Evaluation of the use of antibiotics using the anatomical therapeutic chemical/defined daily dose and Gyssens methods in pneumonia patients at a tertiary care general hospital in Medan

Authors

  • Yulia S. Limbong Faculty of Pharmacy, Universitas Sumatera Utara, Indonesia
  • Khairunnisa Khairunnisa Department of Pharmacology and Clinical/Community Pharmacy, Faculty of Pharmacy, Universitas Sumatera Utara, Indonesia
  • Wiryanto Wiryanto Department of Pharmacology and Clinical/Community Pharmacy, Faculty of Pharmacy, Universitas Sumatera Utara, Indonesia

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20233744

Keywords:

Pneumonia, Gyssenes, ATC/DDD, Antibiotics

Abstract

Background: The impact of irrational antibiotic usage in pneumonia patients is an increase in resistance, an increase in drug side effects, and a failure of therapy that causes patients' health to deteriorate, lowering their quality of life and raising their treatment costs. The primary objective of this study is to assess the extent to which antibiotics are being used rationally in the inpatient facility of a private tertiary care hospital located in Medan.

Methods: The present study employs an observational design with a prospective cross-sectional approach, carried out within the timeframe of September to November 2022. The evaluation of antibiotic utilization was conducted utilizing the anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology and the Gyssens methodology.

Results: The findings of the study indicate that a significant proportion of individuals diagnosed with pneumonia fell between the age range of 46 to 55 years, comprising 23.4% of the overall patient population. Moreover, the male gender was found to be the most prevalent, accounting for 55.81% of the 278 patients who satisfied the inclusion criteria. The findings from the evaluation of antibiotic utilization, employing the ATC classification system and DDD methodology, yielded a rate of 145.72 DDD per 100 days of care. Ceftriaxone exhibited the highest value, reaching 87.59 DDD/100 days of treatment. The evaluation of the Gyssens approach yielded a total of 254 patients who were administered antibiotics in an appropriate manner (category 0), while 24 patients were found to have received unsuitable antibiotics (categories I-VI).

Conclusions: Based on the findings of this study, it can be inferred that the utilization of antibiotics within the hospital under investigation remains inadequate in terms of both quantity and quality.

References

Sari IM, Soertidewi L, Yokota C, Kikuno M, Koga M, Toyoda K. Comparison of Characteristics of Stroke-Associated Pneumonia in Stroke Care Units in Indonesia and Japan. J Stroke Cerebrovasc Dis. 2017;26(2):280-5.

Warganegara E. Pneumonia Nosokomial (Hospital-acquired, Ventilator-associated, dan Health Care-associated Penumonia). J Medice Lampung Univ. 2017;1:612-8.

The Indonesian Ministry of Health. General guidelines for the use of antibiotics. Jakarta: Departement Health Republik Indonesia. 2021.

Yeh JJ, Lin CL, Kao CH. Relationship between pneumonia and cardiovascular diseases: A retrospective cohort study of the general population. Eur J Intern Med. 2019;59:39-45.

Salarbaks AM, Lindeboom R, Nijmeijer W. Pneumonia in hospitalized elderly hip fracture patients: the effects on length of hospital-stay, in-hospital and thirty-day mortality and a search for potential predictors. Injury. 2020;51:1846-50.

Ulfa CF, Supadmi W, Perwitasari DA, Yuniarti E. Correlation Between Appropriateness Prescribing Antibiotics and Clinical Improvement on Hospitalized Patients with Community Acquired Pneumonia Based on The Gyssens Method. J Indonesian Pharm Sci. 2021;19:30-8.

Norrby SR, Petermann W, Willcox PA, Vetter N, Salewski E. A comparative study of levofloxacin and ceftriaxone in the treatment of hospitalized patients with pneumonia. Scand J Infect Dis. 1998;30:397-404.

Eljaaly K, Wali H, Basilim A, Alharbi A, Asfour HZ. Clinical cure with ceftriaxone versus ceftaroline or ceftobiprole in the treatment of staphylococcal pneumonia: a systematic review and meta-analysis. Int J Antimicrob Agents. 2019;54:149-53

Ambami S. Evaluation of the use antibiotics the ATC/DDD method in Pneumonia patients at Jombang District Hospital Period Januari-Desember 2019. Universitas Islam Negeri Maulana Malik Ibrahim. 2020.

