Trends in inpatient antibiotic use in Indonesia and the Philippines during the COVID-19 pandemic
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objective: Increased antibiotic use (AU) has been reported globally during the COVID-19 pandemic despite low rates of bacterial co-infection. We assessed changes in AU during the COVID-19 pandemic in Indonesia and the Philippines. Methods: We evaluated hospital-wide AU over 36 months in six hospitals, 3 in Indonesia and 3 in the Philippines. Intravenous antibiotics commonly used for respiratory conditions were selected and grouped for analysis. AU rates were calculated as monthly defined daily dose per 1000 patient-days or patient discharges. Median AU rates were compared from the pre-pandemic (March 2018-February 2020) and pandemic periods (March 2020-February 2021) using quantile regression to assess for statistical significance. Changes in AU during the COVID-19 pandemic were analyzed using interrupted time series analysis. Results: Significant increases were noted in the median AU rate from the pre-pandemic to pandemic period of all antibiotics combined in 3/6 hospitals (percentage change, Δ, 12.5%-63.6%) and anti-pseudomonal antibiotics in 3/6 hospitals (Δ 51.5%-161.5%). In the interrupted time series analysis, an immediate increase (range: 125.40-1762) in the use of all included antibiotics combined was observed in 3/6 hospitals at the onset of the COVID-19 pandemic. One of these 3 hospitals experienced a statistically significant sustained increase, while another experienced a decrease over time. Conclusions: We observed significant increases in facility-wide inpatient AU during the COVID-19 pandemic in our participating hospitals in Indonesia and the Philippines. These findings reinforce the importance of antibiotic stewardship practices to optimize AU, especially during infectious disease pandemics.
DOI: 10.1017/ash.2025.48
Authors: Amara Z. Fazal, Olivia L. McGovern, Garrett W. Mahon, Fernanda C. Lessa, Maria Tarcela Gler, Jemelyn Garcia, Mark John Festin, Kuntaman Kuntaman, Ida Parwati, Cherry Siregar, Jay Christian D. Muere, Gina De Guzman Betito, Maya Montemayor, Arleen De Leon, Emmeline Borillo, Mark Ramon Victor Llanes, Regina Berba, Musofa Rusli, Mariyatul Qibtiyah, Bambang Pujo Semedi, Rosantia Sarassari, Leonardus Widyatmoko, Basti Andriyoko, Adhi Kristianto Sugianli MD, Dewi Kartika Turbawaty, Ivo Dhanitri Ranita, Franciscus Ginting, Rahmadania Marita Joesoef, Made Ananda Krisna, Twisha S. Patel
Institutions: Centers for Disease Control and Prevention, Makati Medical Center, Asian Hospital and Medical Center, Philippine General Hospital, University of the Philippines Manila, Universitas Airlangga, Dr. Hasan Sadikin General Hospital, Padjadjaran University, Eijkman Institute for Molecular Biology, University of Oxford
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,719
OpenAlex ID: W4411657210