Quantity and quality of antibiotic use in surgical and medical wards in a general academic hospital: A retrospective study

Treatment of infectious diseases uses antibiotics to kill or inhibit the growth of pathogenic bacteria. Inappropriate antibiotic use triggers resistance, which in turn affects patient clinical outcomes, length of hospital stays, and treatment costs. This study aimed to analyze trends in the quantity and quality of antibiotics used in surgical and medical wards. This study was conducted at the Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This retrospective observational study analyzed trends in the quantity and quality of antibiotics in surgical and medical wards by collecting medical records of patients from January to May 2019. Quantity analysis was performed using DDD per 100 patient-days or DDD per 100 bed-days (DDD/100-BD), and quality analysis was performed using the Gyssens category method. The antibiotics most consumed in the surgical wards were ceftriaxone (41.67 DDD/100-BD), levofloxacin (22.82 DDD/100-BD), and cefazoline (17.75 DDD/100-BD). The most consumed in medical wards were ceftriaxone (106.22 DDD/100-BD), levofloxacin (34.95 DDD/100-BD), and metronidazole (26.25 DDD/100-BD). The quality of antibiotics used in surgical wards showed 53.2% appropriate use, 16.9% without indication, and 13.9% inappropriate choice, while in medical wards, they were 66.5%, 29.7%, and 2.1%, respectively. Third-generation cephalosporins and fluoroquinolones were the most consumed antibiotics in surgical and medical wards. The quality of antibiotic use was appropriate, with 53.2-66.5% of antibiotic use appropriate. Establishing an antimicrobial stewardship program would help control antibiotic consumption and optimize antibiotic use in hospitals.