Beta-Lactam Antibiotics Use Evaluation in Hospitalized Pediatric Patients in One Hospital in Cimahi

• Main Author: Polyta Fitriah, Shalvierra
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/45540
• Institution: Institut Teknologi Bandung

One of the big problem in many country in the world, especially developing country, is inappropriate medication-use. WHO estimate that more than 50% of medicines are prescribed, administered, and sold inappropriately. One of the high risk medicine that is used irrationally is beta-lactam antibiotic, especially in pediatric patient. Because the organ function in pediatric patient has not developed yet. This condition may affect the pharmacodynamics and pharmacokinetics of drugs they consumed and eventually will affect the efficacy and/ or toxicity of that drugs. So, the medication-use monitoring for pediatric patients is needed. Currently medication-use monitoring of beta-lactam antibiotic has not been conducted continuously in a hospital in Cimahi. Meanwhile, the medication-use monitoring is a process of quality assurance in hospitals that can be regarded as a technique in the management of formulary system and has many purpose such as promoting optimal therapy or treatment for patients, prevents drug-related problems, evaluate the effectiveness of a treatment, and improve patient safety. Therefore, this study was designed to evaluate the appropriateness of beta-lactam antibiotic in hospitalized pediatric patients. This research was a cross-section-observational study. The first stage of this study was preliminary study, which is performed retrospectively on January till March 2014 to determine the group of medicine that will be evaluated and a number of sample required. Medicationuse criteria was predetermined as a standard for assessing the appropriateness of medicine based on the current literatures and consists medicines profile such as medicines name, dosage form, direction for use, side effects, contraindications, interaction (drug-drug, drug-food, drug-lab test), warning, stability, and incompatibility. Furthermore, the evaluation of medication-use was carried out concurrently on January till March 2015. The medication-use data was analyzed based on PCNE classification scheme for drug-related problems (DRPs) v6.2. In this study, 351 patient were included, consisting of patients both boys and girls aged 0-14 years which are treated in class 1,2, and 3. About 458 DRPs were found including 22 cases inappropriate drugs (C1.1), 127 cases no indication for drug (C1.2), 42 cases inappropriate combination of drugs, or drugs and food (C1.4), 1 case of too many drugs prescibed for indication (C1.6), 137 cases drug dose too low (C3.1) which is the case with the highest number, 89 cases drug dose too high (C3.2), 39 cases duration of treatment too short (C4.1), and 1 case of duration of treatment too long (C4.2). Moreover, the potential DRPs was estimated to be occured for about 1-2 DRPs per patient.