Program Pengendalian Resistensi Antibiotik (PPRA) merupakan program wajib rumah sakit Indonesia sesuai Permenkes No. 8 tahun 2015. Rumkital dr. Ramelan Surabaya termasuk salah satu rumah sakit yang telah menerapkan PPRA. Tujuan penelitian ini adalah untuk mengetahui deskripsi kuantitatif-kualitatif pemakaian antibiotik, serta luaran klinis dan mikrobiologis yang teramati pascapencanangan penerapan PPRA di ICU Rumkital dr. Ramelan Surabaya. Desain penelitian adalah studi observasi cross-sectional yang dilakukan selama 3 bulan (Februari-Mei 2016) di ICU Rumkital dr. Ramelan. Deskripsi kuantitatif diamati menggunakan Days of Therapy (DOT/100 hari-pasien), deskripsi kualitatif menggunakan alur Gyssens. Pengamatan luaran klinis dilakukan terhadap infeksi nosokomial, mortalitas terkait infeksi, dan lama tinggal di ICU (Length of Stay/LOS). Pengamatan luaran mikrobiologis dilakukan terhadap pola penyebaran bakteri multiresisten. Hasil perhitungan jumlah konsumsi antibiotik didapatkan 151,63 DOT/100 hari-pasien. Penilaian kualitas antibiotik menunjukkan hasil 52,73% terapi tepat; 8,18% tidak tepat; 7,27% tanpa indikasi; 31,82% tidak tercapai kesepakatan antar penilai (κ=0,59; p<0,05). Infeksi nosokomial terbanyak yaitu Hospital Acquired Pneumonia (HAP)/Ventilator Associated Pneumonia (VAP), mortalitas terkait infeksi 44,68%; dan LOS rata-rata 7,17±1,9 hari (p<0,05). Belum ditemukan adanya insiden Methicillin-resistant Staphylococcus aureus (MRSA) ataupun Extended Spectrum Beta-Lactamase (ESBL), namun ditemukan dua kasus Multi Drug Resistant (MDR) Acinetobacter baumannii.

Background: Infrequent data exist on the frequency of bacterial co-infections and secondary infection among COVID-19-infected patients admitted to intensive care units (ICU). Objective: To describe the quantity and the quality of antimicrobial usage in COVID-19 with secondary infection, multiple drug resistance organisms and the outcome of antimicrobial treatment. Methods: This study applies observational design with a cross sectional approach. All the patients with laboratory-confirmed severe COVID-19 pneumonia who were discharged from the Intensive Care Unit (ICU) Dr. Ramelan Navy Hospital from February 1st to June 30th 2022 included. The quantity of antibiotics usage was assessed by counting the Defined Daily Dose (DDD). Result: During the study period, 126 patients were referred to the ICU for COVID-19 with severe pneumonia. There were 70.6% (89 patients) treated with antibiotics and 29.4% (37 patients) untreated with antibiotics. Quantitative analysis of 89 patients revealed that levofloxacin was the most common antibiotic prescribed with 43 DDD, followed by Meropenem and Cefoperazone-Sulbactam, which were 17.76 DDD and 16.87 DDD, respectively. Meanwhile, qualitative analysis resulted in 81 antibiotics (43.55%) being used appropriately. No indications of the use of antibiotics were found in 53 antibiotics (28.49%). Klebsiella pneumonia was the main pathogen identified in the blood, sputum. While E. Coli was found to be the main pathogen in urine. Conclusion: A high death rate in patients treated with antibiotics compared to patients not treated with antibiotics.