Muhammad OR, Mutmainah N. Evaluation of the Use of Antibiotics Using the ATC/DDD Method in Pneumonia Patients in the Inpatient Installation in Dr. Moewardi hospital in 2017. Universitas Muhammadiyah Surakarta. 2018.

Fernando SM, Tran A, Cheng W, Klompas M, Kyeremanteng K, Mehta S, et al. Diagnosis of ventilator-associated pneumonia in critically ill adult patients-a systematic review and meta-analysis. Intensive Care Med. 2020;46(6):1170-9.

Telles JP, Cieslinski J, Gasparetto J, Tuon FF. Efficacy of ceftriaxone 1 g daily versus 2 g daily for the treatment of community-acquired pneumonia: a systematic review with meta-analysis. Exp Rev Anti-infect Therap. 2019;17:501-10.

Hardiana I, Laksmitawati DR, Ramadaniati HU. Evaluation of the use antibiotic in community-acquired pneumonia in inpatient installations at Gatot Subroto hospital. Pharm Pharmacol Magazine. 2021;25:1-6.

Fuentes-Hernandez A, Plucain J, Gori F, Pena-Miller R, Reding C, Jansen G, et al. Using a sequential regimen to eliminate bacteria at sublethal antibiotic dosages. PLoS Biol. 2015;13(4):e1002104.

Neubeiser A, Bonsignore M, Tafelski S, Alefelder C, Schwegmann K, Rüden H, et al. Mortality attributable to hospital acquired infections with multidrug-resistant bacteria in a large group of German hospitals. J Infect Public Health. 2020;13(2):204-10.

Islam Z, Qodariyah SM, Nursehah E. Use of antibiotics in the treatment of community acquired pneumonia at Pasar Rebo Hospital and Tarakan Hospotal at Jakarta 2014 years. J Sains Pharm Technol. 2017;8:1-8.

Maliza FN, Gonibala AP. Antibiotic Use Patterns in Inpatient Sepsis Patients at Dr. MOEWARDI Hospital. Pharmed: J Pharm Sci Med Res. 2023;6:11-20.

Juwita DA, Almasdy D, Apriani P. Evaluation of Antibiotics on Chronic Obstructive Pulmonary Disease Patient in Lung Hospital. West Sumatera, Indonesia. Int J Innov Sci Res Technol. 2023;8(7):2395-8.

Rohmah SD, Andrajati R, Yudhorini LT. Qualitative Evaluation of Antibiotic Use in Bacterial Meningitis Patients using the Gyssens Method. J Aisyah. 2023;8:169-78.

Izadi M, Dadsetan B, Najafi Z, Jafari S, Mazaheri E, Dadras O, et al. Levofloxacin Versus Ceftriaxone and Azithromycin Combination in the Treatment of Community Acquired Pneumonia in Hospitalized Patients. Recent Pat Antiinfect Drug Discov. 2018;13(3):228-39.

Indonesian Lung Doctors Association (PDPI). Community Pneumonia: Diagnosis and Guidelines Management in Indonesia. 2014.

Hayati Z, Widyastuti E, Nurjannah N, Mudatsir M, Saputra I. Quality Relationships Use of Antibiotics with Clinical Outcomes of Bacteremia-Induced Patients Methicillin Resistant Staphylococcus aureus (MRSA). J Med Syiah Kuala. 2022;22.

Mayaragate N. Evaluation of the use antibiotic in Gyssens Method for pediatric pneumonia in inpatient installations Akademik Universitas Gadjah Mada hospital. Essay. Universitas Gadjah Mada. 2022.

Nkinda L, Kilonzi M, Felix FF, Mutagonda R, Myemba DT, Mwakawanga DL, et al. Drivers of irrational use of antibiotics among children: a mixed-method study among prescribers and dispensers in Tanzania. BMC Health Serv Res. 2022;22(1):961.

Tambun SH, Puspitasari I, Saftri I. Evaluation of clinical outcomes of antibiotic therapy in patients community acquired pediatric pneumonia patients. JMPF. 2019;9(3):213-24.

Downloads

Published

2023-11-29

How to Cite

Limbong, Y. S., Khairunnisa, K., & Wiryanto, W. (2023). Evaluation of the use of antibiotics using the anatomical therapeutic chemical/defined daily dose and Gyssens methods in pneumonia patients at a tertiary care general hospital in Medan. International Journal of Basic & Clinical Pharmacology, 13(1), 13–21. https://doi.org/10.18203/2319-2003.ijbcp20233744

Issue

Section

Original Research Articles