The appropriateness of initial intravenous empirical antibiotic consumption guided by digital antimicrobial stewardship tool: a correlation with the usage of antibiotics from the access and watch groups in ten Indonesian hospitals

Background RASPRO Indonesia Study Group for Antimicrobial Stewardship & Resistance has developed a digital antimicrobial stewardship (ASP) tool known as the e-RASPRO, which may provide a guideline for clinical decision on antibiotic prescribing for bacterial infection cases by integrating the WHO AWaRe (Access, Watch, Reserve) classification. Methods A multicenter retrospective correlational study was conducted using aggregated monthly hospital antibiotic prescribing data. A correlation test was conducted between the mean percentage on the appropriateness of initial intravenous empirical antibiotic consumption and the mean Defined Daily Dose (DDD) of antibiotics within a year (January to December 2024) in 10 Indonesian hospitals after the socialization of e-RASPRO tool between 2022 and 2024 in four major infections. Results There was a significant positive correlation between the mean of percentages on appropriateness of initial intravenous empirical antibiotic consumption in type I risk stratification guided by e-RASPRO tool and the mean DDD/100 patient-days of intravenous Penicillin as Access group antibiotic ( r = 0.598, 95% CI 0.021–0.873; p = 0.041) and a significant negative correlation with the mean DDD/100 patient-days of intravenous third-generation Cephalosporins as Watch group antibiotic ( r = −0.612, 95% CI −0.878 to −0.044; p = 0.035) after removed linear temporal trends. Conclusion Appropriateness of initial intravenous empirical antibiotic consumption in type I and II risk stratification guided by e-RASPRO tool was correlated with increased consumption of Penicillin as an Access group antibiotic and decreased consumption of third-generation Cephalosporins as a Watch group antibiotic. This study did not describe a causal relationship between the use of the e-RASPRO tool and antibiotic consumption in the hospital.