The Importance of Antibiotic Stewardship

Oct 13, 2025 by wbrum.org 109 views

The Prevalence of Antibiotic Resistance in Non-Surgical Adult Sepsis Patients Who Were Hospitalized at H. Adam Malik Hospital in 2015

Introduction

Sepsis is a life-threatening condition that occurs when the body's response to an infection becomes uncontrolled and causes widespread inflammation. It is a major public health concern worldwide, with high rates of morbidity and mortality. The treatment of sepsis has evolved over the years, with antibiotics being the mainstay of therapy. However, the emergence of antibiotic resistance has become a significant threat to global health, making it challenging to treat sepsis effectively. This article aims to discuss the prevalence of antibiotic resistance in non-surgical adult sepsis patients who were hospitalized at H. Adam Malik Hospital in 2015.

Background

Sepsis is a clinical syndrome caused by infection accompanied by a systemic inflammatory response, known as the Systemic Inflammatory Response Syndrome (SIRS). This condition has the potential to result in high levels of morbidity and mortality, so that it requires fast and appropriate treatment, such as an emergency. In medical practice, sepsis treatment still varies, although antibiotics have been considered as the main solution in overcoming inflammation for more than 60 years, as long as its use is done wisely and on time.

However, in recent years, the phenomenon of antibiotic resistance develops rapidly, has become a serious threat to global health. This causes various treatment choices that exist today to be ineffective. For more than three decades, there is no significant new antibiotic development, so we have the potential to enter the post-antibiotic era, where infection is difficult to treat because bacteria have developed resistance to existing drugs.

The Importance of Antibiotic Stewardship

Antibiotic stewardship is crucial in preventing the spread of antibiotic resistance. It involves the judicious use of antibiotics, ensuring that they are used only when necessary and for the shortest duration possible. This approach can help reduce the selection pressure for resistant bacteria, thereby preserving the effectiveness of antibiotics.

Research Purposes

This study aims to systematically review the prevalence of antibiotic resistance in adult sepsis patients treated in non-surgical units, in order to understand the extent to which this problem has an impact on the treatment of sepsis in Indonesia.

Research Methods

The method used in this study is descriptive with a retrospective approach. The study was conducted in September 2016 at the Central General Hospital (RSUP) H. Adam Malik Medan. Data is collected through a review of patient medical records and reports from the microbiology laboratory. The sample was taken using the total sampling technique, so that all relevant data can be analyzed thoroughly. The data results are then processed and presented in table form to facilitate understanding.

Research Result

Of the total 90 types of antibiotics tested for sensitivity, only 14 antibiotics show resistance rates below 30%. This finding shows that although there are still some effective antibiotic choices, high resistance prevalence indicates the need for serious attention from medical personnel and policy makers.

Conclusion

In the context of the development of treatment in Indonesia today, where the treatment guidelines refer to the national formulary for the use of empirical antibiotics, this situation is at risk of threatening the effectiveness of therapy given to patients. Therefore, it is important to continue to monitor and evaluate the prevalence of antibiotic resistance in order to take appropriate preventive steps. Collaborative efforts in research and development of new antibiotics and education about the use of wise antibiotics are needed to face this challenge.

Implications for Practice

The findings of this study have significant implications for practice. Firstly, it highlights the need for antibiotic stewardship in the treatment of sepsis. Secondly, it emphasizes the importance of monitoring and evaluating the prevalence of antibiotic resistance to inform treatment guidelines. Finally, it underscores the need for collaborative efforts in research and development of new antibiotics and education about the use of wise antibiotics.

Future Directions

The study's findings also suggest several future directions for research. Firstly, it would be beneficial to conduct a prospective study to investigate the impact of antibiotic stewardship on the prevalence of antibiotic resistance. Secondly, it would be interesting to explore the use of alternative treatments for sepsis, such as immunotherapy or antimicrobial peptides. Finally, it would be valuable to investigate the economic impact of antibiotic resistance on healthcare systems.

Limitations

This study has several limitations. Firstly, the study was conducted in a single hospital, which may limit the generalizability of the findings. Secondly, the study relied on retrospective data, which may be subject to biases. Finally, the study did not investigate the impact of antibiotic stewardship on patient outcomes.

Conclusion

In conclusion, the prevalence of antibiotic resistance in non-surgical adult sepsis patients who were hospitalized at H. Adam Malik Hospital in 2015 is a significant concern. The study's findings highlight the need for antibiotic stewardship, monitoring and evaluation of antibiotic resistance, and collaborative efforts in research and development of new antibiotics. The study's limitations suggest several future directions for research, including prospective studies, alternative treatments, and economic impact.
Frequently Asked Questions (FAQs) About Antibiotic Resistance in Sepsis

Q: What is antibiotic resistance?

A: Antibiotic resistance is a phenomenon where bacteria develop resistance to antibiotics, making them ineffective in treating infections. This can lead to the spread of resistant bacteria, making infections harder to treat.

Q: What is sepsis?

A: Sepsis is a life-threatening condition that occurs when the body's response to an infection becomes uncontrolled and causes widespread inflammation. It can lead to organ failure and death if not treated promptly and effectively.

Q: How does antibiotic resistance affect sepsis treatment?

A: Antibiotic resistance can make it challenging to treat sepsis effectively. When bacteria develop resistance to antibiotics, it can lead to the use of more aggressive and toxic treatments, which can have serious side effects.

Q: What are the consequences of antibiotic resistance in sepsis?

A: The consequences of antibiotic resistance in sepsis can be severe, including:

Increased mortality rates
Longer hospital stays
Higher healthcare costs
Spread of resistant bacteria to other patients and communities

Q: How can antibiotic resistance be prevented?

A: Antibiotic resistance can be prevented by:

Using antibiotics judiciously and only when necessary
Completing the full course of antibiotics as prescribed
Avoiding the use of antibiotics for viral infections
Promoting hand hygiene and infection control practices
Supporting research and development of new antibiotics

Q: What are some alternative treatments for sepsis?

A: Alternative treatments for sepsis include:

Immunotherapy: using the body's immune system to fight infections
Antimicrobial peptides: using natural peptides to kill bacteria
Probiotics: using beneficial bacteria to prevent infections
Antiviral and antifungal medications: using medications to treat viral and fungal infections

Q: How can healthcare providers prevent antibiotic resistance in sepsis?

A: Healthcare providers can prevent antibiotic resistance in sepsis by:

Following antibiotic stewardship guidelines
Monitoring and evaluating antibiotic resistance patterns
Using antibiotics judiciously and only when necessary
Promoting hand hygiene and infection control practices
Supporting research and development of new antibiotics

Q: What role can patients play in preventing antibiotic resistance in sepsis?

A: Patients can play a crucial role in preventing antibiotic resistance in sepsis by:

Asking their healthcare provider about the need for antibiotics
Completing the full course of antibiotics as prescribed
Avoiding the use of antibiotics for viral infections
Promoting hand hygiene and infection control practices
Supporting research and development of new antibiotics

Q: What is the future of antibiotic development?

A: The future of antibiotic development is promising, with several new antibiotics in the pipeline. However, it is essential to continue supporting research and development of new antibiotics to stay ahead of the evolving threat of antibiotic resistance.

Q: What can be done to address the global threat of antibiotic resistance?

A: To address the global threat of antibiotic resistance, it is essential to:

Increase funding for antibiotic research and development
Promote antibiotic stewardship and responsible use of antibiotics
Support global efforts to monitor and evaluate antibiotic resistance patterns
Develop and implement effective policies to prevent antibiotic resistance
Educate healthcare providers, patients, and the public about the importance of antibiotic stewardship and responsible use of antibiotics.