Bedah bersih terkontaminasi merupakan prosedur bedah yang dilakukan pada traktus bilier, traktus urinarius, respiratorius dan digestif, reproduksi kecuali ovarium atapun operasi tanpa disertai kontaminasi yang nyata. Bedah bersih terkontaminasi memiliki potensi terjadinya infeksi sebesar 3-11% untuk mencegah dan mengatasi terjadinya infeksi diperlukan pemberian antibiotik. Penelitian ini bertujuan untuk mengevaluasi penggunaan antibiotik dalam satuan Defined Daily Dose (DDD)/100 patient-days pada pasien bedah bersih terkontaminasi di RS Bhayangkara Surabaya. Metode penelitian dilakukan secara retrospektif observasional pada pasien rawat inap bedah dalam periode 1 Januari-31 Desember 2020. Hasil penelitian didapatkan 40 data medis kesehatan pasien yang memenuhi kriteria inklusi dan eksklusi. Total nilai DDD/100 patient-days antibiotik profilaksis tertinggi adalah ceftriaxone 25 DDD/100 patient-days, sedangkan antibiotik terapi yang paling tinggi adalah amoxicillin 38,35 DDD/100 patient-days. Antibiotik yang termasuk dalam segmen DU 90% pada penggunaan antibiotik profilaksis adalah ceftriaxone, cefazolin, dan amoxicillin; sedangkan untuk antibiotik terapi adalah amoxicillin, ceftriaxone, metronidazole, dan cefadroxil. Kesimpulan dari penelitian ini adalah penggunaan antibiotik pada bedah bersih terkontaminasi tinggi dan jenis antibiotik yang paling banyak digunakan adalah antibiotik golongan sefalosporin generasi 3 (ceftriaxone) yang spektrum antibakterinya lebih luas daripada antibiotik golongan sefalosporin generasi 2 (cefazolin).Kata Kunci: DDD/100 patient-days, Bedah Bersih Terkontaminasi, AntibiotikClean-contaminated surgery is a surgical procedure performed on the biliary tract, urinary tract, respiratory and digestive tracts, reproduction except for the ovaries or surgery with no contamination encountered. This procedure has a potential infection in the range of 3-11%, therefore it is necessary to give antibiotics to prevent and treat the possibility of infections. This study was to evaluate the use of antibiotics using the Defined Daily Dose (DDD)/100 patient-days in clean-contaminated surgical patients at Bhayangkara Hospital Surabaya. Data was collected retrospectively observational in surgical inpatients from 1st January-31st December 2020. Total samples 40 met the inclusion and exclusion criteria. The highest total DDD prophylactic antibiotic value was ceftriaxone 25 DDD/100 patient-days. On the other hand, the highest therapeutic antibiotic was amoxicillin 38.35 DDD/100 patient-days. The antibiotics included in the 90% DU segment in the use of prophylactic antibiotics were ceftriaxone, cefazolin, and amoxicillin. Meanwhile, for therapeutic antibiotics, namely amoxicillin, ceftriaxone, metronidazole, and cefadroxil. The use of antibiotics in clean surgery is high and the type of antibiotic that is most widely used is the third generation cephalosporin antibiotic (ceftriaxone) whose antibacterial spectrum is wider than the second generation cephalosporin antibiotic (cefazolin).

Background: COVID-19 is an infectious disease caused by a new type of virus named SARS-CoV-2. There is still no specific treatment for COVID-19; the antibiotic is used for therapy and to prevent severe disease, so the increasing use of antibiotics in COVID-19 patients will lead to a detrimental impact and the risk of antibiotic resistance. Purpose: This study aims to analyze antibiotic use frequency and determine the number of DDD per 100 bed-days in July – December 2020 at Bhayangkara Hospital Surabaya. Methods: This research was a descriptive study with a retrospective study design conducted at Bhayangkara Hospital Surabaya in May – June 2021. The data were collected from 94 medical records, inclusion criteria: all ages; asymptomatic, mild, and moderate categories; all hospitalized patients in July-December 2020 who received antibiotics; the exclusion criteria: non-confirmed COVID-19 patients who had comorbidities and received antibiotics; the patient who died. The variables: frequency of antibiotic use with calculating the number of DDD/100 bed-days and percentage of COVID-19 patients who received antibiotics during hospitalization. Results: The frequency of antibiotic use in asymptomatic, mild, and moderate COVID-19 patients: 86.56 DDD/100 bed-days, the most antibiotic use was azithromycin at 50.42 DDD/100 bed-days and Levofloxacin at 22.70 DDD/100 bed-days. All asymptomatic, mild, and moderate COVID-19 patients (100%) at Bhayangkara Hospital Surabaya were treated with antibiotics, whereas the condition of patients was 5.32% asymptomatic, 48.94% mild, and 45.74% moderate. Conclusion: There is overuse of antibiotics in asymptomatic, mild and moderate COVID-19 patients at Bhayangkara Hospital Surabaya.

