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. 2019 Aug 5;14(8):e0219097.
doi: 10.1371/journal.pone.0219097. eCollection 2019.

Antimicrobial use in an Indonesian community cohort 0-18 months of age

Jarir At Thobari  1   2 , Cahya Dewi Satria  1 , Yohanes Ridora  1 , Emma Watts  3 , Amanda Handley  3   4 , Samad Samad  5 , Novilia S Bachtiar  6 , Julie E Bines  3   7   8 , Yati Soenarto  1 , Jim P Buttery  3   7   9   10   11
Affiliations

Antimicrobial use in an Indonesian community cohort 0-18 months of age

Jarir At Thobari et al. PLoS One. .

Abstract

Background: Antimicrobial resistance has become a global health emergency and is contributed to by inappropriate antibiotic use in community clinical settings. The aim of this study was to evaluate the antimicrobial use pattern in infants from birth until 18 months of age in Indonesia.

Methods: A post-hoc analysis was conducted in 1621 participants from the RV3BB Phase IIb trial conducted in Indonesia from January 2013 through July 2016. Any health events were documented in the trial as adverse events. Concomitant medication surveillance recorded all medications, including antibiotics during the 18 months of follow-up. Information included the frequency, duration of usage, formulation, classes, and their indications, including prophylactic antibiotic and perinatal use.

Results: Of 1621 participants, 551 (33.99%) received at least one antibiotic for treatment of infections during the 18 months observation period. Additionally, during the perinatal period, prophylactic antibiotics were used in 1244 (76.74%) participants and antibiotics consumed in 235 mothers of participants (14.50%). A total of 956 antibiotic consumptions were recorded for 18 months follow up, 67 (7.01%) as part of antimicrobial combinations. The average duration of antibiotic course was 4.92 days. Penicillin and sulfonamides were the most common antibiotic classes consumed (38.81% and 24.48%, respectively).

Conclusions: Despite the low community consumption rate, the overuse of antibiotic in URTIs and non-bloody diarrhea in our setting represents a major opportunity for antimicrobial stewardship, particularly in early life.

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Conflict of interest statement

The authors have the following interests: NSB is a paid employee of PT Biofarma. PT Biofarma is a state-owned company (owned by Indonesia government) that provides all vaccines for Indonesia National Immunization Program. Additionally, PT Biofarma was one of the funders for the RV3-BB Phase IIB trial. The trial was a phase IIB trial and while the RV3-BB rotavirus vaccine is not yet marketed, this vaccine is being developed with the intention for eventual usage in the national immunization program. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow diagram of participants follow-up.
See this image and copyright information in PMC

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