Implement antimicrobial stewardship programs

Oct 13, 2025 by wbrum.org 11 views

The Alarming Rise of Antimicrobial Resistance: A Study on the Relationship between Antibiotic Use and Resistance Rates at H Adam Malik Hospital Medan

Introduction

The world is facing a growing health crisis, with antimicrobial resistance (AMR) emerging as a major concern. In Indonesia, the problem is exacerbated by the high use of unwise antibiotics, leading to pathogens becoming resistant. This study aims to investigate the relationship between the level of use of antibiotics and antimicrobial resistance rates at H Adam Malik Hospital Medan during the period 2021 to 2022.

Background

Antimicrobial resistance is a global health issue that affects the quality of health services. In Indonesia, the problem is further complicated by the high use of unwise antibiotics, which causes pathogens to become resistant. The World Health Organization (WHO) has identified AMR as one of the top 10 global health threats, emphasizing the need for urgent action to address this issue.

Methodology

This study uses a retrospective analytic design with the total sampling method, analyzing secondary data from medical records. The analyzed data includes DDD (Daily Defined Dose) Antibiotics such as Ceftriaxone, Ceftaxime, Ceftazidime, and Meropenem and Bacterial Resistance Numbers * Escherichia coli * and * Klebsiella pneumoniae * against the third generation of tickles, Enem- Resistant Acinetobacter Baumannii), and CRPA (Carbapenem-Resistant Pseudomonas aeruginosa).

Research Result

The results of the analysis showed a significant relationship between the use of cefotaxime and the level of resistance e. coli * (p = 0.048) and * k. pneumoniae (p = 0.048). In addition, the use of ceftazidime has a significant relationship with resistance k. pneumoniae * (p = 0.032), while the use of meropenem shows a significant relationship to CR * resistance e. coli (p = 0.047). However, the use of Ceftriaxone shows an insignificant result of the resistance of the two types of bacteria (p = 0.909 for *e. Coli *and p = 0.361 for *k. Pneumoniae *).

Additional Analysis and Explanation

This study shows that the use of high antibiotics, especially cefotaxime and ceftazidime, is related to an increase in resistance rates in certain pathogens. This is in line with global findings that indicate that the use of inappropriate antibiotics can encourage the development of resistance. Cefotaxime, which is proven to have a significant relationship with resistance e. coli * and * k. Pneumoniae, may indicate that the bacterium adapts to the antibiotics due to excessive use. This decrease in antibiotic effectiveness can result in an increase in cases of infection that is more difficult to handle, thus demanding more serious intervention in the practice of using antibiotics.

The Importance of Wise Antibiotic Use

The importance of awareness of the use of wise antibiotics must also be emphasized among medical personnel and the general public. Development of policies that support the use of rational antibiotics and education about the dangers of antimicrobial resistance is a step that must be taken to overcome this problem. The use of antibiotics should be based on the principles of antimicrobial stewardship, which includes the judicious use of antibiotics, monitoring of antibiotic use, and education of healthcare providers and patients.

Conclusion

From the results of this study, it can be concluded that there is a significant relationship between the use of cefotaxime and the level of resistance e. coli * and * k. pneumoniae. In addition, the use of ceftazidime also has an influence on resistance *k. Pneumoniae *, and Meropenem associated with CR resistance e. coli. Efforts to control the use of antibiotics and raise awareness about antimicrobial resistance need to be strengthened to improve the quality of health services at H Adam Malik Hospital Medan and throughout the world.

Recommendations

Based on the findings of this study, the following recommendations are made:

Implement antimicrobial stewardship programs: Hospitals and healthcare facilities should implement antimicrobial stewardship programs to promote the judicious use of antibiotics.
Monitor antibiotic use: Regular monitoring of antibiotic use should be conducted to identify areas for improvement.
Educate healthcare providers and patients: Education about the dangers of antimicrobial resistance and the importance of wise antibiotic use should be provided to healthcare providers and patients.
Develop policies: Policies that support the use of rational antibiotics should be developed and implemented.
Conduct further research: Further research should be conducted to investigate the relationship between antibiotic use and antimicrobial resistance in different settings.

