Antibiotic Surveillance in the Pediatric Intensive Care Unit (PICU) at Sanglah Hospital Denpasar in the Year of 2015-2017

Dyah Kanya Wati1, *, I Wayan Gustawan1, Ni Nengah Dwi Fatmawati2, I Ketut Tunas3, Putu Andrie Setiawan4
1 Department of Child Health, Udayana University Medical School, Sanglah Hospital, Denpasar, Bali 80114, Indonesia
2 Department of Clinical Microbiology, Udayana University Medical School, Sanglah Hospital, Denpasar, Bali 80114, Indonesia
3 Public Health Dhyana Pura University, Denpasar, Bali 80361, Indonesia
4 Udayana University Medical School, Denpasar, Bali 80225, Indonesia

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© 2019 Wati et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Child Health, Udayana University Medical School, Sanglah Hospital, Denpasar, Bali, Indonesia; Tel: +6281285705152; Fax: 0361244038;E-mail:



Antibiotic surveillance in hospital settings is mandatory for optimal antibiotic therapy for the patient. Only a small number of studies have focused on antibiotic surveillance in hospitalized newborns, infants, and children.


The goal was to evaluate antibiotic use in our Pediatric Intensive Care Unit (PICU) and evaluate it for a possible association with the length of PICU stay.


A retrospective, observational, cohort study was conducted from January 2015 to April 2017, involving subjects who were hospitalized in the PICU at Sanglah Hospital. The inclusion criteria were children aged between 1-month-12-years old, who had a blood culture and antibiotic sensitivity test result in their medical record. The exclusion criteria were incomplete medical records, blood cultures showing 2 types of bacteria at the same time (gram-positive and negative), or contaminated blood results. Factors associated with mortality were analyzed using a Chi-square test, with p < 0.05 considered to be statistically significant and the Risk Ratio (RR) of the associated factors was determined by 95% CI.


Multivariate analysis showed that the significant predictors of PICU length of stay were the appropriate continuation of antibiotics (RR 1.19; 95% CI 1.043 to 1.373; P = 0.047). There were also significant results for antibiotic compatibility and length of stay (RR 3.6; 95% CI 0.869 to 15.428; P = 0.049).


Appropriate continuation of antibiotics and the compatibility of continuation antibiotics were significant predictors of length of PICU stay based on multivariate analysis.

Keywords: Antibiotic, Sensitivity, Resistance, Surveillance, Children, PICU.