Analysis of Defined Daily Dose (DDD) and antibiotic problems in Intensive Care Unit (ICU) patients

Yulistiani, Yulistiani and Barkah, Hargus Haraudi and Utomo, Febriansyah Nur and Andrianto, Lucky and Jathi, Alena Putri and Yudistira, Nurrizky Grahitaning Putra Rohmaana (2026) Analysis of Defined Daily Dose (DDD) and antibiotic problems in Intensive Care Unit (ICU) patients. Exploratory Research in Clinical and Social Pharmacy, 21.

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Abstract

BackgroundThe increasing prevalence of antimicrobial resistance (AMR) in Intensive Care Unit (ICU) is posing a significant challenge to effective infection management. This shows the need for quantitative evaluation of antibiotic use through the Defined Daily Dose (DDD) method, combined with Drug Related Problems (DRPs) analysis to support Antimicrobial Stewardship (AMS) programs. Therefore, this study aimed to analyze the quantitative use of antibiotic using DDD method and identify DRP in ICU patients at Airlangga University Hospital. A retrospective cross-sectional study was conducted using medical records of ICU patients from July to December 2022. Antibiotic consumption was calculated in DDD per 100 patient-days following WHO standards, while DRPs were identified using the Cipolle and Pharmaceutical Care Network Europe (PCNE) v9.1 classifications. A total of 125 ICU patients met the inclusion criteria, with a predominance of pneumonia (40 ) and sepsis (25 ). The results showed that the total antibiotic consumption was 91.54 DDD/100 patient-days, with ceftriaxone having the highest (31.57 DDD/100 patient-days). The most frequent DRPs were unnecessary drug therapy (20 ) and suboptimal therapeutic effects (23 ), mainly due to inappropriate indications and deviations from treatment guidelines. Antibiotic use in ICU was dominated by ceftriaxone, and the high rate of DRPs showed the need for improved AMS. This study showed that strengthening interdisciplinary collaboration, regular audits, and adherence to clinical guidelines were essential steps to optimize antibiotic use and minimize the risk of resistance. © 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/

Item Type: Article
Additional Information: Cited by: 0; All Open Access; Gold Open Access; Green Open Access
Uncontrolled Keywords: Antibiotic, Defined daily dose, DRPs Resistance, Intensive care unit
Subjects: R Medicine > RM Therapeutics. Pharmacology
R Medicine > RM Therapeutics. Pharmacology > RM300-666 Drugs and their actions
Divisions: Artikel Ilmiah > SCOPUS INDEXED JOURNAL
Creators:
CreatorsNIM
Yulistiani, YulistianiUNSPECIFIED
Barkah, Hargus HaraudiUNSPECIFIED
Utomo, Febriansyah NurUNSPECIFIED
Andrianto, LuckyUNSPECIFIED
Jathi, Alena PutriUNSPECIFIED
Yudistira, Nurrizky Grahitaning Putra RohmaanaUNSPECIFIED
Depositing User: Dewi Puspita
Date Deposited: 08 Jul 2026 02:11
Last Modified: 08 Jul 2026 02:11
URI: http://repository.unair.ac.id/id/eprint/143038
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