Evaluasi Penggunaan Antibiotik pada Pasien Rawat Inap di Bangsal Penyakit Dalam RSUD. Dr. H. Abdul Moeloek Provinsi Lampung

  • Dirga Dirga Jurusan Sains, Program Studi Farmasi, Institut Teknologi Sumatera, Lampung, Indonesia
  • Sudewi Mukaromah Khairunnisa Jurusan Sains, Program Studi Farmasi, Institut Teknologi Sumatera, Lampung, Indonesia
  • Atika Dalili Akhmad Jurusan Sains, Program Studi Farmasi, Institut Teknologi Sumatera, Lampung, Indonesia
  • Irfanianta Arif Setyawan Jurusan Sains, Program Studi Farmasi, Institut Teknologi Sumatera, Lampung, Indonesia
  • Anton Pratama Instalasi Farmasi Rumah Sakit Dr. H. Abdul Moeloek, Lampung, Indonesia
Keywords: Evaluation of antibiotic use, Infection, Internal medicine ward

Abstract

The high prevalence of infectious disease in Indonesia causes increased use of antibiotics. It has serious consequences since it can cause germicidal resistance rapidly increased, significant morbidity and mortality, as well as high additional medical costs per year. This study aims to evaluate the appropriateness of antibiotic use inpatients in the internal medicine ward of Dr. H. Abdul Moeloek in Lampung Province. This research was observational (non-experimental) with a descriptive evaluative research design. The data were obtained from the retrospective tracing of medical records that collected by a purposive sampling technique on July-December 2017. A total of 163 inclusion samples are analyzed qualitatively and quantitatively. The qualitative analysis uses standard guidelines for the use of antibiotics and quantitative analysis uses the anatomical therapeutic chemical (ATC)/Defined Daily Dose (DDD) method. The results showed that out of 168 medical records, 19 types of antibiotics were used with a 118.57 DDD value of 100 patient days. The most widely prescribed was ceftriaxone (49.09%). The highest number of infections was diabetic ulcers with an incidence of 42 cases (25%). Out of 168 evaluated cases, 166 cases (98.8%) were appropriate indication, 168 cases (100%) were appropriate patients, 150 cases (89,29%) were appropriate medication, and 89 cases (52,97%) were appropriate dosage. These results indicated that the use of antibiotics inpatients in the internal medicine ward of Dr. H. Abdul Moeloek in Lampung Province were rational but it was necessary to consider selectivity regarding the choice of antibiotic use for infected patients.

References

Kementerian Kesehatan RI. Peraturan menteri kesehatan nomor 2406 tahun 2011 tentang pedoman umum penggunaan antibiotik. Jakarta: Kementerian Kesehatan Republik Indonesia; 2011

Center for Disease Control and Prevention. Antibiotic resistance threats in the United States. Atlanta: U.S. Departement of Health and Human Services; 2013

Direktorat Pelayanan Kefarmasian Kementerian Kesehatan RI. Pedoman umum penggunaan antibiotik. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.

Yadesa TM, Gudina EK, Angamo MT. Antimicrobial use-related problems and predictors among hospitalized medical in-patients in Southwest Ethiopia: Prospective Observational Study. PLOS ONE. 2015 Des;10(2):1-9.

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset kesehatan dasar 2013. Jakarta: Kementerian Kesehatan RI; 2013.

Samuel A, Warganegara E. Pola resistensi bakteri aerob penyebab infeksi luka operasi terhadap antibiotik di ruang rawat inap bagian bedah dan kebidanan RSUD Dr. H. Abdul Moeloek Bandar Lampung. Medical Journal of Lampung University. 2012;1(1):21-35.

Hidayat. Analisis pola kuman dan pola resistensi antibiotik di ruang icu dan ruang perinatologi rumah sakit umum daerah Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2013. Jurnal Medika Malahayati; 2016;3(1):1-14.

Mahmudah R, Soleha TU, Ekowati CN. Identifikasi methicillin-resistant staphylococcus aureus (mrsa) pada tenaga medis dan paramedis di ruang intensivecare unit (icu) dan ruang perawatan bedah rumah sakit umum daerah Abdul Moeloek. Medical Journal of Lampung University. 2013;2(4):70-78.

Kahuripan A, Andrajati R, Syafridani T. Analisis pemberian antibiotik berdasarkan hasil uji sensitivitas terhadap pencapaian clinical outcome pasien infeksi ulkus diabetik di RSUD DR. H. Abdul Moeloek Lampung. Pharmaceutical Sciences and Research (PSR). 2009;6(2):75-87.

Perkumpulan Endokrinologi Indonesia. Konsensus pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia 2015. Jakarta: PB Perkeni; 2015.

Jeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. 2003;361(9368):1545-51

BPS Provinsi Lampung. Jumlah pasien rawat inap menurut jenis penyakit 2014 [Internet]. 2015 Agustus 4 [disitasi 2020 Oktober 1. Diperoleh dari: https://lampung.bps.go.id/statictable/2015/08/04/223/jumlah-pasien-rawat-inap-menurut-jenis-penyakit-2014.html.

World Health Organitation. Thypoid [Internet]. [date unknown] [cited 2020 July 24th. Available from: https://www.who.int/health-topics/typhoid#tab=tab_1

Departemen Kesehatan RI. Laporan tahunan promkes tahun 2006. Jakarta: Depkes RI;2013.

