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

Jarir At Thobari1,2, Cahya Dewi Satria1, Yohanes Ridora1

  • 1Pediatric Research Office, Department of Pediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia.

Plos One
|August 6, 2019
PubMed

Insights

Antimicrobial resistance is a global crisis. This study in Indonesian infants found significant antibiotic use, especially prophylactic, highlighting a need for better antimicrobial stewardship in early childhood.

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial resistance
  • Pharmacovigilance

Background:

  • Antimicrobial resistance (AMR) is a critical global health threat.
  • Inappropriate antibiotic use in community settings contributes significantly to AMR.
  • Understanding antimicrobial consumption patterns in infants is crucial for public health initiatives.

Purpose of the Study:

  • To investigate the pattern of antimicrobial use in Indonesian infants.
  • To analyze antibiotic consumption from birth up to 18 months of age.
  • To identify opportunities for antimicrobial stewardship in early life.

Main Methods:

  • Post-hoc analysis of data from 1621 participants in the RV3BB Phase IIb trial in Indonesia (2013-2016).
  • Systematic recording of all concomitant medications, including antibiotics, during 18 months of follow-up.
  • Detailed documentation of antibiotic frequency, duration, formulation, classes, and indications (prophylactic and perinatal use).

Main Results:

  • 33.99% of infants received at least one antibiotic for infection treatment.
  • High rates of prophylactic antibiotic use were observed: 76.74% in infants and 14.50% in mothers during the perinatal period.
  • Penicillin and sulfonamides were the most frequently consumed antibiotic classes, with an average course duration of 4.92 days.

Conclusions:

  • Despite potentially low community-acquired infection treatment rates, significant antibiotic use, particularly prophylactic, was noted.
  • Overuse in upper respiratory tract infections (URTIs) and non-bloody diarrhea presents a key area for intervention.
  • Early-life antimicrobial stewardship is essential to combat antimicrobial resistance in this population.
Abstract

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