Ikhwan Yuda Kusuma, Ria Benkő, Erika Piroska Papfalvi, Ni Made Amelia Ratnata Dewi, Fiqih Nurkholis, Róbert Nacsa, Dezső Csupor, Mária Matuz
Background: Antimicrobial resistance (AMR) is a global health threat arising from inappropriate antibiotic use. Data on the prescription of antibiotics in emergency departments (EDs), critical care points for infection management, are limited. Objective: This study aimed to assess systemic antibiotic use in an Indonesian ED. Methods: This retrospective observational study was conducted in the Cilacap Teaching Hospital ED in 2022. Data, including patient demographics and systemic antibiotic prescription details (World Health Organization Anatomical Therapeutic Chemical (WHO ATC): J01) were extracted from electronic medical records. Antibiotic use was analyzed according to age groups (children [0–14 years], adults [15–64 years], and the elderly [≥65 years]), administration route, and the World Health Organization Access, Watch, and Reserve classification. Results: Among all ED visits during the study period, 52.1% (14,396/27,640) received systemic antibiotics, and adults comprised 68.5% (9861/14,396) of antibiotic-exposed cases. Cephalosporins were the most frequently prescribed antibiotics in all age groups (42.4–50.9%). Penicillins were more frequently prescribed in children (29.9%) than in adults (10.0%) and the elderly (6.6%), whereas fluoroquinolones were more commonly prescribed in the elderly (21.1%) than in adults (16.2%) and children (3.8%). Watch-class antibiotics, comprising 63.9% of all prescriptions, were commonly prescribed in the elderly (71.9%). Oral route was the predominant form (65.8%), particularly in children (76.5%). The most frequently prescribed antibiotics differed across age groups, with amoxicillin followed by cefixime in children, and cefixime followed by ceftriaxone in both adults and the elderly. Conclusions: This study showed high antibiotic exposure and identified age-related differences in antibiotic prescribing, and patterns that warrant further evaluation within antimicrobial stewardship frameworks, to optimize antibiotic use and mitigate AMR. © 2026 by the authors.
Pharmacy Study Program, Faculty of Health, Universitas Harapan Bangsa, Purwokerto, 53182, Indonesia; Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, Szeged, 6725, Hungary; Institute of Clinical Pharmacy, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, 6725, Hungary; Emergency Department, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, 6725, Hungary; Pharmacy Study Program, Faculty of Medicine and Health Sciences, University of Mataram, Mataram, 83115, Indonesia; Central Pharmacy, Cilacap Regional General Hospital, Cilacap, 53223, Indonesia
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