OBJECTIVES : Antibiotic resistance (ABR) is a global public health concern. One of the causes is inappropriate antibiotic therapy on health care services; accordingly, antibiotics were not working effectively. The patient is difficult to heal and needs longer times of hospitalization and higher lines of antibiotics that may cause higher costs of treatment. National Institute of Health Research and Development conducted operational research to find out costs related to ABR on treatment of patients suffer pneumonia and septicemia.

METHODS : The study sites were in 10 general hospitals in 10 provinces in Indonesia. Data collected from hospitals fulfilled criteria: They have conducted ABR Control Program; Having microbiology laboratory; Clinical pharmacy services have run well; Financial system is computerized and integrated among units. Medical and costs data from patients suffered pneumonia and septicemia in 2017 were collected retrospectively. As the study followed hospital perspective, costs calculated were direct cost of patients i.e., administration; patient room; professionals visit; diagnostic tests; antibiotics and other medicines, disposable medical devices, and other related treatment costs.

RESULTS : Total samples were 3164 consists of 1686 pneumonia and 1478 septicemia samples. There were 323 pneumonia samples tested sensitivity test and 275 of those confirmed resistance toward first choice of antibiotics for pneumonia. There were 574 of septicemia samples tested sensitivity test and 519 of those confirmed resistance toward first choice of antibiotics for septicemia. The result shows that costs of pneumonia hospitalization were 24,4% higher if the patients’ resistance to antibiotics and costs of septicemia hospitalization were 119% higher if the patients’ resistance to antibiotics. There were >90% of patients hospitalized for more than 30 days compare <10% of patients without ABR.

CONCLUSIONS : The study recommends that government and hospital should strengthen AMR control program as the study approved that ABR leads to longer times of length of stay and higher hospital costs.