UNIVERSITAS AIRLANGGA



Detail Article

Folia Medica Indonesiana

ISSN 0303-7932

Vol. 50 / No. 4 / Published : 2014-10

Order : 10, and page :254 - 261

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Original Article :

Analysis of antibiotic usage in patients with bacteremia in the icu unit of dr. soetomo hospital surabaya

Author :

  1. I Gusti Ayu Trisnadewi*1
  2. Suharjono*2
  3. Hardiono*3
  4. Agung Dwi Wahyu Widodo*4
  1. Mahasiswa Fakultas Farmasi
  2. Dosen Fakultas Farmasi
  3. Intensive Care Unit and Reanimation Dr. Soetomo Hospital, Surabaya
  4. Department of Clinical Microbiology, Dr. Soetomo Hospital, Surabaya

Abstract :

Bacteremia is one of major nosocomial infection happen in intensive care unit (ICU). It will increase patient’s hospitalization rateand mortality. Inappropriate usage of antibiotic also can increase morbidity, mortality, cost and antibiotic resistance. Thequalitative evaluation about the appropriateness of the choice, dosage and the duration of antibiotic therapy will be assessed usingGyssen's category. This study is to identified the pattern of bacterial causing bacteremia and their sensitivity to antibiotics, and toanalyze antibiotic usage at Intensive Care Unit at Dr. Soetomo Teaching Hospital with qualitative method using Gyssens's category.This is a descriptive observational cohort, prospective study. Patients who have positive blood culture during observation in ICU,were evaluated from January-March 2013. From May-November 2012 period, retrospectively, the most frequently isolatedmicroorganism was negative-gram bacteria, mostly Acinetobacter followed by gram-positive bacteria, mostly CoNSStaphylodcoccuscoagulase negative. Twenty two patients, with positive blood culture were analyzed prospectively from January-March 2013. The major empirical antibiotic treatment used in ICU were sefoperazon sulbactam and meropenem. The antibioticusage qualitative evaluation using Gyssens’s category, on eleven patients receiving definitive therapy, shows that 45% considereddefinitely appropriate; 27% were inappropriate regarding choice; 27% were inappropriate regarding dosage or duration. Theempirical antibiotics used in ICU, meropenem and cefoperazone sulbactam, is already adequate according to the sensitivity pattern.The antibiotic usage qualitative evaluation using Gyssens’s category, on eleven patients receiving definitive therapy, still showsinappropriateness regarding choice, dosage, or duration. (FMI 2014;50:254-261)

Keyword :

ICU, Bacteremia, Antibiotics, Qualitative evaluation, Gyssens category,


References :

Corona A, Bertolini G, Lipman J, Wilson AP, Singer M ,(2010) Antibiotic use and impact on outcome from bacteraemic critical illness: the Bacteraemia Study in Intensive Care (BASIC) 65, 1276–1285 : J Antimicrob Chemother

Gaynes R, Edwards JR, National Nosocomial Infections Surveillance System ,(2005) Overview of nosocomial infections caused by gram-negative bacilli 41, 848-854 : Clin Infect Dis





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