Evaluation of the Rationality of Drug Use for the Treatment of Acute Pharyngitis and the Relation with Incidence and Prevalence of the Disease at Ibrahim Adjie and Cimahi Selatan Community Health Centers

• Main Author: Nurul Islamiyah, Alfi
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/45502
• Institution: Institut Teknologi Bandung

Indonesia is one of the top five countries with the highest Acute Respiratory Infection (ARI) cases, as many as 6 million episodes per year. Result of Basic Health Research of 2013 stated that the prevalence of ARI in 2007 and 2013 were not different (25.5% and 25%), which indicates that the control and treatment ARI is still not optimal. In 2004 there was a report showing that acute pharyngitis was included in the top 10 cases of outpatient, with total patient of 214.781 people (1.5%). Pharyngitis is infection or inflammation of the mucous membrane of the pharynx and commonly extend into the surrounding tissue. The incidence of acute pharyngitis caused by viruses was 40-60%, while that caused by bacteria was 5-40%. Identifying the cause of acute pharyngitis is a key point in determining the optimal treatment for the patient. Rational use of medicines required that patients received medications appropriate to their clinical needs, in doses that met their own individual requirements, for an adequated period of time, and at the lowest cost to them and their community. This study aimed to evaluate the rational use of medicine, identify the impact of irrationality, to find the connection between the rational use of medicine with incidence and prevalence of the disease, as well as proving whether antibiotic therapy is necessary for patients with acute pharyngitis. This was a observational pharmacoepidemiologic and observational study involving incidence and prevalence of the disease, evaluation the rational use of medicine, carried out retrospectively and concurrently in two Community Health Center (Puskesmas), Ibrahim Adjie and Cimahi Selatan. This study began with a literature review, followed by the determination of the criteria of the patients who became the subject of study as well as the criteria for rational use of medicine. Data collected and analyzed based on the determined criteria. A total of 88.24% of patients received antibiotic therapy whereas only 8.23% of patients who were indicated to receive antibiotics, so there was 80.01% overprescribtion of antibiotics in the treatment of acute pharyngitis. A total of 8.98% of antibiotics were given were not treatment option. There was no significant difference in outcome of therapy between the groups of patients treated with antibiotics and without antibiotics (p=0.3554). There was 62,43% irrationaly used of corticosteroids. The incidence and prevalence of acute pharyngitis in Puskesmas Ibrahim Adjie were 2.45% and 2.31%, respectively with irrationality rate of approximately 83.82%. Meanwhile, the incidence and prevalence of acute pharyngitis in Puskesmas Cimahi Selatan were 2.11% and 2.00%, respectively with irrationaly rate of approximately 91.29%. This data suggest that the use of medicine in the treatment of acute pharyngitis was not rational. Treatment with antibiotics was not superior than without antibiotics in treatment acute pharyngitis, because about 70% acute pharyngitis is caused by virus. The incidence and prevalence were increased by about 0.5-1% compared to 2004 that might be indicate the decline of health services quality.