Evaluasi Ketepatan Antibiotik pada Pasien Sepsis

Ambar Yunita Nugraheni(1), Mahyastuty Shintya Putri(2*), Adi Yusron Saputro(3)

(1) Fakultas Farmasi Universitas Muhammadiyah Surakarta
(2) Muhammadiyah University of Surakarta
(3) Fakultas farmasi Universitas Muhammadiyah Surakarta
(*) Corresponding Author

Abstract

The administration of early intravenous antibiotics was one of the fundamental procedures in sepsis. Inappropriate of antibiotics in septic patients has an impact on mortality and prolongs treatment. The purpose of this study was to evaluate the appropriateness of antibiotics therapy in hospitalized sepsis patients in Central Java based on the parameters right indication, right patient, right drug, and the right dose. This study was observational. Data collected retrospectively and analyzed descriptively. Sampling was done by purposive sampling. The inclusion criteria were inpatients diagnosed with sepsis who received antibiotics therapy with complete medical record data. The exclusion criteria were patients who died of sepsis. Antibiotics analyzed using the DIH 25th edition 2016, IONI 2014, Tata Laksana Sepsis Pada Anak IDAI 2016, Neofax 2014, Kepmenkes PNPK Tata Laksana Sepsis 2017, PPK RS, and SHC Antimicrobial Dosing 2017. Based on data from 108 patients who fulfilled the inclusion criteria obtained results right indication 100%, right patient 97.22%, right drug 90.74%, and the right dose 48.15%. The most used antibiotic was a combination of ampicillin and gentamicin (41.67%), while the single antibiotic was ceftriaxone (12.96%).

Keywords

antibiotic; sepsis; inpatient

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References

Abdullah, Ramatillah D.L. and Eff A.R., 2015. Drug Related Problems that Occurred in Patient Sepsis Macrovascular Disease Complications General Hospital Treatment Room Central of the Army (Army Hospital) Gatot Subroto. Global Journal of Medical Research, 15 (3), 10–14.

American Pharmacist Association, 2016. Drug Information Handbook: A Clinically Relevant Resource for All Healthcare Proffessionals 25th Edition. Lexicomp. Philadelphia.

Astutik A.W., Annisa N., Rusli R. and Ibrahim A., 2017. Kajian Kesesuaian Pemilihan Antibiotik Empiris pada Pasien Sepsis di Instalasi Rawat Inap RSUD Abdul Wahab Sjahranie Samarinda. Proceeding of the 5th Mulawarman Pharmaceuticals Conferences Fakultas Farmasi Universitas Mulawarman Samarinda, pp. 38–47.

Azaria A., 2018. Pola Penggunaan Antibiotik pada Pasien Sepsis Rawat Inap Penyakit Dalam RSUP dr. M. Djamil Padang Tahun 2017. Skripsi. Fakultas Kedokteran. Universitas Andalas. Padang.

Baxter K., Towers K., Fowlie K., Patel H., McFarlane A.M.G., Callachand N., Corbett T.F., Donnelly J., Villén B.G. and Hossin B., 2016. BNF for Children September 2016–2017. Pharmaceutical Press. London.

Blair Sarbacker G. and Sarbacker L.C., 2012. Empiric Antimicrobial Management of Sepsis. U.S. Pharmacist, 37 (8).

Badan POM RI, 2014. Informatorium Obat Nasional Indonesia (IONI). Badan Pengawas Obat dan Makanan Republik Indonesia. Jakarta.

Budi S., Ikawati Z., Dwiprahasto I. and Nuryastuti T., 2017. Evaluasi Drug Related Problems (DRPs) Antibiotik pada Pasien Sepsis di Rumah Sakit di Yogyakarta. Jurnal Ilmu Kefarmasian Indonesia, 15 (1), 43–49.

Chiumello D., Gotti M. and Vergani G., 2017. Clinical Review: Paracetamol in Fever in Critically Ill Patients - An Update. Journal of Critical Care, 38, 245–252.

