Evaluasi Penggunaan Antibiotik pada Pasien Tifoid Rawat Inap di Salah Satu Rumah Sakit Pemerintah Provinsi Bali dengan Metode Gyssens dan ATC/DDD

Abstract

Typhoid is a global health problem especially in developing countries, one of which is in Indonesia. The incidence of antibiotic resistance in typhoid therapy can occur due to inappropriate use of antibiotics. This study aims to determine patterns of antibiotic use as well as the quality and quantity of antibiotic use in typhoid therapy in one of the provincial government hospitals in Bali. This study was an observational study conducted retrospectively which was analyzed using the Gyssens and ATC/DDD methods. The research data were taken from the medical records of patients in the January-December 2019 period that met the inclusion criteria. The results showed that of the 40 total antibiotics prescribing, ceftriaxone was the most widely used antibiotic for typhoid therapy. The quality of antibiotic use as much as 40% is stated rational (category 0), while the other 60% is irrational (categories I-VI) which includes the use of antibiotics with incorrect interval of administration (IIB; 5%), the use of antibiotics that is too long (IIIA; 40%), the use of antibiotics that are too short (IIIB; 5%), there are other antibiotics that are more effective (IVA; 5%), and there are other antibiotics that are less toxic/safer (IVB; 5%). The quantity of antibiotic use was stated more than WHO standards which includes the use of ceftriaxone at 83.80 DDD/100 patient days; levofloxacin at 27.47 DDD/100 patient days; and azithromycin at 3.52 DDD/100 patient days. The results of this study are expected to be a consideration for the hospital as a material for evaluation and improvement in order to improve the rationality of antibiotic use.