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Wisni, A., (2022). PPI Program For Treating Antimicrobial Resistance. Jurnal Health Sains 3 (9)

http//10.46799/jhs.v3i10.625

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2723-6927

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Ridwan Institute

Jurnal Health Sains: p–ISSN: 2723-4339 e-ISSN: 2548-1398

Vol. 3, No. 10, Oktober 2022

PPI PROGRAM FOR TREATING ANTIMICROBIAL RESISTANCE

Anggrieni Wisni

University Muhamadiyah Cirebon Jawa Barat, Indonesia

Email: [email protected]

ARTIKEL INFO

ABSTRACT

Data Received:

10 October 2022

Revision date:

15 October 2022

Received date:

25 October 2022

The problem of antimicrobial resistance is a big thing in

health services both in hospitals and in the community. The

purpose of organizing the PPI program is to be able to find

findings and reduce the possibility of infections that occur

in groups of patients, employees, medical and non-medical

personnel, permanent staff, part-time staff and volunteers,

students and other hospital consumers.

Keywords:

program; handling;

antimicrobial

Introduction

Infectious diseases are one of the main

things in the decline in performance and

productivity. This triggers an increase in

hospital spending on medical expenses. The

problem of antimicrobial resistance is a big

thing in health services both in hospitals and

in the community. This state of resistance is

difficult to treat with empirical antibiotics,

hence the term “superbug” (Unemo & Shafer,

2011). Recently there has been an increase in

multidrug-resistant bacteria, this causes

infections that do not give a good outcome to

the administration of some antibiotics. Health

authorities have described antibiotic

resistance. More broadly antimicrobial

resistance (AMR) is declared a public health

emergency caused by widespread antibiotic

abuse, which has not been matched by the

development of new, equally productive

antibiotics (Lesho & Laguio-Vila, 2019).

In accordance with the regulations

regarding the Guidelines for Infection

Prevention and Control (PPI) in handling

infections in health facilities, an integrated

local approach is needed in accordance with

the surrounding conditions, both hospitals and

the community. In its implementation, the

handling of infectious diseases includes the

need for rational and wise use of antibiotics to

control antimicrobial resistance. PPI activities

are carried out to prevent, minimize exposure

to infection both in the community, visitors to

officers and patients in health facilities. PPI

activities include planning, implementation

and evaluation activities that are directed and

structured in accordance with regulations

(Weeks et al., 2017)

Metode research

Identification methods in high risk

areas, the existence of clear regulations and

good internal coordination flows (Reefke &

Sundaram, 2017).

The focus areas in the hospital PPI

program include: leadership and

organizational structure, human resources and

infrastructure, PPI programs and clear goals,

medical equipment including single use tools,

infectious and B3 waste, nutrition services,

building construction risks, transmission of

infection and quality improvement and

education programs (Mejjad et al., 2021)

