Bacterial Profile and Antibiotic Use in Pneumonia Patients at Dr. Soetomo General Hospital

Author(s): Rika Yulia, Josephine Witha Mariza, Soedarsono, Fauna Herawati*

Journal Name: Current Respiratory Medicine Reviews

Volume 16 , Issue 1 , 2020


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Abstract:

Background: Pneumonia is one of the causes of morbidity and mortality in children and adults worldwide. WHO report in 1999 stated that the main cause of death due to infectious disease is pneumonia. The rising mortality rate among severe pneumonia patients is because they do not receive empirical antibiotic treatment according to the infecting pathogens.

Objective: The purpose of this study is to identify the bacterial profile and the use of antibiotic treatment on pneumonia patients admitted to the pulmonology ward of Dr. Soetomo General Hospital in Surabaya, Indonesia.

Methods: This descriptive observational study used the data from pneumonia patients admitted to the pulmonology ward of Dr. Soetomo General Hospital, Surabaya, from February to April 2018. The data was collected from the patients’ medical records, antibiotic use notes, and culture results of bacterial antibiotic sensitivity test. The total of antibiotic use was calculated using a defined daily dose (DDD) per 100 bed days. The quality of antibiotics was assessed using Gyssens method. The microbial mapping was acquired from a sputum culture test result.

Results: The most prevalent bacteria in pneumonia patients were the Gram-negative bacteria and the most common species was Acinetobacter baumannii followed by Klebsiella pneumoniae. In contrast, the most common Gram-positive bacteria species was Streptococcus viridans. The total antibiotic use was 35.53 DDD/100 bed days, and ceftriaxone was the most commonly used antibiotic with 9.23 DDD/100 bed days. Fifty percent of the antibiotic use was in category wise use of antibiotic.

Conclusion: The Gram-negative bacteria were the most common cause of pneumonia and ceftriaxone was the most commonly used antibiotic for its cure. Fifty percent of the patients received ceftriaxone appropriately.

Keywords: Antibiotic, bacterial profile, defined daily dose, Gyssens method, infection, pneumonia.

[1]
Zar HJ, Madhi SA, Aston SJ, Gordon SB. Pneumonia in low and middle income countries: progress and challenges. Thorax 2013; 68: 1052. –56
[2]
Strategy for coordinated approach to prevention and control of acute diarrhoea and respiratory infection in the South-East Asia Region. World Health Organization New Delhi: WHO SEARO 2010.WHO-SEARO. Available from: . http://repository.unissula. ac.id/10711/4/DAFTAR%20PUSTAKA.pdf
[3]
Health profile for East Java province in 2016. Surabaya: East Java province health service 2017.Available from: https://www.kemkes. go.id/resources/download/profil/PROFIL_KES_PROVINSI_2017/15_Jatim_2017.pdf
[4]
Johnston L. Rational use of antibiotics in respiratory tract infections. S Afr Pharm J 2012; 79(4): 34-9.
[5]
World Health Organization. WHO report on surveillance of antibiotic consumption: 2016-2018 early implementation. 2018..Available from: https://www.who.int/medicines/areas/rational_use/who-amr-amc-report-20181109.pdf?ua=1.
[6]
Lee YT, Kuo SC, Yang SP, et al. Bacteremic nosocomial pneumonia caused by Acinetobacter baumannii and Acinetobacter nosocomialis: a single or two distinct clinical entities? Clin Microbiol Infect 2013; 19(7): 640-5.
[http://dx.doi.org/10.1111/j.1469-0691.2012.03988.x]
[7]
Chung DR, Song JH, Kim SH, et al. Asian Network for Surveillance of Resistant Pathogens Study Group.. High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. Am J Respir Crit Care Med 2011; 184(12): 1409-17.
[http://dx.doi.org/10.1164/rccm.201102-0349OC PMID: 21920919]
[8]
Peraturan Menteri Kesehatan Republik Indonesia Nomor 8 Tahun 2015 Tentang Program Pengendalian Resistensi Antimikroba di Rumah Sakit. Jakarta . 2015.
[9]
Gyssens IC, van den Broek PJ, Kullberg BJ, Hekster Y, van der Meer JW. Optimizing antimicrobial therapy. A method for antimicrobial drug use evaluation. J Antimicrob Chemother 1992; 30(5): 724-7.
[http://dx.doi.org/10.1093/jac/30.5.724 PMID: 1493990.]
[10]
Humphreys M. The influenza of 1918: Evolutionary perspectives in a historical context. Evol Med Public Health 2018; 2018(1): 219-9.
[http://dx.doi.org/10.1093/emph/eoy024.]
[11]
Farida Y, Trisna A, Deasy NW. Study of antibiotic use on pneumonia patient in Surakarta referral hospital. Journal of Pharmaceutical Science and Clinical Research 2017; 2: 44-52.
[http://dx.doi.org/10.20961/jpscr.v2i01.5240]
[12]
Pahriyani A, Khotimah N, Bakar L. Evaluasi Penggunaan Antibiotik Pada Pasien Community Acquired Pneumonia (CAP) di RSUD Budi Asih Jakarta Timur. Farmasains 2015; 2(6): 259-63.
[13]
Mudatsir M, Maimunah M, Fathoni E. Pola Kuman Penyebab Infeksi Paru Non Tuberkulosis Dan Kepekaannya Terhadap Beberapa Antibiotika di RSUD Dr. Zainoel Abidin Banda Aceh. Jurnal Kedokteran Syiah Kuala 2012; 12(3): 149-56.
[14]
Feng DY, Zhou YQ, Zou XL, et al. Factors influencing mortality in hospital-acquired pneumonia caused by Gram-negative bacteria in China. J Infect Public Health 2019.
[http://dx.doi.org/10.1016/j.jiph.2019.02.014. ]
[15]
Narula S, Sharma P, Kumar N, Kumar N, Kumar M. An upsurge of gram negative bacteria in community acquired pneumonia: an alarming trend. J Emerg Med Forecast 2018; 1(1): 1007.
[16]
Rhodes NJ, Cruce CE, O’Donnell JN, Wunderink RG, Hauser AR. Resistance trends and treatment options in Gram-negative ventilator-associated pneumonia. Curr Infect Dis Rep 2018; 20(2): 3.
[http://dx.doi.org/10.1007/s11908-018-0609-x] [PMID: 29511909]
[17]
Watkins RR, Van Duin D. Current trends in the treatment of pneumonia due to multidrug-resistant Gram-negative Bacteria version 2 F1000. Res 2019; 121
[http://dx.doi.org/10.12688/f1000research.16517.2.]
[18]
Indonesian Ministry of Health (IMOH). Pedoman Umum Penggunaan Antibiotik. Jakarta, Indonesia. 2011.Available from: http://www.binfar.depkes.go.id/dat/Permenkes_Antibiotik.pdf


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Article Details

VOLUME: 16
ISSUE: 1
Year: 2020
Published on: 14 September, 2020
Page: [21 - 27]
Pages: 7
DOI: 10.2174/1573398X16666200217122825

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