Impact of irrational antibiotic therapy to hospital cost of care of pneumonia in patients in Dr. Sardjito Hospital

https://doi.org/10.22146/acta%20interna.5002

Edi Sutrisno(1*)

(1) 
(*) Corresponding Author

Abstract


ABSTRACT
Background: The mortality rate from pneumonia remains very high, reaching 15% in the United States while in
Indonesia pneumonia is the second leading cause of death. Antibiotics improve outcomes in those with bacterial
pneumonia. Irrational antibiotic therapy impacts to bacteria resistance, potentially increasing side effects of drugs,
prolonged patient’s length of stay and higher total hospital costs.
Aim: This study aimed to improve the service quality by calculating the percentage of irrational antibiotic therapy
based on Gyssens workfl ow and the additional total of consumables antibiotics costs.
Methods: The study design was retrospective, including 57 pneumonia inpatients in internal medicine department
wards in Dr. Sardjito Hospital, from November 2011 to January 2012. Statistical analyses were conducted by
using Mann-Whitney U test.
Results: From 57 pneumonia inpatients, irrational antibiotic therapy reached 68,4% (39 of 57 patients).
Azithromycin was misused and overused antibiotic. Total excess cost of daily antibiotic were Rp 294,000.00
and consumables antibiotics were Rp 215,000.00
Conclusion: Irrational antibiotic therapy in pneumonia is associated with and an overall impacts on healthcare
costs.
Keywords: irrational antibiotic therapy, health-care cost, and customer satisfaction.

Full Text:

PDF


References

REFERENCES

Brooks, G. F., Butel, J. S., Morse, S. A. (2008).

Mikrobiologi Kedokteran, Penerbit Buku Kedokteran

EGC, Jakarta.

Brunton, L., Lazo, J. S., Parker, K. L., Buxton, Iain

L. O., dan Blumenthal, D. K., (2006). Goodman

and gilman the pharmacological basis of

therapeutics,edisi 11, the McGraw-Hill Companies,

Inc., USA, chapter 42.

Budiharto, M., Suryati, T., Tarigan, I.(2007) Anaisis

biaya obat untuk penyakit kebidanan rawat inap

rumah sakit ( sebelum dan selama krisis). Buletin.

Penelitian system kesehatan. Vol 10 3 Juli 2007:

-222.

Burgess, D. S. (2008). Antimicrobial Regimen

Selection, in JosephT, D., Robert L, T., Gary C,

Y., Gary R, M., Barbara G, W., and L, M. P. (Eds),

Pharmacotherapy: A Pathophysiologic Approach,

McGraw-Hill Company Inc., pp. 1731-1738.

Chamber, F.H.(2002). Antimicrobial Agents in

JG. Hardman, LE. Limbird, AG.Gilman, (Eds),

Table 3. Count of Rationality Antibiotic

Rationality Count Percentage (%)

Rasional (R) 18 31,6%

Irasional (I) 39 68,4%

Table 4. Cost of Antibiotics and Consumables Analysis

N Minimum Maximum Median ± SD P

Cost of AB ( IDR) 57 10.050,00 12.935.096,00 160.445,00 ± 32,00 0,354

Cost of HP (IDR) 57 220.633,80 9.531.362,00 824.060,00 ± 33,89 0,131

Cost of AB/days (IDR) 57 5.025,00 1.847.870,86 5.590,71 ± 36,56 0,328

Cost of HP/days (IDR) 57 35.095,00 943.638,25 31.094,50 ± 32,17 0,020

Edi Sutrisno, Riska Humardewayanti, Putut Bayupurnama

Pharmacological Basis of Therapeutics, 10th edition,

McGraw-Hill, New York, pp. 1143-1169

Cusini, A., Rampini, S, K., Bansal, V., Ledergerber,

B., Kuster, S, P., Ruef, C., Weber, R. (2010).

Different Patterns of Inappropriate Antimicrobial

Use in Surgical and Medical Units at a Tertiary Care

Hospital in Switzerland: A Prevalence Survey. PLoS

ONE 5(11): e14011

Goodman and Gilman. (2006). The Pharmacological

Basis of Therapeutics, 11th Ed, The McGraw-Hill

Companies, USA.

Goodman and Gilman. (2008). Manual of

Pharmacology and Therapeutics,The McGraw-

Hill Companies, USA, pp.707-715.

Greenwood, D., Finch, R., Davey, P., Wilcox,

M.(2007). Antimicrobial Chemotherapy 5th Edition,

Oxford University Press, New York, pp.183 – 193

Guidelines for the Management of adults with

Hospital-acquired, Ventilator-associated, and

Healthcare-associated Pneumonia. (2004).

American Thoracic Society Documents.

Gyssens, I. C. (2005). Audits for Monitoring the

Quality ofAntimicrobial Prescriptions, In: Gould, I

.M., Van der Meer, J .W .M.,eds. Antibiotic Policies:

Theory and Practice, Kluwer Academic/Plenum

Publishers, New York, chapter 12.

Harini, D., Sadjimin, T., Damanik, M. P.(2006). Cost

Effectiveness Kotrimoksazol dan Ampisilin pada

Penderita Infeksi Saluran Kemih.Tesis. Program Pasca

Sarjana Universitas Gajah Mada. Yogyakarta.

Holloway.(2004). Rational Use of Medicine. The

world medicines situation. WHO report.

