Ronald Irwanto Natadidjaja, Widyawati Lekok, Triyoko Septio Marja, Hadianti Adlani, Aziza Ariyani, Sri Mulyani, Siti Rahmah, Raymond Adianto, Yenny Yenny, Meutia Atika Faradilla, Jihan Samira
Appropriateness of initial intravenous empirical antibiotic consumption in type I and II risk stratification guided by e-RASPRO tool was correlated with increased consumption of Penicillin as an Access group antibiotic and decreased consumption of third-generation Cephalosporins as a Watch group antibiotic. This study did not describe a causal relationship between the use of the e-RASPRO tool and antibiotic consumption in the hospital.
BACKGROUND: RASPRO Indonesia Study Group for Antimicrobial Stewardship & Resistance has developed a digital antimicrobial stewardship (ASP) tool known as the e-RASPRO, which may provide a guideline for clinical decision on antibiotic prescribing for bacterial infection cases by integrating the WHO AWaRe (Access, Watch, Reserve) classification.
METHODS: A multicenter retrospective correlational study was conducted using aggregated monthly hospital antibiotic prescribing data. A correlation test was conducted between the mean percentage on the appropriateness of initial intravenous empirical antibiotic consumption and the mean Defined Daily Dose (DDD) of antibiotics within a year (January to December 2024) in 10 Indonesian hospitals after the socialization of e-RASPRO tool between 2022 and 2024 in four major infections.
RESULTS: There was a significant positive correlation between the mean of percentages on appropriateness of initial intravenous empirical antibiotic consumption in type I risk stratification guided by e-RASPRO tool and the mean DDD/100 patient-days of intravenous Penicillin as Access group antibiotic (r = 0.598, 95% CI 0.021-0.873; p = 0.041) and a significant negative correlation with the mean DDD/100 patient-days of intravenous third-generation Cephalosporins as Watch group antibiotic (r = -0.612, 95% CI -0.878 to -0.044; p = 0.035) after removed linear temporal trends.
CONCLUSION: Appropriateness of initial intravenous empirical antibiotic consumption in type I and II risk stratification guided by e-RASPRO tool was correlated with increased consumption of Penicillin as an Access group antibiotic and decreased consumption of third-generation Cephalosporins as a Watch group antibiotic. This study did not describe a causal relationship between the use of the e-RASPRO tool and antibiotic consumption in the hospital.