Treatment patterns of acute respiratory tract infection in children under-fives in Bogor, Indonesia
Abstract
Latar Belakang: Penggunaan obat yang tidak rasional menjadi masalah dalam pelayanan kesehatan, baik di negara maju maupun negara berkembang. Pengobatan Infeksi Saluran Pernafasan Akut (ISPA) tidak hanya tergantung pada antibiotik, tetapi dengan terapi penunjang untuk kasus yang disebabkan oleh virus. Penelitian ini bertujuan untuk mengidentifikasi pola pengobatan pasien ISPA pada balita di rumah sakit di Bogor, Indonesia.
Metode: Penelitian ini dilakukan dengan desain potong lintang menggunakan data rekam medis pasien balita dengan ISPA periode 1 Januari hingga 31 Desember 2015 di rumah sakit pemerintah dan swasta di Bogor. Analisis dilakukan dengan menggunakan uji Chi-Square.
Hasil: Rekam medis yang yang dikumpulkan dari kedua rumah sakit sebanyak 105 kasus. Pola pengobatan pada pasien ISPA rawat jalan (n=32) di rumah sakit swasta adalah mukolitik (81,3%), dekongestan (56,3%), antipiretik (43,8%), dan antibiotik (6,3%). Sementara itu, rumah sakit pemerintah (n=8) menggunakan antibiotik (75%), antipiretik (50%), dan mukolitik (50%). Pola pengobatan pada rawat inap di rumah sakit swasta (n=27) adalah antibiotik (85,2%), antipiretik (63%), kortikosteroid (33,3%), dan mukolitik (25,9%), sedangkan rumah sakit pemerintah (n=38) adalah antibiotik (92,1%), antipiretik (89,5%), kortikosteroid (31,6%), dan mukolitik (71,1%). Faktor-faktor yang mempengaruhi pengobatan pada rawat jalan tidak dapat diidentifikasi karena kurangnya informasi klinis dan hasil tes laboratorium. Pemberian antibiotik pada pasien rawat inap di kedua rumah sakit tidak berhubungan dengan kadar leukosit dan suhu tubuh.
Kesimpulan: Penelitian ini menunjukkan bahwa penggunaan antibiotik untuk ISPA belum sesuai dengan pedoman klinis yang pemberiannya harus didahului dengan pemeriksaan klinis dan mikrobiologis. Kepatuhan terhadap pedoman klinis sangat penting untuk mencegah terjadinya resistensi antibiotik dan mengurangi terjadinya reaksi obat yang tidak diinginkan.
Kata kunci: Anak, antibiotik, infeksi saluran pernafasan akut, pengobatan
Abstract
Background: Irrational use of medicines has become a problem in health services, both in developed and developing countries. Treatment of Acute Respiratory Tract Infections (ARTIs) is not only dependent on antibiotics, but only with supportive treatment for cases caused by viruses. This study aimed to determine treatment patterns for children under-fives with ARTIs in hospitals in Bogor, Indonesia.
Methods: A cross-sectional study was conducted using medical records of patients under-fives with ARTIs in a government and a private hospital in Bogor from January 1st to December 31st, 2015. The analysis was performed using Chi-square test.
Results: There were 105 medical records collected from both hospitals. The pattern of ARTIs’ outpatient treatments (n= 32) at private hospital were mucolytic (81.3%), decongestants (56.3%), antipyretic (43.8%), and antibiotics (6.3%). Meanwhile, the government hospital (n=8) used antibiotics (75%), antipyretics (50%) and mucolytic (50%). The pattern of ARTIs inpatient treatments in private hospitals (n=27) were antibiotics (85.2%), antipyretic (63%), corticosteroids (33.3%), and mucolytics (25.9%). Otherwise, the government hospital (n=38) used antibiotics (92.1%), antipyretic (89.5%), corticosteroids (31.6%) and mucolytics (71.1%). Factors affected outpatient treatment could not be traced because it lacked clinical information and laboratory test results. Meanwhile, antibiotic use for inpatients in both hospitals was not related to blood leukocytes level and body temperature.
Conclusion: This study showed that antibiotics prescribing for ARTIs is still not in accordance with the clinical guidelines that must be preceded by various clinical examinations and microbiological. Adherence to clinical guidelines is important to prevent antibiotic resistance and to decrease adverse effects.
Keywords: Acute respiratory tract infections, antibiotics, children, treatment
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