DRUG USE EVALUATION OF 1 ST AND 3 RD GENERATION- CEPHALOSPORINS IN GENERAL SURGICAL WARD IN ONE HOSPITAL IN CIMAHI

• Main Author: Khalifah Rusyda, Fulky
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/45538
• Institution: Institut Teknologi Bandung

Antibiotic is the most common drug used in the surgical ward as a prophylactic to prevent occurence of surgical site infection (SSI) and as empirical therapy to treat patients. Decision of antibiotic use in the general surgical ward should be made carefully due to most of patients require immediate treatment and to prevent bacterial resistance, minimize health costs, and reduce the risk of adverse drug reactions. Drug use evaluation of 1 st and 3 rd generation-cephalosporins in general surgical ward in one hospital in Cimahi has not been conducted regularly. Therefore, this study was designed to evaluate the appropriateness of the use of 1 st and 3 rd generation-cephalosporins in the general surgical ward as the quality assurance program to ensure therapeutic effectiveness and patient safety. This research was a retrospective-observational study in hospitalized adult and geriatric patients in January to March 2014. Data used for this study were collected from patient medical record including patient data (medical record number, patient name, age, gender, address, date of entry and out of the hospital, payment status, doctor’s name, reason of getting in and out of the hospital, and patient clinical state), disease data (diagnosis and history of disease), drug use data (drug name, strength and dosage form, class of drug therapy, dose, route of administration, and time of drug use), and the result of laboratory test data (type, date, and result of test). The antibiotic use was evaluated based on predetermined criteria which has been generated from current literatures. The criteria contained drug name, indication, dose, strength and dosage form, contraindication, side effect, drug interaction, stability, and precaution to the patients. The existence of Drug Related Problem (DRP) was classified in accordance to the Gyssens algorithm. Approximately 245 patients were recruited in this study and the selected of 1 st and 3 rd generation cephalosporins including cefadroxil, cefotaxime, ceftriaxone, ceftazidime, cefixime, cefoperazone, ceftizoxime, and cefditoren have been evaluated. There were 204 cases of potential DRP has been founded consisted of 32 cases of the category V (medication without indication), 156 cases of category III B (duration too short), 11 cases of category II B (incorrect interval), and 5 cases of unclassified category (indication without medication). In addition, about 113 cases of category VI (incomplete medical record/ not evaluable) has also been founded. The potential of DRP occurrence was estimated to be one DRP per patient and antibiotic which the most contributed to the appropriateness was ceftriaxone (36.68%).