Impact of an antimicrobial resistance control program: pre- and post-training antibiotic use in children with typhoid fever
Journal Title: Paediatrica Indonesiana - Year 2016, Vol 56, Issue 4
Abstract
Inappropriate use of antibiotics may lead to antimicrobial resistance. In 2012, Dr. Soetomo Hospital conducted training for pediatric residents on the proper use of antibiotics to limit antimicrobial resistance.Objective To evaluate the impact of a rational, antibiotic-use training program for pediatric residents on their antibiotic prescriptions for patients with typhoid fever.Methods A cross-sectional, analytic study was conducted. We collected data from children with typhoid fever who were hospitalized in Dr. Soetomo Hospital, pre- and post-training on antibiotic prescriptions. Children with other known bacterial infections or who were discharged on request were excluded. Antibiotic prescriptions were evaluated using Gyssens algorithm based on the local protocol. Chi-square test was used to compare the quality of antibiotic prescriptions, before (year 2012) and after (year 2013) the training.Results Forty-nine patients with 67 prescriptions in 2012 and 34 patients with 48 prescriptions in 2013 fulfilled the inclusion criteria. Patients’ ages ranged from 1-18 years. Diagnoses of uncomplicated and complicated typhoid were found in 74% and 26% of subjects, respectively. First line (chloramphenicol, thiamphenicol, ampicillin, trimetroprim and sulfametoxazol) and second line (ceftriaxone and cefixime) use were 72% and 28%, respectively. All patients were discharged in good condition. Appropriate use of antibiotics was noted in 61% of subjects in 2012 and in 81% of subjects in 2013 (P=0.036). The most common type of error in 2012 and 2013 was dosage imprecision (25% and 17%, respectively).Conclusion Training on appropriate use of antibiotics significantly improved the quality of antibiotics prescribed in children with typhoid fever in Dr. Soetomo Hospital.
Authors and Affiliations
Elfrida Rachmah, Maftuchah Rochmanti, Dwiyanti Puspitasari
Keywords
Related Articles
- EP ID EP446135
- DOI 10.14238/pi56.4.2016.205-10
- Views 42
- Downloads 0
Hypertension, high-dose corticosteroids, and renal infiltration in children with acute lymphoblastic leukemia
Background Hypertension is a rarely recognized complication of acute lymphoblastic leukemia (ALL). The incidence of hypertension in ALL patients in Indonesia remains unknown, but the most common risk factors are corticos...
Caesarean delivery and risk of developing atopic diseases in children
Background Caesarean delivery has been suggested to alterneonatal immune respon ses and increase the risk of atopicdiseases. Howevei; previous studies have reported inconsistentfindings.Objective To investigate a possibl...
Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact
Background Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.Objective To determ...
Behavioral problems in children with epilepsy
Background Epilepsy is a neurological disorder that most oftenaffects children. Most cases of epilepsy are found in developingcountries. Children with epilepsy are at risk of behavioral disordersthat can affect their qua...
Soluble transferrin receptor as an indicator of iron deficiency and febrile seizures
Background Iron deficiency (ID) has a high incidence inIndonesia, and is a risk factor for febrile seizures. The most suitableassay to detect iron deficiency in the presence of inflammationhas not yet been defined. An in...