Kajian Penggunaan Antibiotik pada Pasien Covid-19 Disertai Pneumonia di Instalasi Rawat Inap Rumah Sakit Akademik Universitas Gadjah Mada

ADISTYA ANGGRAINI, Dr. apt. Ika Puspita Sari, M.Si.; Prof. Dr. apt. Tri Murti Andayani, Sp.FRS.

2023 | Skripsi | S1 FARMASI

Covid-19 dan pneumonia memiliki gejala klinis yang hampir sama yaitu demam, batuk, dan sesak napas sehingga dilakukan peresepan antibiotik empiris. Penilaian penggunaan antibiotik pada pasien Covid-19 disertai pneumonia akan menjadi langkah penting untuk mengurangi resistensi antimikroba. Tujuan penelitian ini yaitu untuk mengidentifikasi pola peresepan dan mengetahui kesesuaian penggunaan antibiotik pada pasien Covid-19 disertai pneumonia yang dirawat di RSA UGM. Penelitian ini merupakan penelitian retrospektif dengan rancangan penelitian cross sectional dan data sekunder berupa rekam medis pasien. Populasi penelitian merujuk seluruh pasien rawat inap Covid-19 disertai pneumonia selama periode Juni-Juli 2021 yang mendapatkan terapi antibiotik dengan jumlah sampel 95 pasien. Kesesuaian penggunaan antibiotik dievaluasi secara kualitatif menurut alur Gyssens. Analisis antibiotik empiris berdasarkan Diagnosis dan Penatalaksanaan Pneumonia Covid-19, Pedoman Tatalaksana Covid-19 Edisi III, dan DIH. Hasil analisis disajikan secara deskriptif dalam bentuk tabel persentase. Hasil penelitian menunjukkan pola peresepan antibiotik empiris paling banyak yaitu levofloxacin 750 mg yang diberikan secara intravena sejumlah 35 (36,1%) regimen dan azithromycin dosis 500 mg per oral sejumlah 23 (23,7%) regimen. Rata-rata durasi pemberian azithromycin dan levofloxacin adalah lima dan enam hari. Penilaian kesesuaian penggunaan antibiotik menunjukkan bahwa terdapat 59 (62,1%) kasus penggunaan antibiotik sesuai pedoman dan 36 (37,9%) kasus tidak sesuai pedoman. Regimen penggunaan antibiotik yang sesuai pedoman meliputi monoterapi azithromycin (31,6%), levofloxacin (23,2%), moxifloxacin (5,3%), dan kombinasi azithromycin dan ceftriaxone (2,1%). Kasus ketidaksesuaian pedoman terdiri dari 16,8% kasus kategori IVA; 14,7% kasus kategori IIIA; 2,1% kasus kategori IIIB; 1,1% kasus kategori IIA; dan 3,2% kasus kategori I.

Covid-19 and pneumonia have almost the same clinical symptoms, namely fever, cough and shortness of breath, so empirical antibiotics are prescribed. Assessment of antibiotic use in Covid-19 patients accompanied by pneumonia will be an important step to reduce antimicrobial resistance. The purpose of this study is to identify prescribing patterns and determine the assessment of antibiotics usage in Covid-19 patients with pneumonia who are being treated at RSA UGM. This research is a retrospective study with a cross-sectional study design and secondary data in the form of patient medical records. The study population referred to all Covid-19 hospitalized patients with pneumonia during the June-July 2021 period who received antibiotic therapy with a total subject of 95 patients. The assessment of the use of antibiotics was evaluated qualitatively according to the Gyssens method. Empirical antibiotic analysis based on the Diagnosis and Management of Covid-19 Pneumonia, Guidelines for the Management of Covid-19 Editions III, and DIH. The results of the analysis are presented descriptively in the form of a percentage table. The results showed that the pattern of prescribing empirical antibiotics was the highest, namely levofloxacin 750 mg given intravenously in 35 (36.1%) regimens and azithromycin dose of 500 mg orally in 23 (23.7%) regimens. The mean duration of azithromycin and levofloxacin administration was five and six days, respectively. Assessment of the appropriateness of using antibiotics showed that there were 59 (62.1%) cases of using antibiotics according to the guidelines and 36 (37.9%) cases not according to the guidelines. Antibiotic regimens according to guidelines included monotherapy with azithromycin (31.6%), levofloxacin (23.2%), moxifloxacin (5.3%), and a combination of azithromycin and ceftriaxone (2.1%). Cases of non-compliance with guidelines comprised 16.8% of cases in the IVA category; 14.7% cases category IIIA; 2.1% cases category IIIB; 1.1% of category IIA cases; and 3.2% of category I cases.

Kata Kunci : Covid-19, pneumonia, antibiotik, alur Gyssens