Cataract Disease Diagnostic Expert System Using Forward Chaining Method

Abstract

Antimicrobial resistance is a major health problem associated with inappropriate antibiotic use in healthcare facilities, particularly hospitals. The Antimicrobial Resistance Control Program (PPRA) is implemented in Indonesian hospitals through surveillance, evaluation, education, and antibiotic-use interventions. This literature review aimed to analyze PPRA implementation and its relationship with the rational use of antibiotics in Indonesian hospitals. The literature search covered Indonesian- and English-language scientific articles published from 2018 to 2026 that discussed PPRA implementation, antimicrobial stewardship, antibiotic use, or evaluation of antibiotic rationality in Indonesian hospitals. Based on the source manuscript, 17 articles were included in the synthesis. The review indicates that PPRA implementation includes antibiotic utilization surveillance, qualitative and quantitative evaluation, audits, education, development or application of treatment guidelines, restriction, and pre-authorization of selected antibiotics. Evaluations using the Gyssens, ATC/DDD, and DOT methods indicate that inappropriate antibiotic use remains present across different hospital settings. PPRA has the potential to support more rational antibiotic use; however, the findings across studies are not consistent and are influenced by management support, healthcare professional involvement, availability of guidelines and utilization data, and consistency of monitoring and evaluation. Therefore, PPRA should be implemented continuously and through a multidisciplinary approach, accompanied by evaluation of intervention outcomes.