Drug Related Problems (DRPs) Terapi Antibiotik pada Pasien Sepsis di Bangsal Rawat Inap Rumah Sakit X di Surakarta

Fera Nor Maliza, Alfiana Pramasita Gonibala
DOI: https://doi.org/10.33650/trilogi.v6i2.11304



Abstract

Sepsis is a systemic response to infection that can lead to organ damage and death. Inappropriate use of antibiotics is associated with prolonged hospitalisation and increases the risk of death in sepsis patients. Sepsis leads to high mortality, inappropriate antibiotic use worsens outcomes. This study was an observational study using a cross sectional design. Data collection was done prospectively through searching medical records of sepsis patients aged ≥18 years who were being treated in the inpatient ward of Hospital X in Surakarta. DRPs analysis was conducted based on the PCNE 2017 version 8.02 classification. Data were further analysed using Chi- Square to determine the association of risk factors with the incidence of DRPs. Antibiotic use consisted of empirical and definitive antibiotics with a total of 93 empirical antibiotic uses and 26 definitive antibiotic uses.  The majority of empirical antibiotic use was ampicillin-sulbactam (62.36%), a combination of ampicillin-sulbactam with levofloxacin (20.43%), and the majority of definitive antibiotic use was meropenem (21.73%). DRPs problems in this study were 63.02% (75 cases) of 119 cases of antibiotic use with the most DRPs problems in the effectiveness of therapy in 52.09% of cases of antibiotic use. The risk factors studied (age, gender, length of hospitalisation, number of drugs and comorbidities) are not relate to incidence of drug related problems (P> 0.05).

Keywords

Drug related problems; Sepsis; Antibiotic; Hospitalization; adverse drug events.

Full Text:

PDF

References

Abdullah, B., Laila Ramatillah, D., Rinayanti Eff, A. (2015). Drug Related Problems that Occurred in Patient Sepsis Macrovascular Disease Complications General Hospital Treatment Room Central of the Army Hospital Gatot Subroto. Global Journal of Medical Research: B Pharma, 15(3), 3–7.

Adas, H., S. Jarab, A., O. Hallak, H., R. Khdour, M., L. Mukattash, T., & Z. Samaro, E. (2012). Identi fication of Drug-Related Problems: A Prospective Study in Two General Hospitals. Current Clinical Pharmacology, 7(4), 276–281. https://doi.org/10.2174/157488412803305795

Alam, M. S., Pillai, K. K., Abdi, S. A. H., Kapur, P., Pillai, P. K., & Nagarajan, K. (2018). Adverse drug reaction monitoring during antimicrobial therapy for septicemia patients at a university hospital in New Delhi. Korean Journal of Internal Medicine, 33(6), 1203–1209. https://doi.org/10.3904/kjim.2016.00

Alemkere, G., Bayisa, G., & Belachew, A. (2018). Pattern of Antibiotic Usage and Predictors of Hospital Outcome among Patients with Systemic Bacterial Infection in Nekemte referral Hospital , Western Ethiopia . Journal Infectious Diseases Medical Microbiology, 2(3).

American Society of Hospital Pharmacy. (2010). ASHP statement on the pharmacist’s role in antimicrobial stewardship and infection prevention and control. In American Journal of Health-System Pharmacy (Vol. 67). https://doi.org/10.2146/sp100001

Angus, D., C. Van der Poll T. 2013. Severe Sepsis And Septic Shock. NEJM 2013;369:840-51.

Bunney, P. E., Zink, A. N., Holm, A. A., Billington, C. J., & Kotz, C. M. (2017). Clinical Approach to the Patient with AKI and Sepsis. Physiology & Behavior, 176(1), 139–148. https://doi.org/10.1016/j.physbeh.2017.03.040

Budi, S., Ikawati, Z., Dwiprahasto, I., & Nuryastuti, T. (2017). Evaluasi Drug Related Problems (DRPs ) Antibiotik pada Pasien Sepsis di Rumah Sakit di Yogyakarta ( Evaluation of Drug Related Problems ( DRPs ) Antibiotic in Sepsis Patients in Hospital X at Yogyakarta ). Jurnal Ilmu Kefarmasian Indonesia, 15(1), 43–49.

