Rasionalitas Terapi Antibiotik Empiris pada Pasien Geriatri dengan Community-Acquired Pneumonia di RS Mardi Rahayu


Kristi Noviana Aryadi(1), Zullies Ikawati(2*), Probosuseno Probosuseno(3)

(1) Fakultas Farmasi Universitas Gadjah Mada, Yogyakarta
(2) Department of Pharmacology, Faculty of Pharmacy, Universitas Gadjah Mada
(3) Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author


Community-acquired Pneumonia (CAP) is an acute infectious disease that affects the tissues (lungs) precisely in the alveoli acquired outside the hospital. The incidence of pneumonia increases with age due to changes in physiologic and immunological status associated with aging and the presence of comorbidities in old age. Pneumonia is the biggest infectious disease in Mardi Rahayu Hospital from 2020 to 2022. Inappropriate selection of empiric antibiotics causes antibiotic resistance and their prolonged use can increase the length of stay so that the cost of treatment increases. Rationale analysis of the use of specific empiric antibiotics in geriatric patients with CAP at Mardi Rahayu Hospital has never been carried out. This study aims to determine the rationality of empirical antibiotic therapy in geriatric patients with CAP. This study used a descriptive and analytic observational design with a cross-sectional method. Analysis of the rationality of empirical antibiotic therapy using the Gyssens method. The results showed that the number of geriatric patients diagnosed with CAP who were hospitalized at Mardi Rahayu Hospital from January to December 2022 who met the inclusion criteria was 139 patients with a total of 158 antibiotic regimens. The results of the rationality analysis showed that as many as 95 antibiotic regimens (60.1%) were included in the 0 (zero) category, which means rational use of antibiotics. Irrational use of antibiotics occurred in 63 regimens in category IV-A as 40 cases (25.3%), IV-B as 9 cases (5.7%), IV-C as 2 cases (1.2%), III- A as 9 cases (5.7%), III-B as 20 cases (12.6%) and II-A as 2 cases (1.2%).


antibiotik; geriatri; empiris; pneumonia; rasionalitas

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  1. Perhimpunan Dokter Paru Indonesia. Pneumonia Komunitas : Pedoman Diagnosis dan Penatalaksanaan di Indonesia. Published online 2014.
  2. Setiati, S., Alwi, I., Sudoyo, A.W., Simadibrata, M., Setiyohadi, B., Syam, A.F. Buku Ajar Ilmu Penyakit Dalam. 6th ed.; 2014.
  3. Mulyana, R. Terapi Antibiotika Pada Pneumonia Usia Lanjut. Jurnal Kesehatan Andalas. 2019;8:172-177.
  4. Beckett CL, Harbarth S, Huttner B. Special considerations of antibiotic prescription in the geriatric population. Clinical Microbiology and Infection. 2015;21(1):3-9. doi:10.1016/j.cmi.2014.08.018
  5. Morimoto K, Suzuki M, Ishifuji T, et al. The Burden and Etiology of Community-Onset Pneumonia in the Aging Japanese Population: A Multicenter Prospective Study. Viboud C, ed. PLoS ONE. 2015;10(3):e0122247. doi:10.1371/journal.pone.0122247
  6. Lupisan S, Suzuki A, Macalalad N, et al. Etiology and epidemiology of community-acquired pneumonia in adults requiring hospital admission: A prospective study in rural Central Philippines. International Journal of Infectious Diseases. 2019;80:46-53. doi:10.1016/j.ijid.2018.12.005
  7. Ramirez JA, Wiemken TL, Peyrani P, et al. Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality. Clinical Infectious Diseases. 2017;65(11):1806-1812. doi:10.1093/cid/cix647
  8. Ghia CJ, Rambhad GS. Systematic review and meta-analysis of comorbidities and associated risk factors in Indian patients of community-acquired pneumonia. SAGE Open Medicine. 2022;10:205031212210954. doi:10.1177/20503121221095485
  9. Almirall J, Serra-Prat M, Bolibar I. Risk Factors for Community-acquired Pneumonia in Adults: A Review. Clinical Pulmonary Medicine. 2016;23(3):99-104. doi:10.1097/CPM.0000000000000120
  10. Chou CY, Wang SM, Liang CC, et al. Risk of Pneumonia Among Patients With Chronic Kidney Disease in Outpatient and Inpatient Settings: A Nationwide Population-Based Study. Medicine. 2014;93(27):e174. doi:10.1097/MD.0000000000000174
  11. Sharma L, Losier A, Tolbert T, Dela Cruz CS, Marion CR. Atypical Pneumonia. Clinics in Chest Medicine. 2017;38(1):45-58. doi:10.1016/j.ccm.2016.11.011
  12. Kementerian Kesehatan. Peraturan Menteri Kesehatan Republik Indonesia Nomor 2406/MENKES/PER/XII/2011 tentang Pedoman Umum Penggunaan Antibiotik. Published online 2011.
  13. Marik PE, Taeb AM. SIRS, qSOFA and new sepsis definition. J Thorac Dis. 2017;9(4):943-945. doi:10.21037/jtd.2017.03.125
  14. Avent ML, McCarthy KL, Sime FB, et al. Evaluating Mono- and Combination Therapy of Meropenem and Amikacin against Pseudomonas aeruginosa Bacteremia in the Hollow-Fiber Infection Model. Khursigara CM, ed. Microbiol Spectr. 2022;10(3):e00525-22. doi:10.1128/spectrum.00525-22
  15. Russo A, Bassetti M, Bellelli V, et al. Efficacy of a Fosfomycin-Containing Regimen for Treatment of Severe Pneumonia Caused by Multidrug-Resistant Acinetobacter baumannii: A Prospective, Observational Study. Infect Dis Ther. 2021;10(1):187-200. doi:10.1007/s40121-020-00357-8
  16. Vedamurthy A, Rajendran I, Manian F. Things We Do for No Reason TM : Routine Coverage of Anaerobes in Aspiration Pneumonia. Journal of Hospital Medicine. 2020;15(12):754-756. doi:10.12788/jhm.3506
  17. Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical Infectious Diseases. 2016;63(5):e61-e111. doi:10.1093/cid/ciw353
  18. Olson G, Davis AM. Diagnosis and Treatment of Adults With Community-Acquired Pneumonia. JAMA. 2020;323(9):885. doi:10.1001/jama.2019.21118
  19. Ashley C, Dunleavy A. The Renal Drug Handbook. 0 ed. CRC Press; 2017. doi:10.1201/9781315379456
  20. Aljufri AQ. Rasionalitas Terapi Antibiotik Empiris Terhadap Pasien Dengan Pneumonia Di Instalasi Rawat Inap RSUP Dr. Kariadi Semarang. Thesis. Universitas Gadjah Mada; 2020.
  21. Tambun SH. Evaluasi Luaran Klinis Terapi Antibiotik Pada Pasien Anak Dengan Community Acquired Pneumonia Di Rawat Inap RSUP Dr. Sardjito Yogyakarta. Thesis. Universitas Gadjah Mada; 2019.

DOI: https://doi.org/10.22146/jmpf.86071

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