Deck D.H. and Winston L.G., 2012. Antibiotik Beta-Laktam & Aktif Dinding & Membran Sel Lainnya, Dalam Pendit, B. U., ed. Farmakologi Dasar dan Klinik Edisi 12 Vol. 2. Buku Kedokteran EGC. Jakarta., p. 900.

Estiningsih D., Puspitasari I. and Nuryastuti T., 2016. Identifikasi Infeksi Multidrug-Resistant Organisms (MDRO) pada Pasien yang Dirawat di Bangsal Neonatal Intensive Care Unit (NICU) Rumah Sakit. Jurnal Manajemen dan Pelayanan Farmasi, 6 (3), 243–248.

Eyler R.F. and Shvets K., 2019. Clinical Pharmacology of Antibiotics. Clinical Journal of the American Society of Nephrology, 14, 1080–1090.

Ferrer R., Martin-Loeches I., Phillips G., Osborn T.M., Townsend S., Dellinger R.P., Artigas A., Schorr C. and Levy M.M., 2014. Empiric Antibiotic Treatment Reduces Mortality in Severe Sepsis and Septic Shock From The First Hour: Results From a Guideline-Based Performance Improvement Program. Critical Care Medicine, 42 (8), 1749–1755.

Halisanti O., 2017. Hubungan Antara Sepsis Neonatorum dengan Terjadinya Ikterus Neonatorum di RSUD Karanganyar. Skripsi. Fakultas Kedokteran. Universitas Muhammadiyah Surakarta. Surakarta.

Haryani S. and Apriyanti Y.F., 2016. Evaluasi Terapi Obat pada Pasien Sepsis Neonatal di Ruang Perinatologi RSUP Fatmawati Januari–Februari Tahun 2016. Journal of Fatmawati Hospital.

Hidayati, Arifin H. and Raveinal, 2016. Kajian Penggunaan Antibiotik pada Pasien Sepsis dengan Gangguan Ginjal. Jurnal Sains Farmasi & Klinis, 2 (2), 129–137.

Ikatan Dokter Anak Indonesia, 2016. Konsensus Diagnosis dan Tata Laksana Sepsis pada Anak. Badan Penerbit Ikatan Dokter Anak Indonesia. Jakarta.

Kardana I.M., 2011. Pola Kuman dan Sensitifitas Antibiotik di Ruang Perinatologi. Sari Pediatri, 12 (6), 381–385.

Kepmenkes, 2017, Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/342/2017 tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Sepsis, Jakarta.

Lueangarun S. and Leelarasamee A., 2012. Impact of Inappropriate Empiric Antimicrobial Therapy on Mortality of Septic Patients with Bacteremia: A Retrospective Study.

MacDougall C. and Chambers H.F., 2011. Aminoglycosides, Dalam Brunton, L. L., ed. Goodman & Gilman’s The Pharmacological Basis of Therapeutics 12th Edition. The McGraw-Hill Companies, Inc., San Diego. p. 1505.

Mentari R., 2019. Evaluasi Penggunaan Antibiotik pada Pasien Sepsis di Instalasi Rawat Inap RSUD Pandan Arang Boyolali Tahun 2018 dengan metode Gyssens. Skripsi. Fakultas Farmasi. Universitas Setia Budi. Surakarta.

Najib K.S., Saki F., Hemmati F. and Inaloo S., 2013. Incidence, Risk Factors and Causes of Severe Neonatal Hyperbilirubinemia in South of Iran (Fars Province). Iranian Red Crescent Medical Journal, 15 (3), 260–263.

Napolitano L.M., 2018. Sepsis 2018: Definitions and Guideline Changes. Surgical Infections, 19 (2), 117–125.