Bagshaw, S. M., George, C., & Bellomo, R. (2008). Early acute kidney injury and sepsis: A multicentre evaluation. Critical Care, 12(2). https://doi.org/10.1186/cc6863

Cardozo Junior, L. C. M., & Silva, R. R. da. (2014). Sepsis in intensive care unit patients with traumatic brain injury: factors associated with higher mortality. Revista Brasileira de Terapia Intensiva, 26(2), 148–154. https://doi.org/10.5935/0103-507X.20140022

Charlson, M. E., Pompel, P., Ales, Kathy L., & Mackenzie, C. R. (1987). a New Method of Classifying Prognostic in Longitudinal Studies : Development. Journal of chronic Diseases, 40(5), 373-383. Retrieved from http://www.sciencedirect.com/science/article/pii/0021968187901718

Clifford, K. M., Dy-boarman, E. A., Haase, K. K., Pass, S., & Alvarez, C. A. (2017). Challenges with Diagnosing and Managing Sepsis in Older Adults. HHS Public Access, 14(2), 231–241. https://doi.org/10.1586/14787210.2016.1135052.Challenges

Chou, C. C., Shen, C. F., Chen, S. J., Chen, H. M., Wang, Y. C., Chang, W. S., Lin, M. C. (2019). Recommendations and guidelines for the treatment of pneumonia in Taiwan. Journal of Microbiology, Immunology and Infection, 52(1), 172–199. https://doi.org/10.1016/j.jmii.2018.11.004

Corsonello, A., Abbatecola, A. M., Fusco, S., Luciani, F., Marino, A., Catalano, S., … Lattanzio, F. (2015). The impact of drug interactions and polypharmacy on antimicrobial therapy in the elderly. Clinical Microbiology and Infection, 21(1), 20–26. https://doi.org/10.1016/j.cmi.2014.09.011

Crosby, R., Seedat, F., Tsertsvadze, A., Royle, P., Cooper, J., & McCarthy, N. (2016). Community-onset sepsis and its public health burden: a systematic review. Systematic Reviews, 5(1), 1–19. https://doi.org/10.1186/s13643-016-0243-3

Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Moreno, R. (2013). Surviving Sepsis Campaign. Critical Care Medicine, 41(2), 580–637. https://doi.org/10.1097/CCM.0b013e31827e83af

Derek C. Angus, M.D., M.P.H., and Tom van der Poll, M.D., P. D. (2018). Sepsis and septic shock. The Lancet, 392(10141), 75–87. https://doi.org/10.1016/S0140-6736(18)30696-2

Davey, P., Brown, E., Charani, E., Fenelon, L., Im, G., Holmes, A., Wilcox, M. (2013). Interventions to improve antibiotic prescribing practices for hospital inpatients ( Review ). Cochrane Database of Systematic Reviews Interventions,(4).https://doi.org/10.1002/14651858.CD003543.pub3.www.cochranelibrary.com

Dewi, R. S., Radji, M., & Andalusia, R. (2018). Evaluation of Antibiotic Use Among Sepsis Patients in an Intensive Care Unit. Sultan Qaboos University Med J, 18(August), 367–373. https://doi.org/10.18295/squmj.2018.18.03.017

Diaz, A., Martinez-gonzalez, M. L., Ferrer, R., Ortiz-leyba, C., Piacentini, E., Lopez-pueyo, M. J., Artigas, A. (2012). Antibiotic prescription patterns in the empiric therapy of severe sepsis : combination of antimicrobials with different mechanisms of action reduces mortality. Critical Care, 16(6),

