Quality Assesment of Antibiotic Prescription for Sepsis Treatment in Intensive Care Unit at Top Referral Hospital in West Java, Indonesia

Abstract

Background: Sepsis is a common disease in intensive care unit (ICU) with high mortality rate. Administration of antibiotic has an important role to determine the outcome of sepsis patient. This study aimed to evaluate the quality of antibiotic prescription for sepsis treatment in intensive care unit (ICU). Methods: This descriptive study was conducted by retrieving data from 48 medical records of patients with sepsis, severe sepsis, and septic shock admitted to ICU Dr. Hasan Sadikin General Hospital (RSHS) in 2013. The study was conducted from August to October 2014. Empiric therapy in the ICUat RSHS and Surviving Sepsis Campaign (SSC) guidelines in 2012 were used as a standard for antibiotic prescription. The quality of antibiotic prescription was assessed then categorized based on Gyssens criteria. The collected data were analyzed in the form of frequency and percentage and presented in tables.Results: This study discovered that most of the patients had severe sepsis and septic shock. Based on Gyssens criteria, 35% antibiotic uses were included into category 0 (proper); 1.4% category I (improper timing); 10.5% category IIA (improper dosage); 9.1% category IIB (improper interval); 3.5% category IIC (improper route); 12.6% category IIIA (improper duration; too long); 1.4% category IIIB (improper duration; too short); 16.8% category IVA (improper; other antibiotics were more effective); 4.2% category IVD (improper; other antibiotics had narrower spectrum); and 5.6% category V (improper; no indication). Conclusions: There are still improper uses of antibiotic for sepsis, severe sepsis, and septic shock patients in the ICU.

Quantitative and Qualitative Analysis of Antibiotics in the Intensive Care Unit (ICU)

“…Category 0 antibiotics are indicated effective, non-toxic, appropriate in price and spectrum, dose, interval, route, and time of administration. Appropriate antibiotics use can be seen in previous research done by Adani et al (2017), who found that 35% of 118 antibiotics regimens (86 empiric therapies and 32 definitive therapies) were appropriate and rational (Category 0). This is also evident in research conducted in the ICU of Jakarta's Fatmawati General Hospital.…”

Manajemen Perioperatif pada Syok Sepsis et causa Peritonitis et causa Perforasi Gaster dan Suspek Abdominal Compartment Syndrome

“…Sepsis merupakan suatu kondisi yang sering ditemui di ICU dengan persentase 6 -30%. (Adani, 2017). Suatu penelitian di Spanyol membuktikan bahwa tingkat kematian pada pasien di RS yang disebabkan Syok Septik mencapai 45,7% (Adani, 2017).…”

“…(Adani, 2017). Suatu penelitian di Spanyol membuktikan bahwa tingkat kematian pada pasien di RS yang disebabkan Syok Septik mencapai 45,7% (Adani, 2017). Sepsis diawali dengan adanya gangguan pada host misal oleh karena luka bakar dan infeksi sehingga terjadi respons inflamasi yang dimaksudkan untuk melindungi host dari kerusakan.…”

Hubungan Antara Ketepatan Pemberian Antibiotik Berdasarkan Alur Gyssens dengan Perbaikan Klinis Pasien pada Pneumonia Komunitas

“…Adani, dkk. 27 melakukan penelitian untuk menilai kualitas peresepan antibiotik pada pasien sepsis yang dirawat di ICU RS Dr Hasan Sadikin, Bandung. Jumlah subjek yang diteliti adalah 48 pasien dengan jumlah total resep antibiotik yang dibuat adalah sebanyak 143.…”

“…Penelitian Adani, dkk. 27 bersifat deskriptif karena tidak menilai pengaruh kualitas pemberian antibiotik tersebut terhadap perbaikan dari sepsisnya.…”