Evaluasi Penggunaan Antibiotik dengan Metode Gyssens pada Pasien Stroke Rawat Inap di RSUD Koja secara Retrospektif (Periode KJS dan BPJS)

  • Fransiska Sitompul Magister Ilmu Kefarmasian, Fakultas Farmasi, Universitas Indonesia, Depok, Indonesia
  • Maksum Radji Magister Ilmu Kefarmasian, Fakultas Farmasi, Universitas Indonesia, Depok, Indonesia
  • Anton Bahtiar Magister Ilmu Kefarmasian, Fakultas Farmasi, Universitas Indonesia, Depok, Indonesia
Keywords: Stroke, Infection, Antibiotic, Gyssens method

Abstract

Stroke is a major cause of mortality and morbidity worldwide. Patients with stroke are susceptible to medical complications, especially infections. This study aim to evaluate antibiotic by stroke inpatients hospitalized in RSUD Koja (KJS and BPJS period) with Gyssens methods. The study design is a retrospective cross-sectional. The sample is consisted of 112 medical records from KJS period (July 2013-December 2013) and 74 medical records from BPJS period (January 2014-June 2014) taken by total sampling. The use of antibiotic were analyzed using Chi Square and logistic regression multivariate. The percentage of antibiotic use was 23,11%, mostly were ceftriaxon 33,3%, ceftizozim 7,6% and amoxicillin – clavulanic acid 7,6%. Length of stay more than 7 days was 77,96%. The most common route of antibiotic administration was parenteral (68,67%). Patients that were given antibiotics were,among others,diagnosal by bronchopneumonia (29,33%), pulmonary tuberculosis and 17,6% and urinary tract infection (8,7%). The clinical outcome showed that 69,3% of 186 patients were recovered after antibiotic were given to treat their infections. Gyssen evaluation method showed that rational antibiotic used on KJS period was 77,4% and BPJS periods was 81,3%. There were correlations between rational use at antibiotic and the route of administration, between clinical outcome anduse at diagnosis and route of administration. The conclusion of this study according to Gyssen method is the rational antibiotic influence the clinical outcome (p < 0,05)

References

1. Johnsen SP., Svendsen ML.Ingeman A. Infection in patients with Aaute Stroke. The Open Infectious Diseases Journal. 2012; 6 (Suppl 1:M3) 40-5.
2. Westendorp WF, Vermeij JD, Vermeij F, Den Hertog HM, Dippel DWJ, van de Beek D, et al. Antibiotic therapy for preventing infections in patients with acute stroke. 2012;1: CD008530. Doi:10.1002/14651858.CD008530.pub2
3. Priantoro CT. Studi pola penggunaan antibiotik pada pasien stroke iskemik akut dengan infeksi [skripsi]. Surabaya: Universitas Airlangga; 2011.
4. Corsetyanita DR. Studi Penggunaan antibiotik pada pasien stroke hemoragik (Intraserebral) di RSUD Dr. Soetomo Surabaya [skripsi]. Surabaya: Universitas Katolik Widya Mandala; 2013.
5. Gyssens IC. Audit for monitoring the quality of antimicrobial prescription. I.M. Gould, Jos W.M. van der Meer, editor. Antibiotics Policies: Theory and practice. New York:. Spinger US;2005.197-226.
6. The Amrin Study Group. Antimicrobial resistance, antibiotic usage and infection control; a self-assessment program for Indonesian hospitals. Directorate General of Medicine Care, Ministry of Health, Republic of Indonesia. 2005.
7. Pedoman Pelaksanaan (Manlak) Program KJS. Jakarta : Peraturan Gubernur Provinsi Daerah Khusus Ibukota Jakarta no. 14 ; 2013.
8. Panduan praktis tentang kepesertaan dan pelayanan kesehatan yang diselenggarakan oleh BPJS kesehatan berdasarkan Regulasi yang sudah terbit. Jakarta : BPJS Kesehatan; 2014.
9. Lwanga SK, Lemeshow S. Sample size determination in health studies, a practical manual epidemiological and
statistical methodology. Geneva: WHO; 1991.
10. Rehm, S.J., Sekeres, J.K., Neuner, E. Guidelines for Antimicrobial Usage 2012 – 2013. Mexico: Professional Com.; 2012.
11. Kementerian Kesehatan. Riset Kesehatan Dasar 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2013.
12. Finlayson O., Kapral M., Hall R., Asllani E., Selchen D., Saposnik G.. Risk factors, inpatient care, and outcomes of pneumonia after ischemic stroke. Neurology.2011;77(14);1338-45. Doi:10. 1212/wnl.0b013e31823152b.
13. National Collaboration Cente for Chronic Condition. Stroke: Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). London: Royal Collage of Physicions, 2008.
14. Van de Beek D. Wijdicks EFM. Vermeij, FH. de Haan RJ, Prins JM, Spanjaard L, et al. Preventive antibiotics for infections in acute stroke; A systematic review and meta-analysis. Arrachive of Neurology. 2009; 66(9): 1076-81.
15. Brämer D, Hoyer H, Günther A, Nowack S, Brunkhorst FM, Witte OW,et al. Study protocol : prediction of stroke associated infection by markers of autonomic control. BMC (BioMed Central) Neurology. 2014;14(9):14-9.
16. Avenia N, Sanguinetti A, Cirocchi R, Docimo G, Ragusa M, Ruggiero R, et al. Antibiotic prophylaxis in thyroid surgery : a preliminary multicentric Italian experience. Annals of Surgical Innovation and Research. 2009;3-10.
17. Westendorp WF, Vermeij JD, Dippel DW, Dijkgraaf MG, Van der Poll T, et al. Update of the preventive antibiotics in stroke study (PASS): statistical analysis plan. 2014; 15:382.
Published
2016-02-29
How to Cite
1.
Sitompul F, Radji M, Bahtiar A. Evaluasi Penggunaan Antibiotik dengan Metode Gyssens pada Pasien Stroke Rawat Inap di RSUD Koja secara Retrospektif (Periode KJS dan BPJS). jki [Internet]. 29Feb.2016 [cited 3Jul.2024];6(1):30-8. Available from: http://ejournal2.litbang.kemkes.go.id/index.php/jki/article/view/2915
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Articles