Ferrer, R., Martin-Loeches, I., Phillips, G., Osborn, T. M., Townsend, S., Dellinger, R. P., Levy, M. M. (2014). Empiric Antibiotic Treatment Reduces Mortality In Severe Sepsis And Septic Shock From The First Hour: Results From A Guideline-Based Performance Improvement Program. Critical Care Medicine, 42(8), 1749–1755. https://doi.org/10.1097/CCM.0000000000000330

Goncalves, J., & Povoa, P. (2011). Antibiotics In Critically Ill Patients: A Systematic Review Of The Pharmacokinetics Of Β-Lactams. Critical Care, 15(5), 1–17. https://doi.org/10.1186/cc10441

Green, M. J., Peterson, S. K., Baker, M. W., Friedman, C., Harper, G. R., Rubinstein, W. S., Mauger, D. T. (2014). Septic Shock and Adequacy of Early Empiric Antibiotics in the Emergency Department. J Emerg Med, 7(4), 221–229. https://doi.org/10.1016/j.molcel.2009.10.020.The

Guner, R., Hasanoglu, I., Keske, S., Kalem, A. K., & Tasyaran, M. A. (2011). Outcomes In Patients Infected With Carbapenem-Resistant Acinetobacter Baumannii And Treated With Tigecycline Alone Or In Combination Therapy. Infection, 39(6), 515–518. https://doi.org/10.1007/s15010-011-0161-1

Garnacho-montero, J., Gutierrez-pizarraya, A., & Escoresca-ortega, A. (2015). Adequate antibiotic therapy prior to ICU admission in patients with severe sepsis and septic shock reduces hospital mortality. Critical Care, 1–8. https://doi.org/10.1186/s13054-015-1000-z

Gyawali, B., Ramakrishna, K., & Dhamoon, A. S. (2019). Sepsis : The evolution in definition , pathophysiology , and management. Journal of SAGE, 7:1-13. https://doi.org/10.1177/2050312119835043

Hajj, J., Blaine, N., Salavaci, J., & Jacoby, D. (2018). The Centrality of Sepsis: A Review on Incidence, Mortality, and Cost of Care. Healthcare, 6(3), 90. https://doi.org/10.3390/healthcare6030090

Halbach, J. L., Wang, A. W., Hawisher, D., Cauvi, D. M., Lizardo, R. E., Rosas, J., De Maio, A. (2017). Why Antibiotic Treatment is Not Enough for sepsis Resolution: An Evaluation In An Experimental Animal Model. Infection and Immunity, 85(12), 1–11. https://doi.org/10.1128/IAI.00664-17

Hartog, C. S., Heublein, S., Hartmann, M., Reinhart, K., Welte, T., Thomas–Rueddel, D. O., … Dennler, U. (2018). Hospital Incidence and Mortality Rates of Sepsis: An Analysis of Hospital Episode (DRG) Statistics in Germany From 2007 to 2013. Deutsches Aerzteblatt Online. https://doi.org/10.3238/arztebl.2016.0159

Hidayati, Arifin, H., & Raveinal. (2016). Kajian Penggunaan Antibiotik pada Pasien Sepsis dengan Gangguan Ginjal. Jurnal Sains Farmasi & Klinis, 2(2), 129–137.

Ramadhani, C. E., Gasem, M. H., Indrakusuma, M. E., Amaliah, N., & Indriyati, R. (2024). POLA BAKTERI PENYEBAB SEPSIS DAN KEPEKAANNYA TERHADAP ANTIBIOTIK DI RUMAH SAKIT DAERAH GUNUNG JATI PERIODE 1 JANUARI-31 DESEMBER 2022.


Dimensions, PlumX, and Google Scholar Metrics

10.33650/trilogi.v6i2.11304


Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Alfiana Pramasita Gonibala

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

This ejournal system and its contents are licensed under

a Creative Commons Attribution-ShareAlike 4.0 International License