Survey of antibiotic use of individuals visiting public healthcare facilities in Indonesia.
OBJECTIVE
To estimate the antibiotic use of individuals visiting public healthcare facilities in Indonesia and to identify determinants of use against a background of high resistance rates.


METHODS
Patients on admission to hospital (group A), visiting a primary health center (group B), and healthy relatives (group C) were included in the study. A questionnaire on demographic, socioeconomic, and healthcare-related items including health complaints and consumption of antibiotics was used. Logistic regression was performed to determine the co-variables of antibiotic use.


RESULTS
Of 2996 individuals interviewed, 486 (16%) had taken an antibiotic. Compared to group C (7% consumption), groups B and A exhibited a three-fold and four-fold higher use of antibiotics, respectively. Respiratory (80%) and gastrointestinal (13%) symptoms were most frequent. Aminopenicillins and tetracyclines accounted for 80% of the prescribed antibiotics. Similar antibiotics were self-medicated (17% of users). Age less than 18 years and health insurance were independent determinants of antibiotic use. Urban provenance, being adult, male, and having no health insurance were independent determinants of self-medication.


CONCLUSIONS
In addition to health complaints, other factors determined antibiotic consumption. In view of the likely viral origin of respiratory complaints and the resistance of intestinal pathogens, most antibiotic use was probably unnecessary or ineffective. Future interventions should be directed towards healthcare providers.
Hadi
Usman
U
Department of Internal Medicine, Dr. Soetomo Hospital - School of Medicine, Airlangga University, Jl. Manyar Tirtomoyo II/21, Surabaya 60118, Indonesia. i.gyssens@aig.umcn.nl
Duerink
D Offra
DO
Lestari
Endang Sri
ES
Nagelkerke
Nico J
NJ
Werter
Susanne
S
Keuter
Monique
M
Suwandojo
Eddy
E
Rahardjo
Eddy
E
van den Broek
Peterhans
P
Gyssens
Inge C
IC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy; D019538:Health Care Surveys; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D007214:Indonesia; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011640:Public Policy; D012141:Respiratory Tract Infections / Q000188:drug therapy; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D019037:Urban Health Services; D055815:Young Adult
D000900:Anti-Bacterial Agents