Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic

Abstract Objective: Increased antibiotic use (AU) has been reported globally during the COVID-19 pandemic despite low rates of bacterial co-infection. We assessed changes in AU during the COVID-19 pandemic in Indonesia and the Philippines. Methods: We evaluated hospital-wide AU over 36 months in...

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Main Authors: Amara Z. Fazal, Olivia L. McGovern, Garrett W. Mahon, Fernanda C. Lessa, Maria Tarcela Gler, Jemelyn Garcia, Mark John Festin, Kuntaman Kuntaman, Ida Parwati, Cherry Siregar, Jay Christian D. Muere, Gina De Guzman Betito, Maya Montemayor, Arleen De Leon, Emmeline Borillo, Mark Ramon Victor Llanes, Regina Berba, Musofa Rusli, Mariyatul Qibtiyah, Bambang Pujo Semedi, Rosantia Sarassari, Leonardus Widyatmoko, Basti Andriyoko, Adhi Kristianto Sugianli MD, Dewi Kartika Turbawaty, Ivo Dhanitri Ranita, Franciscus Ginting, Rahmadania Marita Joesoef, Made Ananda Krisna, Twisha S. Patel
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Antimicrobial Stewardship & Healthcare Epidemiology
Online Access:https://www.cambridge.org/core/product/identifier/S2732494X25000488/type/journal_article
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author Amara Z. Fazal
Olivia L. McGovern
Garrett W. Mahon
Fernanda C. Lessa
Maria Tarcela Gler
Jemelyn Garcia
Mark John Festin
Kuntaman Kuntaman
Ida Parwati
Cherry Siregar
Jay Christian D. Muere
Gina De Guzman Betito
Maya Montemayor
Arleen De Leon
Emmeline Borillo
Mark Ramon Victor Llanes
Regina Berba
Musofa Rusli
Mariyatul Qibtiyah
Bambang Pujo Semedi
Rosantia Sarassari
Leonardus Widyatmoko
Basti Andriyoko
Adhi Kristianto Sugianli MD
Dewi Kartika Turbawaty
Ivo Dhanitri Ranita
Franciscus Ginting
Rahmadania Marita Joesoef
Made Ananda Krisna
Twisha S. Patel
author_facet Amara Z. Fazal
Olivia L. McGovern
Garrett W. Mahon
Fernanda C. Lessa
Maria Tarcela Gler
Jemelyn Garcia
Mark John Festin
Kuntaman Kuntaman
Ida Parwati
Cherry Siregar
Jay Christian D. Muere
Gina De Guzman Betito
Maya Montemayor
Arleen De Leon
Emmeline Borillo
Mark Ramon Victor Llanes
Regina Berba
Musofa Rusli
Mariyatul Qibtiyah
Bambang Pujo Semedi
Rosantia Sarassari
Leonardus Widyatmoko
Basti Andriyoko
Adhi Kristianto Sugianli MD
Dewi Kartika Turbawaty
Ivo Dhanitri Ranita
Franciscus Ginting
Rahmadania Marita Joesoef
Made Ananda Krisna
Twisha S. Patel
author_sort Amara Z. Fazal
collection DOAJ
description Abstract Objective: Increased antibiotic use (AU) has been reported globally during the COVID-19 pandemic despite low rates of bacterial co-infection. We assessed changes in AU during the COVID-19 pandemic in Indonesia and the Philippines. Methods: We evaluated hospital-wide AU over 36 months in six hospitals, 3 in Indonesia and 3 in the Philippines. Intravenous antibiotics commonly used for respiratory conditions were selected and grouped for analysis. AU rates were calculated as monthly defined daily dose per 1000 patient-days or patient discharges. Median AU rates were compared from the pre-pandemic (March 2018–February 2020) and pandemic periods (March 2020–February 2021) using quantile regression to assess for statistical significance. Changes in AU during the COVID-19 pandemic were analyzed using interrupted time series analysis. Results: Significant increases were noted in the median AU rate from the pre-pandemic to pandemic period of all antibiotics combined in 3/6 hospitals (percentage change, Δ, 12.5%–63.6%) and anti-pseudomonal antibiotics in 3/6 hospitals (Δ 51.5%–161.5%). In the interrupted time series analysis, an immediate increase (range: 125.40–1762) in the use of all included antibiotics combined was observed in 3/6 hospitals at the onset of the COVID-19 pandemic. One of these 3 hospitals experienced a statistically significant sustained increase, while another experienced a decrease over time. Conclusions: We observed significant increases in facility-wide inpatient AU during the COVID-19 pandemic in our participating hospitals in Indonesia and the Philippines. These findings reinforce the importance of antibiotic stewardship practices to optimize AU, especially during infectious disease pandemics.
