PERBANDINGAN ANTARA RASIONALITAS PENGGUNAAN ANTIBIOTIK PASIEN ANAKRAWAT INAP DENGAN RAWAT JALAN di Puskesmas Halmahera Semarang

Abstract

Background: The increasing prevalence of antibiotic use over time which is not rational in many fields of medicine including pediatrics is one of the causes of antibiotic resistance. Puskesmas has an important role as a first-line health services to improve the national health in Indonesian. Both inpatient and outpatient in Puskesmas provide antibiotic treatment to patients in pharmacy service. Thus, evaluation of the rationality of the use of antibiotics both inpatients and outpatients in the clinic is necessary to be done. Objective: This study was conducted to compare between the rationality of antibiotic use for inpatient and outpatient pediatric patients in Puskesmas Halmahera Semarang. Methods: This study is an analytic observational study with cross sectional design using retrospective approach. The subjects were 200 medical records of in inpatient and outpatient pediatric patients that meet the criteria for inclusion and exclusion in Puskesmas Halmahera Semarang at 2013-2014. The rationality of the use of antibiotics was assessed using criteria Gyssens and reviewed by 3 experts. Chi-square test was used Comparison between the rationality of antibiotic use for inpatient and outpatient pediatric. Results: The irrationality of antibiotic use for inpatient pediatric patients is 78% and for outpatient is 75%. The use of antibiotics which is no indication is 43% in inpatient and 66% in outpatient subject. 74% of inpatients diagnosed with typhoid and 68% of outpatient diagnosed upper respiratory tract infection. Amoxicillin is the most used antibiotics in both inpatient(41%) and outpatient (80%).No statistically significant difference (p = 0.62) between the rationality of antibiotic use for pediatric patients hospitalized with outpatient. However, based on each criterion Gyssen significantly different (p = 0.00) in the category of rationality class V (without indication), IV D (there are more specific antibiotics) and IIA (not appropriate dose). Conclusions: There was no significant difference (p = 0.62) between the rationality of antibiotic use for inpatient and outpatient pediatric patients in Puskesmas Halmahera Semarang. Keywords: rationality, inpatient, outpatient