The implementation of antimicrobial stewardship in Indonesia: a regional survey in hospitals
Abstract
Antibiotic resistance is becoming more common worldwide because of irrational antimicrobial use. Antimicrobial resistance occurs practically all over the world, leading the World Health Organization (WHO) to create a “Global Action Plan on Antimicrobial Resistance” in 2015. This study investigates the implementation of the antimicrobial stewardship program’s actions in Indonesia’s hospitals from the perspective of health professionals. This survey describes activities, the role of pharmacists, the impacts and barriers to the antimicrobial stewardship program. Purposive sampling was used to recruit respondents, including doctors, pharmacists, nurses, pharmaceutical technical employees, and laboratory analysts from two referral hospitals in Central Java Province, Indonesia. Activities of the antimicrobial stewardship program in hospitals are to develop policies and guidelines for using hospital antibiotics 81.48%, develop policies on antimicrobial stewardship 74.07%, and disseminate and increase understanding and awareness of antimicrobial stewardship principles 55.56%. The role of the pharmacist in the antimicrobial stewardship program was to make policies and guidelines for using antibiotics and work programs to control resistance 81.50%, information services for patients and their families and other health workers 74.10%, with the therapy committee team to select and procure antibiotics 55.70% and provide patient counseling 51.90%. The effect of the antimicrobial stewardship program improved the quality of handling infectious cases, antibiotic use 55.56%, and germ patterns 40.74%. The obstacles to implementing the antimicrobial management plan are infrastructure 40.74% and finance 37.04%. Antimicrobial stewardship programs have been implemented in Indonesian hospitals, but some obstacles remain.
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