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spelling doaj-art-0eae30be7fb34a3ebebf5b368dd4a6912025-08-20T03:30:20ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.48Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemicAmara Z. Fazal0https://orcid.org/0000-0003-2582-2142Olivia L. McGovern1Garrett W. Mahon2Fernanda C. Lessa3Maria Tarcela Gler4Jemelyn Garcia5Mark John Festin6Kuntaman Kuntaman7Ida Parwati8Cherry Siregar9Jay Christian D. Muere10Gina De Guzman Betito11https://orcid.org/0000-0002-3440-1588Maya Montemayor12Arleen De Leon13Emmeline Borillo14Mark Ramon Victor Llanes15Regina Berba16Musofa Rusli17Mariyatul Qibtiyah18Bambang Pujo Semedi19Rosantia Sarassari20Leonardus Widyatmoko21Basti Andriyoko22https://orcid.org/0000-0001-9498-1791Adhi Kristianto Sugianli MD23https://orcid.org/0000-0002-2898-6719Dewi Kartika Turbawaty24Ivo Dhanitri Ranita25Franciscus Ginting26Rahmadania Marita Joesoef27https://orcid.org/0009-0006-5193-9669Made Ananda Krisna28https://orcid.org/0000-0002-7681-7135Twisha S. Patel29Centers for Disease Control and Prevention, Atlanta, GA, USACenters for Disease Control and Prevention, Atlanta, GA, USACenters for Disease Control and Prevention, Atlanta, GA, USACenters for Disease Control and Prevention, Atlanta, GA, USAMakati Medical Center, Manila, PhilippinesAsian Hospital and Medical Center, Manila, PhilippinesPhilippine General Hospital, University of the Philippines, Manila, PhilippinesDepartment of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia Faculty of Medicine, Airlangga University, Surabaya, IndonesiaDepartment of Clinical Pathology, Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaAdam Malik Hospital, Medan, IndonesiaMakati Medical Center, Manila, PhilippinesMakati Medical Center, Manila, PhilippinesAsian Hospital and Medical Center, Manila, PhilippinesAsian Hospital and Medical Center, Manila, PhilippinesPhilippine General Hospital, University of the Philippines, Manila, PhilippinesPhilippine General Hospital, University of the Philippines, Manila, PhilippinesPhilippine General Hospital, University of the Philippines, Manila, PhilippinesDepartment of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaDepartment of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaDepartment of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia Faculty of Medicine, Airlangga University, Surabaya, IndonesiaDepartment of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaDepartment of Clinical Pathology, Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaDepartment of Clinical Pathology, Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaDepartment of Clinical Pathology, Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaDepartment of Clinical Pathology, Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaAdam Malik Hospital, Medan, IndonesiaAdam Malik Hospital, Medan, IndonesiaEjikman Institute for Molecular Biology, Jakarta, IndonesiaEjikman Institute for Molecular Biology, Jakarta, Indonesia Biology Department and Nuffield Department of Clinical Medicine, University of Oxford, Oxford, EnglandCenters for Disease Control and Prevention, Atlanta, GA, USA Abstract Objective: Increased antibiotic use (AU) has been reported globally during the COVID-19 pandemic despite low rates of bacterial co-infection. We assessed changes in AU during the COVID-19 pandemic in Indonesia and the Philippines. Methods: We evaluated hospital-wide AU over 36 months in six hospitals, 3 in Indonesia and 3 in the Philippines. Intravenous antibiotics commonly used for respiratory conditions were selected and grouped for analysis. AU rates were calculated as monthly defined daily dose per 1000 patient-days or patient discharges. Median AU rates were compared from the pre-pandemic (March 2018–February 2020) and pandemic periods (March 2020–February 2021) using quantile regression to assess for statistical significance. Changes in AU during the COVID-19 pandemic were analyzed using interrupted time series analysis. Results: Significant increases were noted in the median AU rate from the pre-pandemic to pandemic period of all antibiotics combined in 3/6 hospitals (percentage change, Δ, 12.5%–63.6%) and anti-pseudomonal antibiotics in 3/6 hospitals (Δ 51.5%–161.5%). In the interrupted time series analysis, an immediate increase (range: 125.40–1762) in the use of all included antibiotics combined was observed in 3/6 hospitals at the onset of the COVID-19 pandemic. One of these 3 hospitals experienced a statistically significant sustained increase, while another experienced a decrease over time. Conclusions: We observed significant increases in facility-wide inpatient AU during the COVID-19 pandemic in our participating hospitals in Indonesia and the Philippines. These findings reinforce the importance of antibiotic stewardship practices to optimize AU, especially during infectious disease pandemics. https://www.cambridge.org/core/product/identifier/S2732494X25000488/type/journal_article
spellingShingle Amara Z. Fazal
Olivia L. McGovern
Garrett W. Mahon
Fernanda C. Lessa
Maria Tarcela Gler
Jemelyn Garcia
Mark John Festin
Kuntaman Kuntaman
Ida Parwati
Cherry Siregar
Jay Christian D. Muere
Gina De Guzman Betito
Maya Montemayor
Arleen De Leon
Emmeline Borillo
Mark Ramon Victor Llanes
Regina Berba
Musofa Rusli
Mariyatul Qibtiyah
Bambang Pujo Semedi
Rosantia Sarassari
Leonardus Widyatmoko
Basti Andriyoko
Adhi Kristianto Sugianli MD
Dewi Kartika Turbawaty
Ivo Dhanitri Ranita
Franciscus Ginting
Rahmadania Marita Joesoef
Made Ananda Krisna
Twisha S. Patel
Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
Antimicrobial Stewardship & Healthcare Epidemiology
title Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
title_full Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
title_fullStr Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
title_full_unstemmed Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
title_short Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
title_sort trends in inpatient antibiotic use in indonesia and the philippines during the covid 19 pandemic
url https://www.cambridge.org/core/product/identifier/S2732494X25000488/type/journal_article
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