Analysis of antibiotic use in diabetic ulcer patients at a private hospital in Surabaya
Keywords:
diabetic ulcers, prescribed daily dose, days of therapy, antibiotic resistance, therapeutic guide line
Abstract
Diabetic ulcer is one of the complications of diabetes mellitus in the form of chronic wounds due to neuropathy and peripheral arterial disease. Bacteria enter in a wound and cause a skin infection. Appropriate antibiotic therapy is needed to prevent antibiotic resistance. The purpose of this study was to evaluate the quantity profile of antibiotic use using the prescribed daily dose (PDD) and days of therapy (DOT) methods compared with the therapeutic guidelines (PPAB) in diabetic ulcer patients for the period January 2020 - June 2022 at a private hospital in Surabaya, Indonesia. This observational study with the retrospective data collection using medical records was analysed descriptively. The results showed that the total PDD value was 20.44 g/day. The highest antibiotic prescriptions were ceftriaxone (2.39 g/day) and metronidazole (1.46 g/day), respectively. The total days of therapy was 12.13 DOT; the DOT more than 4.00 were metronidazole (4.15 DOT) and ceftriaxone (4.09 DOT). This study reported a high PDD and DOT that will cause antibiotic resistance in the future.
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https://dspace.uii.ac.id/handle/123456789/34408
https://doi.org/10.1016/j.diabres.2017.04.013
2. Kementrian Kesehatan Republik Indonesia. Tetap produktif, cegah dan atasi diabetes mellitus. Jakarta: Pusat Data dan Informasi Kementrian Kesehatan RI, 2020.
3. Sari YO, Almasdy D, Fatimah A. Evaluasi penggunaan antibiotik pada pasien ulkus diabetikum di Instalasi Rawat Inap (IRNA) Penyakit Dalam RSUP Dr. M. Djamil Padang. J Sains Farm Klin 2018; 5(2):102.
https://doi.org/10.25077/jsfk.5.2.102-111.2018
4. Roza RL, Afriant R, Edward Z. Faktor risiko terjadinya ulkus diabetikum pada pasien diabetes mellitus yang dirawat jalan dan inap di RSUP Dr. M. Djamil dan RSI Ibnu Sina Padang. J Kesehat Andalas 2015; 4(1):229.
https://doi.org/10.25077/jka.v4i1.229
5. Pemayun TGD, Naibaho RM, Novitasari D, Amin N, Minuljo TT. Risk factors for lower extremity amputation in patients with diabetic foot ulcers: A hospital-based case-control study. Diabet Foot Ankle 2015; 6:29629.
https://doi.org/10.3402/dfa.v6.29629
6. Darwis I, Hidayat H, Wisnu GNPP, Mentari S. Bacteriological profile and antibiotic susceptibility pattern of diabetic foot infection in a tertiary care hospital in Lampung, Indonesia. Malays J Med Sci 2021; 28(5):42-53.
https://doi.org/10.21315/mjms2021.28.5.4
7. Ramirez-Acuña JM, Cardenas-Cadena SA, Marquez-Salas PA, Garza-Veloz I, Perez-Favila A, Cid-Baez MA, et al. Diabetic foot ulcers: Current advances in antimicrobial therapies and emerging treatments. Antibiotics 2019; 24(4):193.
https://doi.org/10.3390/antibiotics8040193
8. Perkumpulan Endokrinologi Indonesia (PERKENI). Pedoman pengelolaan dan pencegahan diabetes mellitus tipe 2 dewasa di Indonesia, 2021. Jakarta: Perkumpulan Endokrinologi Indonesia (PERKENI), 2021.
9. Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia No. 8 Tahun 2015 tentang Program Pengendalian Resistensi Antimikroba di Rumah Sakit. Jakarta: Hukor Depkes RI, 2015;23–4.
10. Agistia N, Mukhtar H, Nasif H. Efektivitas antibiotik pada pasien ulkus kaki diabetik. J Sains Farm Klin 2017; 4(1):43.
https://doi.org/10.29208/jsfk.2017.4.1.144
11. Lomasky LE, Teson FR. The state of the world. Justice a distance. 2015; 1–30.
https://www.cdc.gov/drugresistance/index.html
12. Senneville É, Albalawi Z, van Asten SA, Abbas ZG, Allison G, Aragon-Sanches J, et al. IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023). Clin Infect Dis 2023; 2:ciad527.
https://doi.org/10.1093/cid/ciad527.
13. Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 28 Tahun 2021 tentang Pedoman Penggunaan Antibiotik. Jakarta: Hukor Depkes RI, 2021.
14. Al-Rubeaan K, Al Derwish M, Ouizi S, Youssef AM, Subhani SN, Ibrahim HM, et al. Diabetic foot complications and their risk factors from a large retrospective cohort study. PLoS One 2015; 10(5):e0124446.
15. Trisnawati SK, Setyorogo S. Faktor risiko kejadian diabetes melitus tipe II di Puskesmas Kecamatan Cengkareng Jakarta Barat tahun 2012. J Ilm Kesehat 2013; 5(1):611.
16. Khalique S. Evaluation of the Effect of inadaptable risk factors & social status on diabetic foot ulcer. Int J ENDORSING Heal Sci Res 2014; 2(2):78-81.
https://doi.org/10.29052/IJEHSR.v2.i2.2014.78-81
17. Chuan F, Zhang M, Yao Y, Tian W, He X, Zhou B. Anemia in patients with diabetic foot ulcer: Prevalence, clinical characteristics, and outcome. Int J Low Extrem Wounds 2016; 15(3):220-6.
https://doi.org/10.1177/1534734616660224
18. Hariftyani AS, Novida H, Edward M. Profile of diabetic foot ulcer patients at tertiary care hospital in Surabaya, Indonesia. J Berkal Epidomol2021; 9(3):293-302.
https://doi.org/10.20473/jbe.V9I32021.293-302
19. Khanbhai M, Loukogeogarkis S, Wright J, Hurel S, Richards T. Anemia, infection, diabetic foot disease: What are the relationship? Diab Foot J 2012; 15(4): 150-8.
20. Mutmainah I. Hubungan kadar gula darah dengan hipertensi pada penderita diabetes melitus tipe 2 di Rumah Sakit Umum Daerah Karanganyar. Surakarta: Fakultas Kedokteran Universitas Muhammadiyah Surakarta, 2013.
21. Umboh MJ, Tooy GC, Bajak CMA, Kasaluhe MD. Faktor- faktor yang berhubungan dengan kejadian ulkus kaki diabetik di Wilayah Kerja Puskesmas Manganitu Sangihe. J Ilm Sesebanua 2022; 6(1):1-7.
https://doi.org/10.54484/jis.v6i1.492
22. Gibbons GW. Diabetic foot sepsis. Semin Vasc Surg. 1992;5(4):244–8.
23. Nugroho J. Perbedaan antara prescribed daily dose dengan who defined daily dose pada peresepan antibiotik untuk pasien rawat jalan di Puskesmas Mantri Jeron, Yogyakarta. 2011. Yogyakarta: Fakultas Kedokteran Universitas Islam Indonesia, 2011.
https://dspace.uii.ac.id/handle/123456789/34408
