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All Journal Pharmaciana: Jurnal Kefarmasian Jurnal Ilmiah Medicamento
I Putu Yudistira Mahaputra
Universitas Mahasaraswati Denpasar
Health Professions Medicine & Pharmacology Public Health

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Antibiotic consumption and resistance: a 3-years ecological study for four critical groups of bacteria in a general regional hospital Dwi Arymbhi Sanjaya; Nyoman Budiartha Siada; Rr Asih Juanita; I Putu Yudistira Mahaputra; Made Gek Adisti Kamalia; Herleeyana Meriyani
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.
Association Between Antibiotic Consumption and Pseudomonas aeruginosa Non-Susceptibility: A Five-Year Ecological Study at Bali Regional General Hospital Dwi Arymbhi Sanjaya; Herleeyana Meriyani; Rr. Asih Juanita; Nyoman Budiartha Siada; I Putu Yudistira Mahaputra
Jurnal Ilmiah Medicamento Vol 12 No 2 (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.v12i2.14763

Abstract

Background: Pseudomonas aeruginosa is a major cause of healthcare-associated infections (HAIs), which are difficult to eradicate because of the bacterium’s intrinsic and acquired resistance mechanisms. However, evidence regarding the association between hospital antibiotic consumption and antimicrobial resistance remains inconsistent.Objective: This study determines the association between systemic antibiotic consumption and P. aeruginosa non-susceptibility using five years of hospital surveillance data.Methods: A retrospective ecological study was conducted using surveillance data from Bali Regional General Hospital between January 2019 and December 2023. The relationship between antibiotic consumption [defined as daily doses (DDD) per 100 patient-days] and resistance was analyzed by a generalized linear model in which the number of non-susceptible isolates was used as the dependent variable. Moreover, antibiotic consumption, the bed occupancy rate (BOR), the calendar year, and the antibiotic agent (with meropenem taken as the reference category) were used as independent variables.Results: The study included 77 P. aeruginosa isolates and 35 antibiotic-year observations. No statistically significant association was found between antibiotic consumption and non-susceptibility (OR 1.049, 95% CI 0.980–1.122; p = 0.168) or between BOR and non-susceptibility (OR 1.024, 95% CI 0.992–1.057; p = 0.152). Calendar year was inversely associated with the modeled non-susceptibility outcome (OR 0.716, 95% CI 0.592–0.866; p < 0.001). Ceftazidime and cefepime had higher odds of non-susceptibility than meropenem.Conclusion: Antibiotic consumption does not fully explain P. aeruginosa non-susceptibility. Factors such as antibiotic-specific resistance mechanisms and infection prevention and control practices might also have a role in the differences in non-susceptibility.
Co-Authors Dwi Arymbhi Sanjaya Herleeyana Meriyani Made Gek Adisti Kamalia Nyoman Budiartha Siada RR. Asih Juanita