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All Journal JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Pharmaceutical And Biomedical Sciences Journal (PBSJ) Medical Sains : Jurnal Ilmiah Kefarmasian Jurnal Pharmacopoeia
Yusna Fadliyyah Apriyanti
Universitas Bengkulu
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemistry Education Health Professions Medicine & Pharmacology Public Health Other

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REVIEW: APPLICATION OF THE ATC/DDD METHOD FOR ANTIBIOTIC EVALUATION IN INDONESIA Yusna Fadliyyah Apriyanti; Saepudin
Medical Sains : Jurnal Ilmiah Kefarmasian Vol 8 No 3 (2023)
Publisher : Sekolah Tinggi Farmasi Muhammadiyah Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37874/ms.v8i3.888

Abstract

The global consumption of antibiotics has increased rapidly by 65% in units of daily doses over the last 15 years. Researchers predict that there will be a 200% increase in global antibiotic consumption by 2030, if there is no change in policy implementation. This article aims to provide knowledge regarding the use of the anatomical therapeutic chemical/defined daily doses (ATC/DDD) method to evaluate antibiotics in Indonesia, which is expected to provide additional knowledge for the quantitative evaluation of antibiotics. The literature data sources used were PubMed and Google Scholar online databases, using the Mendeley® tool for manager reference. There were 71 articles that met the criteria and were discussed systematically. Most of the ATC/DDD methods were used to evaluate antibiotics in 90.1% of inpatients and 9.9% of outpatients. In the application of this method, 94.4% of the data collection was carried out retrospectively, with most study designs using a cross-sectional 76%. The selected research period varied from 1 month to 5 years, with 59.1% of the study locations being carried out at the tertiary service level. The ATC/DDD method can also be used in a quasi-experimental design that examines comparisons before and after the intervention. The use of this method as an evaluation of the use of antibiotics in the specified study population resulted in the highest DDD/100 days of ceftriaxone hospitalization in 27 articles. Amoxicillin had the highest DDD/1000 patient-days in of 6/7 articles in the outpatient population...
Five Years Outpatients Antibiotics Consumption at Public Tertiary Hospital in Bengkulu According to Access, Watch and Reserve Classification Apriyanti, Yusna Fadliyyah; Saepudin; Siti Maisharah S. Gadzi
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 10 No. 3 (2023): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v10i32023.360-368

Abstract

Background: Access, Watch, and Reserve (AWaRe) antibiotics classification was released in 2019 by the World Health Organization (WHO) to enhance antimicrobial stewardship programs in all healthcare facilities. As a result, WHO advises global action to increase the availability of antibiotics from the Access group by more than 60%.Objective: to determine antibiotics consumption for outpatients at a public tertiary hospital in Bengkulu, Sumatera-Indonesia, from 2018 to 2022, focusing on antibiotics from Access class according to the AWaRe classification from WHO and Ministry of Health Republic of Indonesia (MoHRI). Methods: This is a cross-sectional survey analyzing aggregate data on antibiotics use for outpatients at the hospital during the study period. Data on antibiotics were collected from the hospital pharmacy department, while data on patient visits were collected from the medical records department.  The quantity of antibiotics used was calculated using the ATC/DDD method and expressed in DDD/1000 patient-day (PD), which was then converted into a percentage. Results: During the study period, 50-60% and 65-73% out of 14-19 antibiotic agents are from Access class according to WHO and MoHRI AWaRe classification, respectively. Quantitatively, according to the WHO and MoHRI AWaRe classification, the consumption of antibiotics from the Access class was 25-50% and 33-71% of total consumption, respectively. In addition, the segment of drug utilization 90% (DU90%) of antibiotics was dominated by antibiotics from Watch class. Conclusion: The hospital has not yet met the WHO target for antibiotic consumption from the Access class, highlighting the need for some effective efforts from Watch class to limit the usage of antibiotics.
Impact of National Antibiotic Guideline Implementation on Meropenem Utilization in a Teaching Hospital in Bengkulu, Indonesia Yusna Fadliyyah Apriyanti; Susi Delvera; Bella Donna Perdana Putra
Pharmaceutical and Biomedical Sciences Journal (PBSJ) Vol. 7 No. 2 (2025)
Publisher : Pharmacy Department, Faculty of Health Sciences, UIN Syarif Hidayatullah Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15408/pbsj.v7i2.46946

