019). The trend for annual antibiotic consumption over 2017-2019 was defined as defined daily doses/100 bed-days. The relationship between total antibiotic consumption and the percentage of antibiotic resistance among four isolated critical bacteria was explored in time series analysis and linear regression. The most frequently used antibiotic was ampicillin (220.33 DDD/100 bed-days), ciprofloxacin (126.86 DDD/100 bed-days), and ampicillin-sulbactam (126.34 DDD/100 bed-days). There was a significant relationship between antibiotic consumption (ampicillin, ampicillin-sulbactam, ceftazidime, gentamicin, amikacin, and ciprofloxacin) in DDD/100 bed-days and antibiotic resistance in E. coli, K. pneumoniae, and P. aeruginosa (p<0.05) but not statically significant in A. baumannii (p=0.062). The annual usage fluctuated or remained stable, with no statistically significant trends change. The relationship between antibiotic consumption and antibiotic resistance was significant in three out of four critical groups of bacteria.
The Association between Resistance of Sepsis-Inducing Bacteria to First-Line Antibiotics and Sepsis Outcome: A Retrospective Cross-Sectional Study Meriyani, Herleeyana; Sanjaya, Dwi Arymbhi; Juanita, Rr. Asih; Siada, Nyoman Budiartha; Yudiartha, I Wayan Maysa; Suryawan, Kadek
Jurnal Ilmiah Medicamento Vol 12 No 1 (2026): Jurnal Ilmiah Medicamento (In progress)
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v12i1.13597

Abstract

Background: Sepsis is a significant infectious disease linked to high mortality rates. Several bacterial pathogens that cause sepsis have shown resistance to first-line antibiotics. This resistance in sepsis-causing bacteria to initial antibiotic agents threatens treatment success, elevating mortality risk, healthcare costs, and prolonged hospital stays.Objective: This study aimed to investigate the relationship between the resistance of sepsis-causing bacteria to first-line antibiotics and sepsis treatment outcomes.Methods: This cross-sectional study was a single-center retrospective study. Data were collected from sepsis patients admitted to the intensive care unit of a general hospital in Bali between 2022 and 2023. The patients included in this study were those with a positive bacterial infection, as provided in the culture result. Therapy outcomes were evaluated based on discharge status: improved or unimproved (deceased). The resistance of sepsis-causing bacteria to first-line antibiotics, including fluoroquinolones, third- and fourth-generation cephalosporins, piperacillin-tazobactam, and vancomycin, was assessed through blood cultures. The relationship between antibiotic resistance and therapy outcomes was analyzed using the Gamma correlation coefficient. This study included 57 of 108 sepsis patients, primarily male (57.89%) and older than 60 years (57.89%).Results: A strong, significant positive correlation was observed between the resistance of sepsis-causing bacteria to third-generation cephalosporins and therapy outcomes (p=0.001; r=0.637). In contrast, resistance to fluoroquinolones (p=0.108; r=0.387), fourth-generation cephalosporins (p=0.377; r=-0.199), piperacillin-tazobactam (p=0.816; r=-0.060), and vancomycin (p=0.911; r=0.030) did not significantly impact therapy outcomes. The outcome of sepsis therapy is associated with resistance of sepsis-causing bacteria to third-generation cephalosporins but not to fluoroquinolones, fourth-generation cephalosporins, piperacillin-tazobactam, or vancomycin. This study uses a relatively small sample size, which precludes subgroup analyses.Conclusion: Non-significant findings for some antibiotics may reflect insufficient power; further study is needed to assess the correlation between resistance of sepsis-causing bacteria to fluoroquinolones, fourth-generation cephalosporins, piperacillin-tazobactam, and vancomycin.
Co-Authors Chusna, Nurul Ciptawati, Ni Wayan Dwi Arymbhi Sanjaya Fredinan Yulianda Kamalia, Made Gek Adisti Ketupapa, Florentina Gabriela Ketut Agus Adrianta Mahaputra, I Putu Yudistira Mahaputra, Yudistira Megawati, Fitria Ni Made Dharma Shantini Suena Ni Nyoman Wahyu Udayani Ni Putu Udayana Antari Noviani, Lusy Nyoman Budiartha Siada Putra, I Made Agus Sunadi RR. Asih Juanita SARTIKAWATI, NI KADEK AYU Suryawan, Kadek Wardani, I Gusti Agung Ayu Kusuma Wintariani, Ni Putu Yudiartha, I Wayan Maysa