Antibiotic Use in Pediatric Patients with Acute Lymphoblastic Leukemia and Febrile Neutropenia at Dr. Soetomo General Hospital, Surabaya: A Point Prevalence Study

Background: Febrile neutropenia is a serious and potentially life-threatening complication in pediatric patients with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. Profound neutropenia increases susceptibility to bacterial infections, making early empirical antibiotic therapy essential. However, inappropriate antibiotic use may contribute to antimicrobial resistance. Data regarding antibiotic utilization patterns in pediatric ALL patients with febrile neutropenia in Indonesia remain limited.

Methods: This study was a descriptive point prevalence survey conducted among pediatric patients aged 0–17 years diagnosed with ALL and febrile neutropenia at Dr. Soetomo General Hospital, Surabaya. Data were collected retrospectively from medical records of hospitalized patients between January and June 2025. Variables analyzed included patient demographics, severity of neutropenia, empirical antibiotic regimens, routes of administration, and microbiological culture results.

Results: total of 104 pediatric patients were included, with a predominance of males and school-aged children. More than half of the patients experienced severe neutropenia. Ampicillin–sulbactam was the most frequently prescribed empirical antibiotic, administered intravenously in the majority of cases. Positive blood culture results were predominantly Gram-positive bacteria, with Staphylococcus hemolytic as the most common isolate, followed by Gram-negative bacteria such as Pseudomonas aeruginosa.

Conclusion: Ampicillin–sulbactam was the main empirical antibiotic used in pediatric ALL patients with febrile neutropenia at Dr. Soetomo General Hospital and was generally consistent with recommended treatment guidelines. Continuous evaluation of local microbiological patterns and antibiotic prescribing practices is necessary to optimize therapy and support antimicrobial stewardship programs.