Abstract
Intoduction: The cat breeder every day began by feeding, bathing, cutting the nails and cleaning the Antimicrobial resistance is a major public health concern closely associated with irrational antibiotic use in healthcare facilities, particularly hospitals. The Antimicrobial Resistance Control Program (PPRA) is one of the strategies implemented in Indonesian hospitals to promote the rational use of antibiotics and control the development of antimicrobial resistance. This literature review aimed to analyze the implementation of PPRA and its contribution to improving the rational use of antibiotics in Indonesian hospitals. A literature search was conducted for scientific articles published between 2018 and 2026 that discussed PPRA implementation, antibiotic use, rational antibiotic therapy, and antibiotic utilization evaluation in Indonesian hospitals. A total of 17 articles that met the inclusion criteria were included in the literature synthesis. The findings indicate that PPRA implementation in various hospitals involves antibiotic utilization surveillance, qualitative and quantitative evaluations, antibiotic use audits, restrictions or pre-authorization of selected antibiotics, and multidisciplinary involvement in antimicrobial stewardship. Evaluations using the Gyssens and ATC/DDD methods demonstrated that irrational antibiotic use remains present in several healthcare settings; however, various antimicrobial stewardship interventions showed potential to improve the appropriateness of antibiotic selection and utilization. The effectiveness of PPRA implementation is influenced by multidisciplinary collaboration, adherence to therapeutic guidelines, availability of antibiotic utilization data, and consistency in program implementation. Therefore, PPRA plays an important role in improving the rational use of antibiotics and supporting efforts to control antimicrobial resistance in Indonesian hospitals.