Limitations

This study has several limitations, including:

Retrospective design: The study used a retrospective design, which may limit the generalizability of the findings.
Limited data: The study analyzed secondary data from medical records, which may not be comprehensive.
Limited sample size: The study had a limited sample size, which may affect the reliability of the findings.

Future Directions

Future studies should aim to investigate the relationship between antibiotic use and antimicrobial resistance in different settings, including community and hospital settings. Additionally, studies should aim to identify the factors that contribute to antimicrobial resistance and develop effective strategies to prevent and control antimicrobial resistance.
Frequently Asked Questions (FAQs) about Antimicrobial Resistance and Antibiotic Use

Q: What is antimicrobial resistance?

A: Antimicrobial resistance (AMR) is the ability of microorganisms, such as bacteria, viruses, and fungi, to resist the effects of antimicrobial agents, such as antibiotics, antivirals, and antifungals. This means that the microorganisms are no longer killed or inhibited by the antimicrobial agents, making infections harder to treat.

Q: What causes antimicrobial resistance?

A: Antimicrobial resistance is caused by the misuse and overuse of antimicrobial agents, such as antibiotics. When antimicrobial agents are used excessively or inappropriately, they can select for resistant microorganisms, which can then spread to others.

Q: What are the consequences of antimicrobial resistance?

A: The consequences of antimicrobial resistance are severe and far-reaching. They include:

Increased morbidity and mortality from infections that are harder to treat
Increased healthcare costs due to longer hospital stays and more intensive treatments
Decreased quality of life for patients with resistant infections
Economic burden on healthcare systems and economies
Potential loss of effective treatments for life-threatening infections

Q: What can be done to prevent antimicrobial resistance?

A: To prevent antimicrobial resistance, the following measures can be taken:

Use antimicrobial agents judiciously and only when necessary
Monitor antimicrobial use and resistance patterns
Implement antimicrobial stewardship programs
Educate healthcare providers and patients about the importance of antimicrobial use
Develop and implement policies to promote responsible antimicrobial use
Conduct research to develop new antimicrobial agents and treatments

Q: What is the role of healthcare providers in preventing antimicrobial resistance?

A: Healthcare providers play a critical role in preventing antimicrobial resistance. They should:

Use antimicrobial agents judiciously and only when necessary
Monitor antimicrobial use and resistance patterns
Implement antimicrobial stewardship programs
Educate patients about the importance of antimicrobial use
Develop and implement policies to promote responsible antimicrobial use

Q: What can patients do to prevent antimicrobial resistance?

A: Patients can play a critical role in preventing antimicrobial resistance by:

Asking their healthcare providers about the need for antimicrobial agents
Following their healthcare provider's instructions for antimicrobial use
Not demanding antibiotics for viral infections or other conditions that do not require antimicrobial treatment
Not sharing antimicrobial agents with others
Not using antimicrobial agents for non-medical purposes

Q: What is the current state of antimicrobial resistance?

A: The current state of antimicrobial resistance is alarming. According to the World Health Organization (WHO), antimicrobial resistance is a major global health threat, and the number of resistant infections is increasing. In the United States, the Centers for Disease Control and Prevention (CDC) reports that antimicrobial resistance is a significant public health concern, and the number of resistant infections is increasing.

Q: What is being done to address antimicrobial resistance?

A: To address antimicrobial resistance, governments, healthcare organizations, and researchers are working together to:

Develop new antimicrobial agents and treatments
Implement antimicrobial stewardship programs
Monitor antimicrobial use and resistance patterns
Educate healthcare providers and patients about the importance of antimicrobial use
Develop and implement policies to promote responsible antimicrobial use

Q: What is the future of antimicrobial resistance?

A: The future of antimicrobial resistance is uncertain, but it is clear that the problem will continue to grow unless action is taken to address it. To prevent antimicrobial resistance, it is essential to use antimicrobial agents judiciously and only when necessary, to monitor antimicrobial use and resistance patterns, and to develop and implement policies to promote responsible antimicrobial use.