Abstract

The World Health Organization (WHO) classified antibiotics into the AWaRe categories to encourage rational prescribing and reduce inappropriate use of broad-spectrum agents. Indonesia adopted this framework through the National Antibiotic Guideline outlined in Ministry of Health Regulation No. 28/2021, which strengthened antimicrobial stewardship (AMS) efforts in hospitals. Although WHO categorized meropenem in the Watch group, the national guideline reclassified it as a Reserve antibiotic, highlighting its critical role as a last-line treatment for multidrug-resistant infections and the need for strict oversight. This study aimed to evaluate the impact of the guideline’s implementation on meropenem utilization in a teaching hospital and assess its position within the Drug Utilization 90% (DU90%) segment from 2020 to 2022. Using a cross-sectional design, aggregated inpatient antibiotic consumption data were analyzed across pre-intervention (May 2020–August 2021) and post-intervention (September 2021–December 2022) periods. Antibiotic use was quantified using Defined Daily Doses per 100 patient-days (DDD/100 PD) according to the ATC/DDD methodology, and DU90% analysis was applied to identify antibiotics accounting for 90% of total consumption. Meropenem showed a significant 43% reduction in the DDD/100 PD score during the post-intervention period (t = 4.427; p < 0.05), suggesting that the guideline contributed to a more controlled, optimized use of this high-priority antibiotic. However, meropenem consistently remained within the DU90% segment throughout the three years, indicating that despite reduced utilization, it continued to account for a substantial proportion of antibiotic use in the hospital. These findings underscored the importance of sustained AMS implementation and strict regulatory adherence to preserve meropenem effectiveness and mitigate the risk of antimicrobial resistance.
Implikasi Perbedaan Klasifikasi AWaRe WHO Dan Kemenkes RI Terhadap Evaluasi Penggunaan Antibiotik: Tinjauan Literatur Yusna Fadliyyah Apriyanti; Reza Rahmawati; Muthia Nurhidayah; Baha Udin
Jurnal Pharmacopoeia Vol 5 No 1 (2026): Maret 2026
Publisher : Poltekkes Kemenkes Bengkulu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33088/jp.v5i1.1255

Abstract

The AWaRe classification was developed by the WHO to support antimicrobial stewardship through standardized evaluation of antibiotic use. Several countries, including Indonesia, have implemented AWaRe classifications adapted to national clinical needs and policy priorities, although such adaptations may lead to variations in the interpretation of antibiotic use indicators and stewardship performance. A literature search was conducted using the Google Scholar database with the keywords “AWaRe classification”, “antibiotic use evaluation”, “WHO”, and “Indonesia”, accompanied by the addition of the affixes "AND" and "OR", and selection by the publication date starting January 2023, and ten (10) studies met the inclusion criteria. The selected studies were analyzed using thematic and comparative synthesis to identify patterns of antibiotic consumption, dominance of AWaRe categories, and the impact of classification differences on stewardship indicators. The included studies covered outpatient care (30%), inpatient care (30%), intensive care units (20%), community pharmacies (10%), and national antibiotic distribution (10%). Most studies (90%) reported dominance of Watch antibiotics, while increased use of Reserve antibiotics (40%) and Watch antibiotics dominated the DU90% segment (80%) of studies. Indonesian studies (20%) showed that national adaptation of the AWaRe classification increased the apparent proportion of Access antibiotics by approximately 15–30%.  In conclusion, AWaRe is a valuable tool for monitoring antibiotic use; however, stewardship interpretation is highly sensitive to the classification system applied. Dual reporting using both WHO and national AWaRe classifications is recommended to ensure accurate, transparent, and globally comparable evaluation of antibiotic use in support of effective antimicrobial stewardship policies.
Co-Authors Baha Udin Bella Donna Perdana Putra Muthia Nurhidayah Reza Rahmawati Saepudin Saepudin Siti Maisharah S. Gadzi Susi Delvera