Alba S, Bakker MI, Hatta M, Scheelbeek PFD, Dwiyanti R, Usman R, et al. Risk Factors of Typhoid Infection in the Indonesian Archipelago. PLOS ONE. 2016;11(6):1-14.

Mogasale V, Mogasale VV, Ramani E, Lee JS, Park JY, Lee KS, et al. Revisiting typhoid fever surveillance in low and middle income countries: lessons from systematic literature review of population-based longitudinal studies. BMC infectious Diseases. 2016 Jan 29;16(35): 1-12.

Purba AKR, Mariana N, Gestina A, Wulandari RR, Wijaya SH, Postma M. PIN98 National burden of sepsis in Indonesia: an analysis based on focal infection. Value in Health. 2019 Nov 1;22(3):S655

Anggriani Y, Restinia M, Mitakda VC, Rochsismandoko, Kusumaeni T. Clinical outcomes penggunaan antibiotik pada pasien infeksi kaki diabetik. Jurnal Sains Farmasi & Klinis. 2015;1(2):111-21.

Trisnawati SK, Setyorogo S. Faktor risiko kejadian diabetes melitus tipe II di Puskesmas Kecamatan Cengkareng Jakarta Barat tahun 2012. Jurnal Ilmiah Kesehatan. 2013;5(1):6-11.

Decroli E, Karimi J, Manaf A, Syahbuddin S. Profil ulkus diabetik pada penderita rawat inap di bagian penyakit dalam RSUP Dr. M. Djamil Padang. Majalah Kedokteran Indonesia. 2008;58(1):3-7.

Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman tata laksana pencegahan penyakit kardiovaskular pada perempuan. Edisi 1. Jakarta: PERKI; 2015.

Rajagopalan S. Serious infections in elderly patients with diabetes mellitus. Clinical Infectious Diseases. 2005 April 1;40(7):990-6.

Currie B, Ur E, Ransom T. Clinical practice guidelines: a global perspective. In: Ekoe JM, Rewers M, Williams R, zimmet P, editors. The epidemiology of diabetes mellitus. 2nd ed. UK: John willey & Sons, Ltd; 11 Sept 2008. p 641-55.

Rachmawati S, Fazeri RL, Norcahyanti I. Gambaran penggunaan antibiotik di bangsal penyakit dalam RSUD Bangil Kabupaten Pasuruan. Journal of Pharmaceutical Science and Clinical Research. 2020 Mar 26;5(1):12-21.

Carolina M, Widayati A. Evaluasi penggunaan antibiotika dengan metode DDD (defined daily dose pada pasien anak rawat inap di sebuah rumah sakit pemerintah di Yogyakarta periode Januari-Juni 2013. Media Farmasi. 2014 Mar;11(1):81-9.

Andriana S, Safitri I. Hasil peer review teman sejawat: studi penggunaan antibiotika pasien pneumonia anak di RS PKU Muhammadiyah Yoyakarta dengan metode Defined Daily Dose (DDD). Jurnal Ilmiah Ibnu Sina.2016;1(2):151-62.

Scholze K, Wenke M, Schierholz R, Groß U, Bader O, Zimmermann O, et al. The reduction in antibiotic use in hospitals: a retrospective single-center study on microbiological characteristics and mortality. Deutsches Arzteblatt International. Oct 2015;112(42):714–21. doi: 10.3238/arztebl. 2015: 0714.

Lestari PD, Utami ED, Suryoputri MW. Evaluasi penggunaan antibiotik di bangsal penyakit dalam RSUD Prof. Dr. Margono Soekarjo Purwokerto. 2018;6(1):20-8.

Sholih MG, Sudarjat H, Saula LS. Gambaran penggunaan antibiotik berdasarkan metode ATC/DDD dan DU 90% di salah satu puskesmas Karawang. Health Science Growth (HSG) Journal. 2019 Jul 31;4(1):31–7.

Sukmawati IGAND, Jaya MKA, Swastini DA. Evaluasi penggunaan antibiotik pada pasien tifoid rawat inap di salah satu rumah sakit pemerintah Provinsi Bali dengan metode gyssens dan atc/ddd. Jurnal Farmasi Udayana. 2020 Jun 26;IX(1):37-44.

Pusat Informasi Obat Nasional BPOM. Sefalosporin [Internet]. 2015 [diakses 2020 September 30]. Diperoleh dari: http://pionas.pom.go.id/ioni/bab-5-infeksi/51-antibakteri/512-sefalosporin-dan-antibiotik-betalaktam-lainnya/5121.

Mahmudah F, Sumiwi SA, Hartini S. Studi penggunaan antibiotik berdasarkan ATC/DDD dan DU 90% di bagian bedah digestif di salah satu rumah sakit di Bandung. Jurnal Farmasi Klinik Indonesia. 2016;5(4):293-8.

de With K, Allerberger F, Amann S, Apfalter P, Brodt H-R, Eckmanns T, et al. Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases. Infection. 2016 Apr 11;44:395–439.

Published
2021-02-23
How to Cite
1.
Dirga D, Khairunnisa S, Akhmad A, Setyawan I, Pratama A. Evaluasi Penggunaan Antibiotik pada Pasien Rawat Inap di Bangsal Penyakit Dalam RSUD. Dr. H. Abdul Moeloek Provinsi Lampung. jki [Internet]. 23Feb.2021 [cited 25Apr.2024];11(1):65-. Available from: http://ejournal2.litbang.kemkes.go.id/index.php/jki/article/view/3570