Published online by Cambridge University Press:  03 September 2025

APSIC 2024.

Trend changing to the access category antibiotic usage after digital antimicrobial stewardship tool E-RASPRO 9 months implementation in an Indonesian hospital

Antimicrobial Stewardship & Healthcare Epidemiology
doi:10.1017/ash.2025.107

Hadianti Adlani 1,2, Aziza Ariyani 2, Ronald Irwanto Natadidjaja 1,2,3 and Anti Dharmayanti 1,2

1. Indonesian Society of Infection Control (INASIC) Branch Banten,
2. RASPRO Indonesia Study Group and
3. Faculty of Medicine Universitas Trisakti

Abstract:
Background: Antimicrobial Stewardship Program (ASP) is a global issue. World Health Organization (WHO) stated, there are 3 categories of antimicrobial: ACCESS, WATCH, and RESERVE. e-RASPRO as a digital ASP may alter antibiotic prescribing pattern by prioritizing ACCESS category as suggested by WHO. Methods: This manuscript was a ward retrospective survey data of 9 months Define Daily Dose (DDD) average before-after implementing the electronic-RASPRO (e-RASPRO) on ACCESS & WATCH antibiotic. Results: Number of inpatients 9 months before-after e-RASPRO implementation were 7,754 and 6,794. Within 9 months after implementing e-RASPRO there was a trend of antibiotic prescription shifting from WATCH category antibiotic to ACCESS category antibiotic. There was a trend of reduced Define Daily Dose (DDD) average of WATCH category antibiotic. 24.82% of 3rd generation Cephalosporin, 33.20% of Quinolones, 14.76% of Carbapenems and 100% of Piperacillin Tazobactam DDD average were reduced. While, in ACCESS Category Antibiotic, there were an elevation of Penicillin and Aminoglycosides DDD average up to 528.66% and 137.66%. Conclusion: T here are trend changing of DDD average from WATCH to ACCESS category antibiotic following the 9 months implementation of e-RASPRO. We need further study to judge the effectiveness of e- RASPRO as a digital ASP tools.

Keywords: digital antimicrobial stewardship, Define Daily Dose, ACCESS, WATCH