ANTIBIOTIC RESISTANCE IN HOSPITALS IN INDONESIA: ANTIBIOTIC USE AND ASSOCIATED COSTS

Abstract

Antimicrobial resistance (AMR) reveals a serious, worldwide threat to public health. One of the causes is inappropriate antibiotic (AB) therapy in health services. It leads to patients’ difficulty healing, needs longer times, and other higher lines of antibiotics lead to higher treatment costs. This study aimed to describe the situation of antibiotic resistance (ABR) in hospitals related to antibiotic use and its costs. Research was conducted in 2018. Sample locations were in 10 public hospitals in 10 provinces. Hospitals selected must fulfill the following criteria: having a microbiology laboratory; running AMR Control Program; clinical pharmacy services running well; financial hospital being computerized. Medical and cost data from patients who suffered from pneumonia and septicemia in 2017 were collected retrospectively. Data calculated were the costs of administration, patient’s room, professional visit, diagnostic test, medicines, and other treatments and were analyzed descriptively. Total samples were 3164 cases: 1686 pneumonia and 1478 septicemia. The most used AB in pneumonia and septicemia was cephalosporin, followed by fluoroquinolone. The results of sensitivity tests for pneumonia and septicemia cases were 14.9% and 9.6%, respectively. There were >90% of patients hospitalized for more than 30 days compared to <10% without ABR. Result also shows that costs of pneumonia and septicemia hospitalization were 149.0% and 262.3% higher if the patients were resistant to antibiotics. The sensitivity test results for pneumonia and septicemia showed more resistance than in sensitive cases. This study has demonstrated that antibiotic resistance leads to longer hospital stays and greatly increased hospital costs.