Oppert M., Engel C., Brunkhorst F.-M., Bogatsch H., Reinhart K., Frei U., Eckardt K.-U., Loeffler M. and John S., 2008. Acute Renal Failure in Patients with Severe Sepsis and Septic Shock - A Significant Independent Risk Factor for Mortality: Results from The German Prevalence Study. Nephrology Dialysis Transplantation, 23 (3), 904–909.

Oshima T., Kodama Y., Takahashi W., Hayashi Y., Iwase S., Kurita T., Saito D., Yamaji Y. and Oda S., 2015. Empiric Antibiotic Therapy for Severe Sepsis and Septic Shock, Surgical Infections, 20 (10), 1–7.

Rahmantika F., Sari I.P. and Wahyono D., 2016. Identifikasi Infeksi Multidrug-Resistant Organisms (MDRO) pada Pasien yang Dirawat di Bangsal Pediatric Intensive Care Unit (PICU) RSUP dr. Soeradji Tirtonegoro Klaten Periode Januari 2013-Desember 2015. Thesis. Fakultas Farmasi. Universitas Gadjah Mada. Yogyakarta.

Rhodes A., Evans L.E., Alhazzani W., Levy M.M., Antonelli M., Ferrer R., Kumar A., Sevransky J.E., Sprung C.L., Nunnally M.E., Rochwerg B., Rubenfeld G.D., Angus D.C., Annane D., Beale R.J., Bellinghan G.J., et al., 2017. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Critical Care Medicine, 45 (3), 486–552.

Rukmana R.W., 2018. Evaluasi Rasionalitas Penggunaan Antibiotik pada Pasien Sepsis di Intensive Care Unit (ICU) RSUD dr. Moewardi Surakarta Tahun 2016-2017. Skripsi. Fakultas Farmasi. Universitas Muhammadiyah Surakarta. Surakarta.

Saraswati D.D., Pudjiadi A.H., Djer M.M., Supriyatno B., Syarif D.R. and Kurniati N., 2014. Faktor Risiko yang Berperan pada Mortalitas Sepsis. Sari Pediatri, 15 (5), 281–288.

Stanford Antimicrobial Safety and Sustainability Program, 2017. Stanford Health Care Antimicrobial Dosing Reference Guide. Stanford Medicine. Stanford.

Tazami R.M., Mustarim and Syah S., 2013. Gambaran Faktor Risiko Ikterus Neonatorum pada Neonatus di Ruang Perinatologi RSUD Raden Mattaher Jambi Tahun 2013. Jambi Medical Journal, 1 (1).

Truven Health Analytics, 2014. Micromedex Neofax Essentials 2014. Truven Health Analytics. Greenwood Village.

Turnidge J., 2003. Impact of Antibiotic Resistance on The Treatment of Sepsis. Scandinavian Journal of Infectious Diseases, 35, 677–682.

van Vught L.A., Scicluna B.P., Wiewel M.A., Hoogendijk A.J., Klouwenberg P.M.C.K., Ong D.S.Y., Cremer O.L., Horn J., Franitza M., Toliat M.R., Nürnberg P., Bonten M.M.J., Schultz M.J. and van der Poll T., 2017. Association of Gender With Outcome and Host Response in Critically Ill Sepsis Patients. Critical Care Medicine, 20 (30), 1–9.

Wardani I.S., 2017. Tatalaksana Sepsis Berat pada Pasien Lanjut Usia. Jurnal Kedokteran Unram, 7 (4), 33–39.

Yulianasari M., 2019. Evaluasi Penggunaan Antibiotik secara Kualitatif pada Pasien Sepsis di Instalasi Rawat Inap RSUD dr. Soediran Mangun Sumarso Wonogiri Tahun 2016-2018 dengan metode Gyssens. Skripsi. Fakultas Farmasi. Universitas Setia Budi. Surakarta.

Zarbock A., Gomez H. and Kellum J.A., 2014. Sepsis-Induced Acute Kidney Injury Revisited: Pathophysiology, Prevention and Future Therapies. Current Opinion in Critical Care, 20 (6), 588–595.

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