Penggunaan Antibakteri Golongan Carbapenem pada Pasien Dewasa Rawat Inap Sebuah Rumah Sakit Swasta di Surabaya
Abstract
Kasus resistensi terhadap carbapenem merupakan salah satu masalah kesehatan global. Penggunaan yang tidak bertanggung jawab secara luas, berulang, dan dalam jangka waktu yang panjang merupakan faktor yang menentukan terjadinya fenomena tersebut. Tujuan penelitian ini adalah memberikan gambaran penggunaan dan kesesuaian penggunaan carbapenem untuk beberapa penyakit infeksi pada sebuah rumah sakit swasta di Surabaya. Penelitian ini merupakan penelitian deskriptif dengan menggunakan data rekam medis pasien dewasa yang mendapatkan carbapenem selama periode Januari 2014–September 2014 sebagai bahan penelitian. Penggunaan carbapenem dinyatakan dalam defined daily dose (DDD). Proses analisis kesesuaian jenis, dosis, dan durasi pemberian antibiotik dilakukan dengan menggunakan pedoman terapi Infectious Disease Society of America (IDSA) terbaru sebagai pustaka utama dan Drug Information Handbook edisi 22 sebagai pustaka pendukung. Kesesuaian jenis antibiotik dibandingkan dengan hasil kultur juga dianalisis dalam penelitian ini. Sebanyak 255 data rekam medis pasien dewasa dianalisis dalam penelitian ini. Total penggunaan carbapenem selama periode pengamatan sebesar 1462,25 DDD. Densitas penggunaan carbapenem dapat diklasifikasikan rendah yaitu hampir 20% dari total pasien rawat inap per hari mendapat carbapenem (19,39 DDD/100 bed-days). Sebagian besar penggunaan carbapenem diberikan secara IV bolus. Terdapat 72,95% dan 59,52% penggunaan carbapenem yang dinyatakan sesuai berdasarkan analisis dengan menggunakan pedoman terapi dan hasil kultur, secara berturut-turut. Dengan mempertimbangkan profil penggunaan tersebut, carbapenem perlu digunakan secara lebih bertanggung jawab. Penelitian terkait profil resistensi patogen terhadap golongan carbapenem perlu dilakukan sebagai bahan evaluasi pengambilan kebijakan terkait penggunaan antibakteri golongan tersebut.
Kata kunci: Carbapenem, DDD, defined daily dose, drug utilization review
Carbapenem Utilization among Adults Inpatients in One Private Hospital in Surabaya
Carbapenem resistance is one of the most frightening health problems globally. What determines the occurrence of carbapenem resistance phenomenon is the widely, repeated, irresponsible utilization of carbapenem over a long period of time. This research was aimed to provide an overview of the carbapenem utilization and its appropriateness compared with the guidelines. This research was a descriptive research that analyzed medical record data of adult patients who used carbapenem from January to September 2014 in one private hospital in Surabaya. The carbapenem utilization was defined in defined daily dose (DDD). Identifying the appropriateness of antibiotics’ type, dosage regimen, and duration of treatment were conducted by using the newest Infectious Disease Society of America (IDSA) guidelines as the main reference and Drug Infomation Handbook 22th edition (2014) as the secondary reference. Moreover, the appropriateness of type of antibiotics used for each patient was also analyzed by comparing the actual dosage used with the microbiology culture results. There were 255 adult patient’s medical records used in the present research. The total amount of carbapenem utilization during the observation period was 1462.25 DDD. The density of carbapenem utilization could be considered as low, i.e. almost 20% of total inpatients per day being prescribed with carbapenem (19.39 DDD/100 bed-days). There were 72.95% and 59.52% carbapenem utilization which were defined appropriate based on the analysis using IDSA guidelines and bacteria culture results respectively. Considering the profile of antibiotics utilization in this hospital, the antibiotics prescribing pattern could be improved to a more responsible pattern. Further researches exploring the relationship between pathogen resistance and carbapenem consumption need to be conducted in relation to the consideration in making local hospital regulation regarding the use of antibiotics in the hospital settings.
Keywords: Carbapenem, DDD, defined daily dose, drug utilization review
Keywords
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DOI: https://doi.org/10.15416/ijcp.2017.6.4.267
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