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November 28-29, 2016 Valencia, Spain
4th World Congress on
Infection Prevention and Control
Volume 4, Issue 8 (Suppl) J Infect Dis Ther 2016
ISSN: 2332-0877, JIDT an open access journal Infection Control 2016
November 28-29, 2016
Restricted antimicrobial policy: A positive outcome on Gram-negative bacilli susceptibility pattern from
inpatients wards in Indonesia
Cucunawangsih1, Fonny Cokro 2 and Nata Pratama Hardjo Lugito1
1University of Pelita Harapan, Indonesia
2Siloam Teaching Hospitals, Indonesia
Background: The increased prevalence of MDRO following overutilization of broad spectrum antibiotics has become a global
emergency. At the end of September 2013, a restricted antimicrobial control program (RACP) was released in our institution. In this
study, we evaluated the influence of RACP on susceptibilities of Gram-negative bacilli (GNB) from patients admitted in wards of
Siloam Teaching Hospitals, Tangerang, Indonesia.
Materials &Methods: This retrospective study enrolled 1,866 data of GNB from January 2013 to June 2015. The RACP implemented
uses a front-end approach which requires authorization of RACP team member based on local antibiotic guideline and prior
susceptibility pattern. The team consists of clinician, clinical pharmacist and clinical microbiologist, which functions to restrict the
use of carbapenems, fourth generation cephalosporins and tigecycline. Cumulative susceptibility testing was done using an automated
method from VITEX-2 Compact® or conventional disk diffusion in accordance with Clinical and Laboratory Standard Institute
(CLSI) guideline.
Results: The predominant GNB isolated was Escherichia coli (21.7%) followed by Klebsiella pneumonia (16.6%), Pseudomonas
aeruginosa (10.9%) and Acinetobacter baumanii (9.5%). There was a significant increase of GNB susceptibility against cefpirome from
57% in 2013 to 73% in 2015. Similarly, the susceptibility thrived from 78-83% against imipenem, 74-75% against tigecycline and 63-
64% against cefepime consecutively in 2013 to 2015. The susceptibility against meropenem in 2013 and 2015 was 80%.
Conclusions: The use of RACP yielded a positive effect on antibiotic susceptibility rate of GNB organisms. Furthermore, RACP is an
effective program in lowering antibiotics utilization in our institution.
Biography
Cucunawangsih is affiliated to the University of Pelita Harapan, Indonesia.
Cucunawangsih et al., J Infect Dis Ther 2016, 4:8 (Suppl)