Kajian Penggunaan Antibiotik pada Neonatus Intensive Care Unit di Sebuah Rumah Sakit Pemerintah di Surabaya
Abstract
Penggunaan antibiotik menjadi salah satu terapi yang banyak diberikan pada bayi di Neonatal Intensive Care Unit (NICU). Penelitian ini ditujukan untuk mengetahui profil dan mengkaji biaya, ketepatan dan ketercampuran atau kompatibilitas penggunaan antibiotik pada pasien di NICU salah satu rumah sakit pemerintah di Surabaya dalam kurun waktu November–Desember 2015. Penelitian ini merupakan penelitian potong lintang yang dilakukan secara prospektif dengan memanfaatkan data rekam medis sebagai sumber data utama. Seluruh informasi yang diperoleh dari pasien NICU yang menggunakan antibiotik dan masuk dalam kriteria inklusi dan eksklusi dianalisis secara deskriptif. Total 32 orang pasien dilibatkan dalam penelitian ini. Penggunaan antibiotik terdiri dari 25 kali penggunaan antibiotik tunggal dan 14 kali penggunaan antibiotik kombinasi. Ampisilin merupakan antibiotik tunggal yang paling banyak digunakan, sedangkan penggunaan antibiotik kombinasi terbanyak adalah penggunaan kombinasi ampisilin dan gentamisin. Dari total seluruh pasien, hanya terdapat 13 pasien dengan diagnosis infeksi dan hanya 2 pasien (15,38%) yang mendapat terapi antibiotik yang tepat. Proses pergantian terapi didominasi oleh proses de-eskalasi yaitu sebesar 44,44%. Berdasarkan analisis kompatibilitas, terdapat banyak pencampuran sediaan antibiotik intravena yang tidak dapat diklasifikasikan compatible atau not compatible akibat tidak tersedianya informasi terkait kompatibilitasnya. Biaya penggunaan antibiotik yang harus dikeluarkan pasien rata-rata sebesar Rp265.252,00 (min–max= Rp16.100,00 s.d. Rp2.091.590,00). Ketepatan penggunaan antibiotik di ruang NICU perlu ditingkatkan sebagai upaya untuk meminimalkan risiko dampak negatif khususnya peningkatan biaya dan risiko resistensi.
Kata kunci: Biaya antibiotik, kajian penggunaan antibiotik, kompatibilitas, neonatal intensive care unit
Antibiotics Utilization Review in a Neonate Intensive Care Unit of a Public Hospital in Surabaya
Abstract
Antibiotic is frequently used in the Neonatal Intensive Care Unit (NICU). The aim of this study was to identify the usage pattern and to review the cost, appropriateness, and compatibility of antibiotics given to the patients in the NICU of one public hospital in Surabaya during November to December 2015. This was a cross-sectional study using medical record as the main source of the data. All information about eligible patients receiving antibiotics in the NICU was analysed descriptively. A total of 32 patients was involved in this study. The antibiotics utilization profile consisted of 25 single and 14 combination therapy. Ampicillin and ampicillin-gentamycin were found as the most frequently used in the single and combination therapy, consecutively. From all patients received antibiotics, 13 patients had confirmed with infections problem and only 2 patients (15.38%) received appropriate antibiotics therapy. From all therapeutic modification made, 44.44% was de-escalation. According to the compatibility analysis, lots of antibiotic intravenous admixtures in this research could not be clearly identified as compatible or not compatible because no information was available. The average cost of antibiotics per patient was IDR 265,252 (range IDR 16,100 to IDR 2,091,500). There is a need to optimize the use of antibiotics in the NICU in order to minimize the risk of adverse outcomes especially the increased cost and risk of resistance.
Keywords: Antibiotics utilisation review, compatibility, cost of antibiotics, neonatal intensive care unit
Keywords
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DOI: https://doi.org/10.15416/ijcp.2019.8.1.58
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