Juwono, R., dan Prayitno, A., 2003, Terapi Antibiotik,

In: Aslam, dkk.,Farmasi Klinis, Penerbit PT Elex Media

KomputindoGramedia, Jakarta, pp.321-333.

Kuntaman, Paraton, H., 2011, Strategi pengendalian

resistensi antimikroba dalam Workshop 2011: Peran

aktif farmasis pada pengelolaan kasus infeksi dan

pengendalian penggunaan antibiotik, Tim PPRA,

HISFARSI dan IAI Jawa Timur, pp.12.

Mandell, L. A., Wunderink, R. G., Anzueto, A.,

Bartlett, J. G., Campbell, G. D., Dean, N. C., Dowell,

S. F., File, T. M., Musher, D. M., Niederman, M.

S., Torres, A., Whitney, C. G., 2007, Infectious

Diseases Society of America/American Thoracic

Society Consensus Guidelines on the management

of Community-Acquired Pneumonia in Adults.

Linical Infectious Diseases, 44: 27-72.

Munaf, S., Nattadiputra, S., 2009, Kumpulan Kuliah

Farmakologi, Penerbit Buku Kedokteran EGC,

Jakarta, pp. 3-15, pp. 599-607.

Nasronudin, 2011, Penyakit Infeksi di Indonesia

Solusi Kini dan Mendatang. Pusat Penerbitan dan

Percetakan Unair. Surabaya.

Nelwan, R.H.H.,2006, Pemakaian Antimikroba

Secara R,asional di Klinik dalam buku Ajar Ilmu

penyakit Dalam Jilid III, edisi IV, Pusat Penerbitan

Departemen Ilmu Penyakit Dalam FKUI Jakarta,

pp.1722-1723

Ningrum, I.,2008, Evaluasi Penggunaan Antibiotik

Berdasarkan Kriteria Gyssens Pasien Rawat Inap

Kelas III di Bagian Ilmu Penyakit Dalam RSUP

Dr.Kariadi Periode Agustus – Desember 2008, Skripsi,

Fakultas Kedokteran Universitas Diponegoro, p.1.

Puspita, 2011, Evaluasi rasionaitas penggunaan

antibiotik untuk terapi infeksi pada pasien rawat

inap di Bangsal Penyakit Dalam RSUP Dr. Sardjito.

Tesis. Program Pasca Sarjana Universitas Gajah

Mada. Yogyakarta.

Puteri, T. D., 2012, Analisis biaya penggunaan

antibiotikpada pasien pneumonia di instalasi rawat

inap anak RSUP Dr. M. Djamil Padang.

Raveh, D., Muallem-Zilcha, E., Greenberg, A.,

Wiener-Well, Y. Schlesinger, Y., Yinnon, A.M.,

, Prospective drug utilization evaluation of

three broad spectrum antimicrobials : cefepime,

piperacillin-tazobactam and meropenem, Q J Med,

: 397–406

Russell D.A., 2004, Hugo and Russel’s

Pharmaceutical Microbiology 7th edition, edited

by Stephen Denyer, Norman A. Hodges, Sean P.

Gorman, Blackwell, United Kingdom

Sastramihardja, H. S., 1997, Penggunaan Antibiotika

yang Rasional, editor, Muchtaruddin Mansyur, IDI,

Jakarta, pp. 1-4.

Shah, B. A., Ahmed, W., Dhobi, G. N., Shah,

N. N., Khursheed, S. Q., Haq, I., 2010, Validity

of Pneumonia Severity Index and CURB-65

Severity Scoring Systems in Community Acquired

Pneumonia in an Indian Setting. Indian J Chest Dis

Allied Sci, 52: 9-17.

Smyth, E., 2009, Guidelines for antimicrobials

stewardship in Hospital in Irland, SARI Hospital

antimicrobials working group, Health Protection

Surveillance Centre, Dublin

Soedarsono, 2010, Pneumonia in Wibisono, M.J.,

Winariani, Hariadi, S., Buku Ajar Penyakit Paru.

Departemen Ilmu Penyakit Paru FK- UNAIR. Edisi

; 149-79.

Tünger, O., Dinç G., Ozbakkaloglu, B., Atman, U,

C., Algun, U., 2000, Evaluation of rational antibiotic

use, International Journal of Antimicrobial Agents,

: 131–135

White, R. L., 2005, How Do measurements of Antibiotic

Consumtion Relate to Antibiotic Resistance?, In

Antibiotic Policy : Theory and Practice, Edited by

Gould and van de Meer, Kluwer academic/Plenum

Publisher, New York, pp.75 – 98

WHO, 2003, Introduction to Drug Utilization

Research/WHO Collaborating Centre for Drug

Statistics and Methodology, WHO Collaborating

Centre for Drug Statistics and Methodology, WHO

Collaborating Centre for Drug Utilization Research

and Clinical Pharmacological Service, WHO, Oslo,

Norway.

WHO, 2004, Practical guidelines for Infection

control in Health Care Facilities, WHO Regional

Offi ce for South East Asia, New Delhi.



DOI: https://doi.org/10.22146/acta%20interna.5002

Article Metrics

Abstract views : 533 | views : 420

Refbacks

  • There are currently no refbacks.




Copyright (c) 2013 Acta Interna The Journal of Internal Medicine

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Acta Interna The Journal of Internal Medicine Indexed by:

 

 Indonesia Onesearch Google Scholar IPI Indonesian Publication Index

 website statistics View My Stats  

 

 

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.