ANTIBIOTICS USE REVIEW AND ANALYSIS OF RISK FACTORS AFFECTING LENGTH OF STAY IN PEDIATRIC PATIENT WITH BRONCHOPNEUMONIA AT RSUP DR. HASAN SADIKIN BANDUNG

• Main Author: Ariefa, Sharfina
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/45519
• Institution: Institut Teknologi Bandung

Pneumonia is the leading cause of death in children worldwide, which rate of death is higher than the combination of AIDS, malaria and measles. Every year, more than 2 million children died because of pneumonia from 9 million death of children each year worldwide. In developing countries, such as Indonesia, the incidence of pneumonia in children less than 5 years of age is 0,28 events per child per year. Pneumonia is on the first rank of infant mortality (15.5%) of all causes of death in Indonesia. In RSUP Dr. Hasan Sadikin Bandung, bronchopneumonia is on the second rank of the most cause disease in hospitalized patients in 2014 at 331 cases from 5873 total cases each year. Pneumonia in children are often occurs simultaneously with the process of acute bronchi infection or known as bronchopneumonia. The appropriate treatment for bronchopneumonia is antibiotic therapy. The high morbidity and mortality of pneumonia in children aged under five in developing countries are affected by a variety of risk factors, among others: low birth weight (LBW), incomplete or no receive vaccine, adequate breastfeeding, malnutrition, overcrowded, and high exposure to air pollution. More than 1 million lives could be saved through the implementation of optimal prevention and antibiotics treatment. This study aimed to identify the use of antibiotics and analyze the relationship between risk factors due to their length of stay. This research was a cross sectional study that was conducted retrospectively on bronchopneumonia patients aged 0-14 years in the period January 2014 to December 2014. Analysis of risk factors affecting length of stay using chi-square (x 2 ). From this study, 141 patients are include in inclusion criteria, 75 patients were treated ?5 days and 66 patients were treated> 5 days. The most antibiotics use in patient with or without comorbid is ampicilin iv (29,05% dan 42,59%). The highest use of antibiotic combination is ampicilin iv + cefotaxime iv (26,75%). The possible interaction are occurs in the combination of gentamicin iv + cefotaxime iv. Appropriate indication is 100% and appropriate dose is 98.58%. Blood culture that has positive results found in 19 patients (13.48%), and the pattern of antibiotic resistance was found to be greatest on cefixime, sefmetazolin, and ampicillin at 100%. Based on resistance pattern in hospital, 79,57% pathogen resistance to cefixime. Nutritional status, comorbid, air pollution, overcrowded, low birth weight, ventilation, sunlight, and immunization have no relationship with length of stay of patient, while no adequate breastfeeding have strong relationship with length of stay of patient. The use of antibiotics are appropriate dose and most precise indication. The most used of antibiotics is ampicillin iv in monotherapy or in combination with cefotaxime iv. The risk factors that affect the length of stay is patient who didn’t get exclusive breastfeeding.