The Relationship Between Appropriateness of Antibiotic Use Based on the Gyssens Algorithm and Mortality: A Retrospective Cohort Study in Indonesian Tertiary Hospital

Authors

  • Fadrian Fadrian 1. Division of Tropical and Infectious Disease, Department of Internal Medicine, Dr. M. Djamil Central General Hospital, Padang, Indonesia. 2. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Andalas, Padang, Indonesia. 3. Antimicrobial Resistance Stewardship Committee, Dr. M. Djamil Central General Hospital, Padang, Indonesia.
  • Gestina Aliska 1. Antimicrobial Resistance Stewardship Committee, Dr. M. Djamil Central General Hospital, Padang, Indonesia. 2. Department of Clinical Pharmacology, Dr. M. Djamil Central General Hospital, Padang, Indonesia. 3. Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine, Universitas Andalas, Padang, Indonesia.
  • Widya Nur Utami Antimicrobial Resistance Stewardship Committee, Dr. M. Djamil Central General Hospital, Padang, Indonesia.

Keywords:

antibiotics, Gyssens algorithm, infectious

Abstract

Background: Some studies have reported that antibiotic use as therapy and prophylaxis in hospitals is inappropriate in approximately 9% to 64% of cases. The Gyssens algorithm is used for qualitative evaluation by assessing the appropriate antibiotic use. This study aimed to determine and evaluate the quality of antibiotic use in inpatients at Dr. M. Djamil Central General Hospital by using the Gyssens algorithm. Methods: This was a retrospective cohort study at Dr. M. Djamil Central General Hospital from January to December 2021. We collected data from the medical records of inpatients who received antibiotics using a random sampling technique, and the number of patients from each department was calculated through a preliminary survey. Results: There were three hundred and sixty samples from the population that met the inclusion and, adults (59.4%), patients treated for >14 days (38.9%), patients discharged with improvement (66.9%), and patients diagnosed with pneumonia (49.5%). Most antibiotics were appropriate (56.5%), with ceftriaxone being the most commonly used antibiotic (199 cases ). Appropriate antibiotic use (Gyssens 0) is mostly found in the Internal Medicine Department Meanwhile, antibiotic use without indications (Gyssens V) is mostly found in the Surgery Department. A significant correlation was found betweenthe appropriateness of antibiotic administration patient outcomes after discharge from the hospital (p < 0.05). There was an increase in the risk of death in inappropriate antibiotic use (Gyssens I-IV) and antibiotic use without indications (Gyssens V) by 1.96 and 4.05 times, respectively. Conclusion: There are many cases of inappropriate antibiotic use in Dr. M. Djamil Central General Hospital; therefore, education regarding appropriate antibiotic use is necessary.

References

Afekouh H, Baune P, Abbas R, De Falvelly D, Guermah F, Haber N. Antibiotic prescription evaluation in the rehabilitation ward of a geriatric hospital. Med Mal Infect. 2015;45(11–12):427–35.

Cusini A, Rampini SK, Bansal V, et al. Different patterns of inappropriate antimicrobial use in surgical and medical units at a tertiary care hospital in Switzerland: A prevalence survey. PLoS One. 2010;5(11):e14011.

Luciana T, Andrajati R, Rianti A, Khan A. Rational antimicrobial use in an intensive care unit in Jakarta, Indonesia: A Hospital-Based, Cross-Sectional Study. Tropical Journal of Pharmaceutical Research. 2015 May 6;14(4):707.

Katarnida SS, Murniati D, Katar Y. Evaluasi penggunaan antibiotik secara kualitatif di RS Penyakit Infeksi Sulianti Saroso, Jakarta. Sari Pediatri. 2016 Nov 9;15(6):369.

Sihite EN, Ramadhan AM, Samsul E. Evaluasi penggunaan antibiotik secara kuantitatif dan kualitatif pada pasien bedah digestif di RSUD Abdul Wahab Sjahranie Samarinda. Proceeding of Mulawarman Pharmaceuticals Conferences. 2021;14:214–21.

Hadi U, Duerink DO, Lestari ES, Nagelkerke NJ, Keuter M, In’t Veld DH, Suwandojo E, Rahardjo E, van den Broek P, Gyssens IC. Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia. Clinical microbiology and infection. 2008;14(7):698-707.

