Novan Y I Pratama, Primadi Avianto
Faculty of Pharmacy, Universitas Airlangga, Department of Clinical Pharmacy, Kampus C UNAIR, Mulyorejo Rd. Surabaya, Indonesia.
Pharmacy Section, Bangka Tengah District Health Office, Bangka Belitung, Indonesia.
J Basic Clin Physiol Pharmacol. 2020 Jan 11;30(6):/j/jbcpp.2019.30.issue-6/jbcpp-2019-0248/jbcpp-2019-0248.xml. doi: 10.1515/jbcpp-2019-0248.
Background Inappropriate antibiotic therapy is accelerating the development of antimicrobial resistance (AMR). Upper respiratory tract infections (URTIs) are predominantly caused by viruses, resulting in the prescription of antibiotics to a few selected patients. Previous studies in primary health care centers (PHCCs) in Indonesia have shown a high percentage of antibiotic therapy for URTIs. This study tries to analyze the difference in profiles of antibiotic prescription in the treatment of children and adults with URTI in Bangka Tengah, Indonesia. Methods Random prescriptions from patients diagnosed with URTIs (sinusitis, bronchitis, common cold, and pharyngitis) from all PHCCs in Bangka Tengah were collected from January to February 2018. Prescriptions from patients with overlapping diagnoses, such as URTI with diarrhea or typhoid, were excluded. Results During the two months of data collection, 1348 prescriptions for adults and children with URTIs were studied. Children were 1.30 (95% CI, 1.03-1.58) times more likely to be treated with antibiotics compared to adults. Amoxicillin was the most commonly prescribed antibiotic both in children (92.3%) and adults (78.6%). Ciprofloxacin was commonly prescribed in adults (14.6%) but not in children (0.3%). Conclusions This study confirms the major antibiotic overuse in patients with URTI, especially in children. Owing to the fact that children are more likely to get URTI of viral origin, they receive high percentage of antibiotic therapy. These findings support the need for collaborated intervention to decrease unnecessary prescription of antibiotics in Bangka Tengah.
背景 不恰当的抗生素治疗正在加速抗菌药物耐药性（AMR）的发展。上呼吸道感染（URTIs）主要由病毒引起，导致仅对少数特定患者开具抗生素处方。此前在印度尼西亚初级卫生保健中心（PHCCs）进行的研究表明，URTIs患者接受抗生素治疗的比例很高。本研究旨在分析印度尼西亚邦加中部地区儿童和成人URTI患者抗生素处方情况的差异。方法 收集2018年1月至2月邦加中部地区所有PHCCs诊断为URTIs（鼻窦炎、支气管炎、普通感冒和咽炎）患者的随机处方。排除诊断重叠患者的处方，如伴有腹泻或伤寒的URTIs患者。结果 在两个月的数据收集期间，研究了1348例成人和儿童URTIs患者的处方。与成人相比，儿童接受抗生素治疗的可能性高1.30倍（95%置信区间，1.03 - 1.58）。阿莫西林是儿童（92.3%）和成人（78.6%）中最常开具的抗生素。环丙沙星在成人中常用（14.6%），但在儿童中未使用（0.3%）。结论 本研究证实URTIs患者中存在严重的抗生素过度使用现象，尤其是儿童。由于儿童更易患病毒源性URTIs，他们接受抗生素治疗的比例很高。这些发现支持在邦加中部地区开展联合干预以减少不必要抗生素处方的必要性。