PPI work programs in hospitals

include: hand hygiene or hand hygiene,

cleanliness of the environmental area of

PPI Program For Treating Antimicrobial Resistance 
 
Jurnal Health Sains, Vol. 3, No. 10, Oktober 2022  1505 
health  facilities,  surveillance  of  the  risk  of 
infection  in  hospitals,  investigation  of 
outbreaks  or  out  breaks,  increasing 
supervision  on  the  use  of  antimicrobials, 
conducting  periodic  risk  assessments, 
determining target of reducing infection risk, 
infection  risk  review and  always  conducting 
periodic monitoring and evaluation of the PPI 
program (Mudjianto et al., 2018). Supervision 
of the use of antimicrobials is closely related 
to the handling of antibiotic resistance which 
is currently an issue in the world of health and 
education. 
Prescription antibiotics are used to treat 
a number of different bacterial infections. But 
in  reality  antibiotics  are  also  consistently 
prescribed  without  adequate  clinical 
indications,  for  example,  to  treat  viral 
infections (Craig et al., 2010). This situation 
is  one  of  the  causes  of  antibiotic  resistance. 
Antibiotic resistance occurs when germs such 
as  bacteria  and  fungi  develop  the  ability  to 
overpower  the  drugs  designed  to  kill  them. 
That  means  the  germs  are  not  killed  and 
continue  to grow.  Infections caused  by  such 
antibiotic-resistant  bacteria  are  difficult  and 
sometimes impossible to treat. In most cases, 
antibiotic-resistant  infections  require  longer 
hospital  stays,  more  frequent  doctor  visits, 
more  follow-up  and  more  expensive 
alternatives.  Antibiotic  resistance  doesn't 
mean  the  body  has  become  resistant  to 
antibiotics but bacteria have become resistant 
to  antibiotics.  designed  to  control  infection 
(Brookes-Howell et al., 2012). 
Antibiotic  resistance  has  the  potential 
to  affect  humans  at  every  stage  of  life, 
including  the  healthcare,  veterinary  and 
agricultural  industries.  Antibiotic  resistance 
makes  it  one  of  the  most  pressing  public 
health problems in the world. Each year in the 
United  States  at least 2.8  million  people are 
infected  with  bacteria  or  fungi  that  are 
resistant to antibiotics. At the same time more 
than  35,000 people died  as a  result. No  one 
can  completely  avoid  the  risk  of  resistant 
infection, but some people are at greater risk 
than  others  (e.g.  people  with  chronic 
diseases).  If  antibiotics  lose  their 
effectiveness, then we lose the ability to treat 
infections  and  control  public  health  threats 
(Frieri et al., 2017). Many medical advances 
depend on the ability to fight infection using 
antibiotics,  including  joint  replacements, 
organ  transplants,  cancer  therapy,  and 
treatment  of  chronic  diseases  such  as 
diabetes, asthma, and rheumatoid arthritis as 
well as other medical measures. 
The  emergence  of  infections  that  are 
resistant  to  various  antibiotics  has  led  to  a 
debate  about  the  practice  of  prescribing 
doctors  about  the  rational  administration  of 
antibiotics  in  the  treatment  of  various 
diseases,  including  infectious  diseases 
themselves  (Allerberger  et al., 2016).  It also 
gives  serious  consideration  to  the 
recommended indications and length of time 
for  antibiotic  therapy  in  the  clinical  field  as 
well  as  its  widespread  use  in  animal 
husbandry and other non-therapeutic purposes  
(Okocha et al., 2018). Although antimicrobial 
resistance is a consequence of patient overuse 
of  antibiotics,  the  contribution  of  routine 
antibiotic  use  in  animal  agriculture  to  this 
emerging  public  health  crisis  is  often 
overlooked. According to the CDC, the use of 
agricultural  antibiotics  is  responsible  for 
approximately  20%  of  resistant  infections  in 
humans (Makary et al., 2018) 
The  widespread  use  of  antibiotics  is 
driving the evolution of resistance. It has been 
clear since the introduction of antibiotics into 
clinical practice that the development of new 
antibiotics  can  never  keep  pace  with  the 
emergence  of  resistance  (Li  &  Webster, 
2018).  Each  introduction  of  an  antibiotic  is 
followed,  relatively  quickly,  by  documented 
resistance  to  that  antibiotic.  Thus,  the  main 
way  to  reduce  antibiotic  resistance  is  to 
promote the judicious use of antibiotics. One 
area of great importance is in the health care 

Anggrieni Wisni

Jurnal Health Sains, Vol. 3, No. 10, Oktober 2022 1506

setting, where among the infected patients

here many are immunocompromised.

However, we cannot forget other

important arenas that use antimicrobials in

large quantities, such as the agricultural

industry. In particular, the use of

antimicrobials in agriculture not only exerts

evolutionary pressure to promote the

development of resistance, but also provides

links in the chain of resistance gene

transmission through dispersal to

groundwater, as well as through human

consumption (Biohaz Et Al., 2021). This is a

concern that needs to be seriously considered

regarding the relationship between routine use

of antibiotics in animals and the decreased

effectiveness of antibiotics in treating human

infections.

Misuse of antibiotics is believed to be

the main cause associated with the high

number of resistant pathogenic and

commensal bacteria worldwide. Both the dose

and how to use it. Misuse of antibiotics is

believed to be the main cause associated with

the high administration of antibiotics

contributing to the selection of resistant

strains.

Results and Discussion

use of antibiotics. The challenges of

implementing PPRA include: lack of funding,

lack of internal hospital team support for the

PPRA program, not yet optimal clinical

management, lack of socialization of

activities and workload overload and lack of

infrastructure (Gulbs et al., 2018)

Evaluation of the implementation of

PPRA surveillance still shows the

inappropriate use of antibiotics (Hadi et al.,

2013). However, several centers have shown

improvements in the quality of antimicrobial

prescriptions after the implementation of the

program (). So that guidelines for rational use

of antibiotics need to be improved and

evaluated periodically to prevent resistance.

Conclusion

PPI work programs in hospitals

include: hand hygiene or hand hygiene,

cleanliness of the environmental area of

health facilities, surveillance of the risk of

infection in hospitals, investigation of

outbreaks or out breaks, increasing

supervision on the use of antimicrobials,

conducting periodic risk assessments,

determining target infection risk reduction,

infection risk review and always carry out

periodic monitoring and evaluation of the

program.

PPI Program For Treating Antimicrobial Resistance 
 
Jurnal Health Sains, Vol. 3, No. 10, Oktober 2022  1507 
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