{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:11:46Z","timestamp":1790831506302,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["106680\/Z\/14\/Z"],"award-info":[{"award-number":["106680\/Z\/14\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global emergence of antimicrobial resistance is driven by antibiotic misuse and overuse. However, systematic data in Indonesian hospitals to adequately inform policy are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate patterns and quality indicators of antibiotic prescribing in six general hospitals in Jakarta, Indonesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a hospital-wide point prevalence survey (PPS) between March and August 2019, using Global-PPS and WHO-PPS protocols. The analysis focused on antibacterials (antibiotics) for systemic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1602 inpatients, 993 (62.0%) received \u22651 antimicrobial. Of 1666 antimicrobial prescriptions, 1273 (76.4%) were antibiotics. Indications comprised community-acquired infections (42.6%), surgical prophylaxis (22.6%), hospital-acquired infections (18.5%), medical prophylaxis (9.6%), unknown (4.6%) and other (2.1%). The most common reasons for antibiotic prescribing were pneumonia (27.7%), skin and soft tissue infections (8.3%), and gastrointestinal prophylaxis (7.9%). The most prescribed antibiotic classes were third-generation cephalosporins (44.3%), fluoroquinolones (13.5%), carbapenems (7.4%), and penicillins with \u03b2-lactamase inhibitor (6.8%). According to the WHO AWaRe classification, Watch antibiotics accounted for 67.4%, followed by 28.0% Access and 2.4% Reserve. Hospital antibiotic guidelines were not available for 28.1% of prescriptions, and, where available, guideline compliance was 52.2%. Reason for the antibiotic prescription, stop\/review date and planned duration were poorly documented. Culture-guided prescriptions comprised 8.1% of community-acquired infections and 26.8% of hospital-acquired infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data indicate a high rate of empirical use of broad-spectrum antibiotics in Indonesian hospitals, coupled with poor documentation and guideline adherence. The findings suggest important areas for antimicrobial stewardship interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlab047","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T08:11:32Z","timestamp":1615968692000},"source":"Crossref","is-referenced-by-count":39,"title":["A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5306-3254","authenticated-orcid":false,"given":"Ralalicia","family":"Limato","sequence":"first","affiliation":[{"name":"Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erni J","family":"Nelwan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia"},{"name":"Faculty of Medicine, University of Indonesia, Jakarta, Indonesia"},{"name":"Infectious Disease and Immunology Research Cluster, Indonesian Medical Education and Research Institute, Jakarta, Indonesia"},{"name":"Metropolitan Medical Centre Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manzilina","family":"Mudia","sequence":"additional","affiliation":[{"name":"Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"de Brabander","sequence":"additional","affiliation":[{"name":"Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helio","family":"Guterres","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia"},{"name":"Faculty of Medicine, University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enty","family":"Enty","sequence":"additional","affiliation":[{"name":"Royal Taruma Hospital, Jakarta, Indonesia"},{"name":"Faculty of Medicine and Health Sciences, Atma Jaya Catholic University, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifael Y","family":"Mauleti","sequence":"additional","affiliation":[{"name":"Fatmawati General Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mayasari","sequence":"additional","affiliation":[{"name":"St. Carolus Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"Firmansyah","sequence":"additional","affiliation":[{"name":"Prof. Dr. Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Hizrani","sequence":"additional","affiliation":[{"name":"Metropolitan Medical Centre Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5007-7896","authenticated-orcid":false,"given":"Raph L","family":"Hamers","sequence":"additional","affiliation":[{"name":"Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK"},{"name":"Faculty of Medicine, University of Indonesia, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"2021070810422345100_dlab047-B1","author":"O\u2019Neill","year":"2014"},{"key":"2021070810422345100_dlab047-B2","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/S1473-3099(14)70780-7","article-title":"Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data","volume":"14","author":"Van Boeckel","year":"2014","journal-title":"Lancet Infect Dis"},{"key":"2021070810422345100_dlab047-B3","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/S0140-6736(05)17907-0","article-title":"Outpatient antibiotic use in Europe and association with resistance: a cross-national database study","volume":"365","author":"Goossens","year":"2005","journal-title":"Lancet"},{"key":"2021070810422345100_dlab047-B4","doi-asserted-by":"crossref","first-page":"E3463","DOI":"10.1073\/pnas.1717295115","article-title":"Global increase and geographic convergence in antibiotic consumption between 2000 and 2015","volume":"115","author":"Klein","year":"2018","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2021070810422345100_dlab047-B5","author":"WHO. 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