Analysis of Antibiotics on Patients Surgery, before and after Used Guidelines for Antibiotics (PPAB)

Abstract

ABSTRAK Sejak tahun 2011 World Health Organisasi (WHO) dan Komite Pengedalian Resisten Antimikroba (KPRA) sejak 2015, untuk menetapkan kebijakan penggunaan antibiotik dengan menyusun formularium dan Pedoman Penggunaan Antibiotik (PPAB). Penggunaan antibiotik berlebihan berkontribusi pada resistensi maka penelitian ini bertujuan, menganalisis besarnya perbedaan penggunaan antibiotik pada pasien rawat inap bedah sebelum digunakan PPAB (Periode Mei 2018) dan setelah digunakan PPAB (Periode Mei 2019) dengan ATC / DDD (Defined Daily Dose). Jenis dan rancangan penelitian adalah deskriptif cross-sectional dengan data retrospektif. Data yang diambil meliputi peresepan antibiotik di ruang bedah. Data dianalisis dengan uji tanda (sign test) dan uji wilcoxon dengan hasil sign test yang bertanda negatif sebanyak 9 dan bertanda positif sebanyak 2 dan uji wilcoxon menyatakan Sig.(2-tailed 0,062) (α=0,05) artinya penggunaan antibiotik sebelum dan setelah digunakan PPAB tidak berbeda atau sama berdasarkan statistik. Tetapi dari persentasi penggunaan antibiotik terdapat 9 antibiotik yang penggunaannya menurun setelah digunakan PPAB seperti sefoperason 50%, seftriaxon 52%, sefuroxime 87%, sepirom 90%, siproflosasin 17%, gentamisin 99%, levofloxasin 60%, metronidazol 79% dan moxifloksasin 86%. Disimpulkan PPAB perlu ditingkatkan dalam penggunaan antibiotik di RSUD dr.H.Slamet Martodirdjo dan penggunaa seftriakson dapat meningkatkan multi drug resistant. Dengan demikian perlu adanya evaluasi dan monitoring dalam menerapkan PPAB. Kata kunci: ATC/DDD; Pasien Bedah; PPAB ABSTRACT Since 2011 the World Health Organization (WHO) and the National Antimicrobial Resistant Control Committee (KPRA) in indonesia since 2015, to establish antibiotic use policies by developing formularies and Antibiotic Use Guidelines (PPAB). Excessive use of antibiotics contributing to resistance, this study aims, analyzing the magnitude of differences in antibiotic use patients surgery before PPAB (May 2018 period) and after PPAB (May 2019 period) with ATC / DDD (Defined Daily Dose). Type and design of the study is descriptive cross-sectional with retrospective. Data taken included prescribing antibiotics. Data were analyzed by sign test and Wilcoxon test with 9 negative sign and 2 positive sign results and Wilcoxon test stated Sig. (2-tailed 0.062)> (α = 0.05), meaning that use of antibiotics before and after PPAB is not different or the same based on statistics. But from the percentage of antibiotic 9 decreased after PPAB, such as cefoperazone 50%, cefriaxone 52%, cefuroxime 87%, cefpirome 90%, ciprofloxacin 17%, gentamicin 99%, levofloxacin 60%, metronidazole 79% and moxifloxacin 86%. Concluded that PPAB needs to be improved in the use of antibiotics in RSUD dr.H. Islamet Martodirdjo and the use of ceftriaxone can increase multi drug resistant. Thus the need for evaluation and monitoring in implementing PPAB. Keywords: ATC/DDD; Surgical Patients; PPAB

Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention

“…There were 13 reports that reported data on the effect of AMS interventions in hospitals (11 reports), 24 , 27 , 33 , 46 , 85 , 86 , 87 , 88 , 89 , 90 , 91 primary care (1), 92 and community pharmacies (1) 93 ( Table 2 ). Twelve reports used a pre-post design, and one was a randomized controlled trial.…”

Optimizing antibiotic use in Indonesia: a systematic review and synthesis of current evidence to inform opportunities for intervention

“…Studies that evaluated the implementation of antibiotic prescribing guidelines or clinical pathway (7 reports) reported mixed effects on antibiotic consumption and favourable effects on prescribing appropriateness. 23, 31, 47, 86, 88, 90, 91 Studies that evaluated education and/or training interventions (5 reports) reported mixed effects on antibiotic consumption and prescribing appropriateness. 31, 87–89, 92…”

“…A total of 20 reports (5 193 626 patients) reported data on antibiotic consumption. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Most of the studies were conducted in hospital settings (16 reports, 76.2%), in Java (14 reports, 66.7%), and between 2016-2021 (17 reports, 81.0%; Table S4). The pooled estimate of overall antibiotic…”

“…A total of 13 reports reported data on the effect of AMS interventions, of which 11 in hospitals, 23,28,31,33,47,[86][87][88][89][90][91] 1 in primary care, 92 and 1 in community pharmacies 93 (Table 2). Twelve reports used a pre-post design, and one was a randomized controlled trial.…”

“…31,88,89,92 Studies that evaluated the implementation of antibiotic prescribing guidelines or clinical pathway (7 reports) reported mixed effects on antibiotic consumption and favourable effects on prescribing appropriateness. 23,31,47,86,88,90,91 Studies that evaluated education and/or training interventions (5 reports) reported mixed effects on antibiotic consumption and prescribing appropriateness. 31,[87][88][89]92 The one study that evaluated antibiotic restriction with pre-approval found that consumption of restricted antibiotics decreased and of unrestricted narrow-spectrum antibiotics increased.…”