Evaluation of the use of antibiotics using the anatomical therapeutic chemical/defined daily dose and Gyssens methods in pneumonia patients at a tertiary care general hospital in Medan

Abstract

Background: The impact of irrational antibiotic usage in pneumonia patients is an increase in resistance, an increase in drug side effects, and a failure of therapy that causes patients' health to deteriorate, lowering their quality of life and raising their treatment costs. The primary objective of this study is to assess the extent to which antibiotics are being used rationally in the inpatient facility of a private tertiary care hospital located in Medan. Methods: The present study employs an observational design with a prospective cross-sectional approach, carried out within the timeframe of September to November 2022. The evaluation of antibiotic utilization was conducted utilizing the anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology and the Gyssens methodology. Results: The findings of the study indicate that a significant proportion of individuals diagnosed with pneumonia fell between the age range of 46 to 55 years, comprising 23.4% of the overall patient population. Moreover, the male gender was found to be the most prevalent, accounting for 55.81% of the 278 patients who satisfied the inclusion criteria. The findings from the evaluation of antibiotic utilization, employing the ATC classification system and DDD methodology, yielded a rate of 145.72 DDD per 100 days of care. Ceftriaxone exhibited the highest value, reaching 87.59 DDD/100 days of treatment. The evaluation of the Gyssens approach yielded a total of 254 patients who were administered antibiotics in an appropriate manner (category 0), while 24 patients were found to have received unsuitable antibiotics (categories I-VI). Conclusions: Based on the findings of this study, it can be inferred that the utilization of antibiotics within the hospital under investigation remains inadequate in terms of both quantity and quality.