OBJECTIVE : Diarrhea is the second cause of childhood morbidity and mortality particularly in developing country. Inappropriate antibiotics prescription for acute diarrhea in children is one of the most challenging health care problem among countries, including Indonesia. The aim of this study was to provide profile of antibiotics utilization in children with acute diarrhea in Dr. Soetomo Academic General Hospital
METHODS : Descriptive study in 3214 children aged 1 month – 17 years diagnosed as acute diarrhea admitted to pediatric ward in Dr Soetomo Academic General Hospital from 2011 to 2019 had been conducted. Acute diarrhea was diagnosed based on stool frequency more than three times a day and change in stool consistency. Factors such as sex, age, degree of dehydration, comorbidities, and antibiotic therapy were evaluated.
RESULT : Most of the patients were boys (59%) and under 1 year of age (57.3%). There were 5% patients without dehydration, 84% patients with mild-moderate dehydration, and 9% with severe dehydration. There was 32.9% patients with comorbidities, such as pneumonia (10.7%), neurological infection (8.4%), septicemia (0.6%), malnutrition (9.3%), HIV (0.3%), surgical case (1.7%), cancer (1.1%), urinary tract infection (0.6%), and tuberculosis (0.1%). Antibiotic was used in 31.5% patients. Patients with acute diarrhea without dehydration showed the highest antibiotic utilization 61.15%(p<0.001). Antibiotic usage during 2018 were ampicillin (46%), ceftriaxone (22%), and combination of ampicillin with gentamycin (32%).
CONCLUSION : One third patients with acute diarrhea received antibiotic administration, especially in children with comorbidities and without dehydration. The most antibiotic given was ampicillin.