Skala dan Pola Penggunaan Antibiotik Pada Infeksi Saluran Pernapasan Akut (ISPA) : Surveilans ATC/DDD 2021-2025 Di RSUD Prof. Dr. Margono Soekarjo

Putri Dwi Anggraeni; Ikhwan Yuda Kusuma; Peppy  Octaviani; Silma Kaaffah

doi:10.56359/pharmgen.v5i2.1183

Authors

Putri Dwi Anggraeni Universitas Harapan Bangsa
Ikhwan Yuda Kusuma Universitas Harapan Bangsa
Peppy Octaviani Universitas Harapan Bangsa
Silma Kaaffah

DOI:

https://doi.org/10.56359/pharmgen.v5i2.1183

Keywords:

ATC/DDD, DU90%, antibiotic stewardship, resistensi antibiotik, ISPA

Abstract

Pendahuluan: Infeksi saluran pernapasan akut (ISPA) merupakan salah satu penyebab utama rawat inap dan penggunaan antibiotik di seluruh dunia serta berkontribusi terhadap meningkatnya resistensi antimikroba. Pemantauan penggunaan antibiotik sangat penting untuk mendukung penggunaan antibiotik yang rasional dan memperkuat program antimicrobial stewardship.

Tujuan: Penelitian ini bertujuan untuk mengevaluasi kuantitas dan pola penggunaan antibiotik pada pasien rawat inap dengan ISPA dengan metode Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) dan Drug Utilization 90% (DU90%).

Metode: Penelitian deskriptif retrospektif ini menggunakan data rekam medis pasien dewasa yang didiagnosis ISPA (kode ICD-10 J00–J06 dan J20–J22) di RSUD Prof. Dr. Margono Soekarjo, Indonesia, selama periode 2021–2025. Penggunaan antibiotik dihitung sebagai DDD/100 patient-days berdasarkan metodologi WHO ATC/DDD, sedangkan pola peresepan dianalisis menggunakan metode DU90%. Hasil: Total 237 pasien memenuhi kriteria inklusi dengan total konsumsi antibiotik sebesar 502,49 DDD/100 patient-days dengan penggunaan tahunan berkisar antara 81,13–120,51 DDD/100 patient-days. Antibiotik yang paling banyak digunakan adalah sefiksim, seftriakson, azitromisin, levofloksasin, dan seftazidim. Analisis DU90% menunjukkan bahwa tujuh jenis antibiotik menyumbang sekitar 90% dari total penggunaan, yang didominasi oleh antibiotik kategori Watch menurut klasifikasi WHO AWaRe.

Kesimpulan: Penggunaan antibiotik pada pasien rawat inap dengan ISPA didominasi oleh antibiotik spektrum luas kategori Watch. Surveilans penggunaan antibiotik secara berkelanjutan menggunakan metode ATC/DDD dan DU90% diperlukan untuk mendukung program antimicrobial stewardship serta mengoptimalkan penggunaan antibiotik di rumah sakit.

References

Arumugham, V. B., Gujarathi, R., & Cascella, M. (2023). Third-generation cephalosporins. In StatPearls [Internet]. StatPearls Publishing.

Awaluddin, A. (2023). Monitoring the Use of Antibiotics in Children Patients Acute Respiratory Infection Using ATC/DDD Method. Jurnal Penelitian Pendidikan IPA, 9(12), 10973–10978.

Bulfone, T. C., Malekinejad, M., Rutherford, G. W., & Razani, N. (2021). Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review. The Journal of Infectious Diseases, 223(4), 550–561. https://doi.org/10.1093/infdis/jiaa742

Collignon, P., Beggs, J. J., Walsh, T. R., Gandra, S., & Laxminarayan, R. (2018). Anthropological and socioeconomic factors contributing to global antimicrobial resistance: A univariate and multivariable analysis. The Lancet Planetary Health, 2(9), e398–e405.

Dolk, F. C. K., Pouwels, K. B., Smith, D. R. M., Robotham, J. V., & Smieszek, T. (2018). Antibiotics in primary care in England: Which antibiotics are prescribed and for which conditions? Journal of Antimicrobial Chemotherapy, 73(suppl_2), ii2–ii10. https://doi.org/10.1093/jac/dkx504

Effendi, F., & Evelin, A. (2020). Evaluasi Penggunaan Antibiotik Pasien Infeksi Saluran Pernafasan Akut (ISPA) dengan Metode ATC/DDD di Puskesmas Beji Depok Periode Januari-Juni 2019. Jurnal Farmamedika (Pharmamedika Journal), 5(1), 8–13.