Sundariningrum RW, Setyanto DB, Natadidjaja RI. Evaluasi kualitatif antibiotik metode gyssens dengan konsep regulasi antimikroba sistem prospektif RASPRO pada pneumonia di Ruang Rawat Intensif Anak. Sari Pediatri. 2020;22(2):109.

Sitompul F, Radji M, Bahtiar A. Evaluasi penggunaan antibiotik dengan metode Gyssens pada pasien stroke rawat inap di RSUD Koja secara retrospektif (Periode KJS Dan BPJS). Indonesian Pharmaceutical Journal. 2016;6(1):30–8.

Rohmah SD, Andrajati R, Yudhorini LT. Qualitative evaluation of antibiotic use in bacterial meningitis patients using the Gyssens method. Jurnal Aisyah: Jurnal Ilmu Kesehatan. 2023;8(S1):169–78.

Masyrifah M, Andrajati R, Yudhorini LT. Qualitative evaluation of antibiotics use with Gyssens method in sepsis patients at Fatmawati Central General Hospital Jakarta. Pharmaceutical Sciences and Research. 2022;9(2).

Chen LK, Nathanael J, Shakinah S, et al. Association between early antibiotic administration and in-hospital mortality in moderate and severe COVID-19 patients. Jurnal Penyakit Dalam Indonesia. 2022;9(4).

Fadrian F, Linosefa L, Ridhwan F. M, Hasnah H, Syafa Ayuni A. Multidrug-resistant organisms and determinant factors in sepsis patients. Iran. Iran J Med Microbiol. 2023;17(5):596-605.

Elly U, Yusticia K. The role of age and comorbidities on the outcome of confirmed clinically critical Covid-19 patients treated with Remdesivir At Indonesia’s National Referral Hospital. Afr J Infect Dis. 2022;17(1):55-59.

Ma’rifah N, Hasmono D, Hadi U, Kuntaman K. Analysis of quality of antibiotic usage on patient with internal and surgical service. FMI. 2021;57(1):1-5.

Sukmawati IGAND, Adi Jaya MK, Swastini DA. Evaluasi Penggunaan antibiotik pada pasien tifoid rawat inap di salah satu rumah sakit pemerintah Provinsi Bali dengan metode Gyssens dan ATC/DDD. Jurnal Farmasi Udayana. 2020;26:37.

Fadrian F, Chen K, Kumalawati J, Rumende CM, Shatri H, Nelwan EJ. The validation of drug resistance in pneumonia (DRIP) score in predicting infections due to drug-resistant pathogens in community-acquired pneumonia at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Acta Med Indones. 2021;53(4):416–22.

Barcha M, Steinberg Y, Kozlovsky D, Gvili AG. Ceftriaxone versus ampicillin for the treatment of community-acquired pneumonia. A propensity-matched cohort study. Clin Microbiol Infect. 2023;29(1):70-6.

Metlay JP, Watere GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):45-67.

Ibrahim AM, Widyati W, Prasetyadi FOH. Analisis Kualitatif penggunaan antibiotik pada pasien rujukan dengan metode analisis alur Gyssen di RSPAL Dr. Ramelan Surabaya. MPI (Media Pharmaceutica Indonesiana). 2020 Dec 22;3(2):88–95.

Adani SD, Zulfariansyah A, Santoso PTR. Quality assessment of antibiotic prescription for sepsis treatment in intensive care unit at top referral hospital in West Java, Indonesia. Althea Medical Journal. 2017 Jun;4(2):286–92.

Dhillon J, Agustin H, Burhan E, et al. Evaluation of antibiotics use based on gyssens method and their relationship to the outcome of hospitalized community-acquired pneumonia patients in Persahabatan General Hospital Jakarta. [Jakarta]: Universitas Indonesia; 2020.

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Published

2024-07-16

How to Cite

Fadrian, F., Aliska, G., & Utami, W. N. (2024). The Relationship Between Appropriateness of Antibiotic Use Based on the Gyssens Algorithm and Mortality: A Retrospective Cohort Study in Indonesian Tertiary Hospital. Acta Medica Indonesiana, 56(2), 137. Retrieved from https://www.actamedindones.org/index.php/ijim/article/view/2538

Issue

Vol. 56 No. 2 (2024): Acta Medica Indonesiana

Section

ORIGINAL ARTICLE

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