Profil Penggunaan Antibiotik pada Pasien COVID-19 Di Rumah Sakit dr. Soepraoen Malang

Abstract

Antibiotics are used to treat co-infection in COVID-19 patients during the pandemic. Research data show that cases of bacterial co-infection in COVID-19 patients are 5%. Uncontrolled use of antibiotics will accelerate bacterial resistance. Accurate selection of antibiotics, dosage, frequency of use and duration of administration are needed to avoid nosocomial infections of resistant bacteria and reduce treatment costs. The purpose of this study was to determine the quality of antibiotic use in COVID-19 patients at dr. Soepraoen Malang. This study is a retrospective descriptive with a cross-sectional approach. Data were obtained from medical records and drugs from pharmacy installations. The population is hospitalized patients with confirmed COVID-19. Samples were hospitalized patients with confirmed COVID-19 who met the inclusion and exclusion criteria. The sample size was 258 patients selected by purposive sampling method during October 2019 to March 2020. The results of the study were patients 46-55 years old = 41%, male patients = 64%, female = 36%; moderate disease degree = 17%, severe = 83%; patients recovered = 95%, died = 5%. Choice of antibiotics, iv azithromycin; levofloxacin iv; azithromycin p.o; levofloxacin p.o is 100%. Meropenem iv 86.05%; moxifloxacin p.o 14.37%; ceftriaxone iv 10.08%; cefixime p.o 3.49%; moxifloxacin iv 2.71%; cefotaxime iv 1.94%; cefadroxil p.o 0.39%; doxycycline p.o 0.39%. The accuracy of the dose of azithromycin (iv; p.o) 100%, levofloxacin (iv; p.o) 100%, the accuracy of the frequency of use of azithromycin (iv; p.o) 100%, levofloxacin (iv; p.o) 100%. The accuracy of the administration of iv azithromycin injection was 99.57%, levofloxacin iv 98.34%, azithromycin p.o. 89.29%; levofloxacin p.o 100%. The conclusion of this study is that the use of antibiotics in COVID-19 patients has met the correct 4 criteria, namely the right selection of drugs, the right dose, the right frequency of use and the right duration of administration.

Keywords: COVID-19; antibiotics; 4 right

ABSTRAK

Antibiotik digunakan untuk mengatasi ko-infeksi pada pasien COVID-19 di masa pandemi. Data penelitian menunjukkan bahwa kasus ko-infeksi bakteri pada pasien COVID-19 adalah <5%. Penggunaan antibiotik yang tidak terkendali akan mempercepat resistensi bakteri. Ketepatan pemilihan antibiotik, dosis, frekuensi penggunaan serta lama pemberian, diperlukan untuk menghindari infeksi nosokomial bakteri resisten serta menurunkan biaya pengobatan. Tujuan penelitian ini adalah mengetahui kualitas penggunaan antibiotik pada pasien COVID-19 di rumah sakit dr. Soepraoen Malang. Penelitian ini adalah deskriptif retrospektif dengan pendekatan cross-sectional. Dta diperoleh dari rekam medis dan obat dari instalasi farmasi. Populasi adalah pasien rawat inap yang terkonfirmasi COVID-19. Sampel merupakan pasien rawat inap yang terkonfirmasi COVID-19 yang memenuhi kriteria inklusi dan eksklusi. Ukuran sampel adalah 258 pasien yang dipilih dengan metode purposive sampling selama bulan Oktober 2019 sampai Maret 2020. Hasil penelitian pasien 46-55 tahun = 41%,  pasien laki-laki = 64%, perempuan = 36%;  derajat penyakit sedang = 17%,  berat = 83%;  pasien sembuh = 95%, meninggal = 5%. Pemilihan antibiotik, azithromycin iv; levofloxacin iv; azithromycin p.o; levofloxacin p.o adalah 100%. Meropenem iv 86,05%; moxifloxacin p.o 14,37%; ceftriaxone iv 10,08%; cefixime p.o 3,49%; moxifloxacin iv 2,71%; cefotaxime iv 1,94%; cefadroxil p.o 0,39%; doxycycline p.o 0,39%. Ketepatan dosis azithromycin (iv; p.o) 100%, levofloxacin (iv; p.o) 100%, ketepatan frekuensi penggunaan azithromycin (iv; p.o) 100%, levofloxacin (iv; p.o) 100%.  Ketepatan lama pemberian injeksi azithromycin iv 99,57%, levofloxacin iv 98,34%, azithromycin p.o 89,29%; levofloxacin p.o 100%. Kesimpulan penelitian ini adalah penggunaan antibiotik pada pasien COVID-19 telah memenuhi kriteria 4 tepat, yaitu tepat pemilihan obat, tepat dosis, tepat frekuensi penggunaan dan tepat lama pemberian.

Kata kunci: COVID-19; antibiotik; 4 tepat