The clinical manifestations associated with COVID-19 disease is mainly due to a dysregulated host response related to the overexpression of inflammatory markers. Until recently, only remdesivir had gained FDA approval for COVID-19 hospitalized patients and there are currently no evidence-based therapeutic options or options for prevention of complications that have been established. Some medical treatments such as antivirals, antibacterials, antithrombotics, antipyretics, corticosteroids, interleukin inhibitors, monoclonal antibodies, convalescent plasma, immunostimulants, and vitamin supplements have been utilized. However, there are limited data to support their effectiveness. Hence, this study was attempted to identify and evaluate the effectiveness of antibacterials and antivirals used for COVID-19 using a retrospective cross-sectional approach based on the medical records of adult patients in four hospitals. The number of antibacterials was calculated in defined daily dose (DDD) per 100 bed-days unit. Both mixed-logit regression and analysis of covariance were used to determine the effectiveness of the aforementioned agents in relation to COVID-19 outcome and patients’ length of stay. The model was weighed accordingly and covariates (e.g., age) were considered in the model. Heart disease was found to be the most common pre-existing condition of COVID-19 hospitalized patients in this study. Azithromycin, an antibacterial in the Watch category list, was used extensively (33–65 DDD per 100 bed-days). Oseltamivir, an antiviral approved by the FDA for influenza was the most prescribed antiviral. In addition, favipiravir was found to be a significant factor in improving patients’ COVID-19 outcomes and decreasing their length of stay. This study strongly suggests that COVID-19 patients’ received polypharmacy for their treatment. However, most of the drugs used did not reach statistical significance in improving the patients’ condition or decreasing the length of stay. Further studies to support drug use are needed.

Introduction: Corona Virus Disease-2019 (COVID-19) is divided into five degrees that are asymptomatic, mild, moderate, severe and critical. Recently, Favipiravir known as off-label antivirals for COVID-19 that inhibits RNA-dependent RNA polymerase (RdRp) and is administered orally 2x1600 mg as loading dose and 2x600 mg as a maintenance dose. Methods: This observational retrospective study aims to determine effectiveness (PCR/Rapid Ag, temperature, respiratory rate, oxygen saturation, and chest X-ray) and side effects (digestive, uric acid, liver, blood, glucose, and lipids profile) of Favipiravir in mild and moderate COVID-19; which inclusion criteria were Favipiravir (5-10 days); a group of antibacterials: Azithromycin (therapy A), Levofloxacin (therapy B), and combination (therapy C); vitamins, minerals, symptomatic and comorbid therapy; and Fondaparinux used in moderate degree then described quantitatively. Results: This study obtained 47 HMR dominated by males (55%), aged 19-30 years (36%), cough symptoms (72,3%), and no comorbid status (70.2%). Favipiravir (6-7 days) is effective for mild and moderate degree in all effectiveness parameters with average length in mild degree was 6-12 days and moderate degree was 8-13 days. Possible interaction with Paracetamol was found. Most side effects were diarrhea and no significant side effects were found on liver profile (AST and ALT), glucose profile, and blood profile (leukocytes and erythrocytes). Conclusions: This result suggests that increasing collaboration of pharmacists with other healthcare in monitoring the use of Favipiravir related to interactions, uric acid, and lipid profiles, also effects in patients under 18 years, men, and elderly is important.