title: Three years of antibacterial consumption in Indonesian Community Health Centers: The application of anatomical therapeutic chemical/defined daily doses and drug utilization 90% method to monitor antibacterial use.
abstract: BACKGROUND
  Irrational use of antibacterial drugs in Community Health-Care Centers (CHCs) may lead to increased resistance, morbidity, and mortality.
  
  
  OBJECTIVE
  The aim of this study was to determine patterns of antibacterial use at CHCs in a district of Indonesia and use this as data for an antibiotic policy.
  
  
  METHODS
  The observational-descriptive study was conducted in a district of Indonesia to obtain antibacterial use from 2008 to 2010.
  
  
  METHODS
  The data obtained from the report on the use of medicines were classified and processed using the anatomical therapeutic chemical (ATC) and defined daily doses (DDD) method, with DDD/1000 patients as a unit measurement. The number of patients was obtained from attending patients in that research period. The most abundant antibacterial drugs use segment was identified by the drug utilization 90% (DU90%) method.
  
  
  METHODS
  Descriptive analysis were performed in this study.
  
  
  RESULTS
  Fourteen kinds of antibacterial drugs were used in 61 CHCs. The total of antibacterial drug use during the period 2008-2010 was 871.36 DDD/1000 patients/day. Declining antibacterial use was observed between 2008 and 2010. Six kinds of antibacterial drugs were the most commonly used. The data show that the average use per visit was as high as 24.41 DDD.
  
  
  CONCLUSIONS
  Amoxicillin, sulfamethoxazole and trimethoprim are antibacterials that have to be reconsidered by physicians for use in the Bandung CHC. The high use of antibacterial drugs, as described in the study, can be used as reference to develop an antimicrobial stewardship program and increase awareness of resistance, adverse drug reaction and drug interaction of antibacterial drugs.
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Ivan S
authors.initials: IS
authors.lastname: Pradipta
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Elis
authors.initials: E
authors.lastname: Ronasih
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Arrum D
authors.initials: AD
authors.lastname: Kartikawati
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Hartanto
authors.initials: H
authors.lastname: Hartanto
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Rizki
authors.initials: R
authors.lastname: Amelia
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Ellin
authors.initials: E
authors.lastname: Febrina
authors.affiliation: Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Rizky
authors.initials: R
authors.lastname: Abdulah
keywords: Anatomical therapeutic chemical; Indonesian Community Health-Care Center; antibiotic; defined daily doses; drug utilization 90%; pharmacoepidemiology