Diagnostic and antibiotic use practices among COVID-19 and non-COVID-19 patients in the Indonesian National Referral Hospital

Robert Sinto, Khie Chen Lie, Siti Setiati, Suhendro Suwarto, Erni J Nelwan, Mulya Rahma Karyanti, Anis Karuniawati, Dean Handimulya Djumaryo, Ari Prayitno, Sumariyono Sumariyono, Mike Sharland, Catrin E Moore, Raph L Hamers, Nicholas P J Day and Direk Limmathurotsakul

PLOS ONE, 2024, vol. 19, issue 3, 1-14

Abstract: Background: Little is known about diagnostic and antibiotic use practices in low and middle-income countries (LMICs) before and during COVID-19 pandemic. This information is crucial for monitoring and evaluation of diagnostic and antimicrobial stewardships in healthcare facilities. Methods: We linked and analyzed routine databases of hospital admission, microbiology laboratory and drug dispensing of Indonesian National Referral Hospital from 2019 to 2020. Patients were classified as COVID-19 cases if their SARS-CoV-2 RT-PCR result were positive. Blood culture (BC) practices and time to discontinuation of parenteral antibiotics among inpatients who received a parenteral antibiotic for at least four consecutive days were used to assess diagnostic and antibiotic use practices, respectively. Fine and Grey subdistribution hazard model was used. Results: Of 1,311 COVID-19 and 58,917 non-COVID-19 inpatients, 333 (25.4%) and 18,837 (32.0%) received a parenteral antibiotic for at least four consecutive days. Proportion of patients having BC taken within ±1 calendar day of parenteral antibiotics being started was higher in COVID-19 than in non-COVID-19 patients (21.0% [70/333] vs. 18.7% [3,529/18,837]; p

Date: 2024
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DOI: 10.1371/journal.pone.0297405

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