Guitor, A. K., & Wright, G. D. (2018). Antimicrobial Resistance and Respiratory Infections. Chest, 154(5), 1202–1212. https://doi.org/10.1016/j.chest.2018.06.019

Ilboudo, A. K., Cissé, A., Milucky, J., Tialla, D., Mirza, S. A., Diallo, A. O., Bicaba, B. W., Charlemagne, K. J., Diagbouga, P. S., Owusu, D., & others. (2024). Predictors of severity and prolonged hospital stay of viral acute respiratory infections (ARI) among children under five years in Burkina Faso, 2016–2019. BMC Infectious Diseases, 24(1), 331.

Kasse, G. E., Cosh, S. M., Humphries, J., & Islam, M. S. (2024). Antimicrobial prescription pattern and appropriateness for respiratory tract infection in outpatients: A systematic review and meta-analysis. Systematic Reviews, 13(1), 229. https://doi.org/10.1186/s13643-024-02649-3

Khadse, S. N., Ugemuge, S., & Singh, C. (2023). Impact of antimicrobial stewardship on reducing antimicrobial resistance. Cureus, 15(12).

Kharroubi, S. A., & Diab-El-Harake, M. (2022). Sex-differences in COVID-19 diagnosis, risk factors and disease comorbidities: A large US-based cohort study. Frontiers in Public Health, 10, 1029190.

Klein, E. Y., Impalli, I., Poleon, S., Denoel, P., Cipriano, M., Van Boeckel, T. P., Pecetta, S., Bloom, D. E., & Nandi, A. (2024). Global trends in antibiotic consumption during 2016–2023 and future projections through 2030. Proceedings of the National Academy of Sciences, 121(49), e2411919121.

Koh, S. W. C., Low, S. H., Goh, J. C., & Hsu, L. Y. (2025). Increase in Antibiotic Utilisation in Primary Care Post COVID-19 Pandemic. Antibiotics, 14(3), 309. https://doi.org/10.3390/antibiotics14030309

Limato, R., Lazarus, G., Dernison, P., Mudia, M., Alamanda, M., Nelwan, E. J., Sinto, R., Karuniawati, A., Rogier Van Doorn, H., & Hamers, R. L. (2022). Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention. The Lancet Regional Health - Southeast Asia, 2, 100013. https://doi.org/10.1016/j.lansea.2022.05.002

Malik, S. S., & Mundra, S. (2022). Increasing consumption of antibiotics during the COVID-19 pandemic: Implications for patient health and emerging anti-microbial resistance. Antibiotics, 12(1), 45.

Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., Cooley, L. A., Dean, N. C., Fine, M. J., Flanders, S. A., Griffin, M. R., Metersky, M. L., Musher, D. M., Restrepo, M. I., & Whitney, C. G. (2019). 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. American Journal of Respiratory and Critical Care Medicine, 200(7), e45–e67. https://doi.org/10.1164/rccm.201908-1581ST

Misworo, M., Kusuma, I. Y., Kurniasih, K. I., Nurkholis, F., & Fauziah, F. (2025). Antibiotic Use and Prescribing Patterns for Respiratory Tract Infections (ICD-10: J00-J99) in Indonesia During the COVID-19 Pandemic. Journal of Pharmaceutical and Sciences, 837–846. https://doi.org/10.36490/journal-jps.com.v8i2.849

Morici, G., Cibella, F., Cogo, A., Palange, P., & Bonsignore, M. R. (2020). Respiratory Effects of Exposure to Traffic-Related Air Pollutants During Exercise. Frontiers in Public Health, 8, 575137. https://doi.org/10.3389/fpubh.2020.575137

Pani, S., Barliana, M. I., Halimah, E., Pradipta, I. S., & Annisa, N. (2015). Monitoring the Use of Antibiotics by the ATC/DDD Method and DU 90%: Observational Studies in Community Health Service Centers in North Gorontalo District. Indonesian Journal of Clinical Pharmacy, 4(4), 275–280. https://doi.org/10.15416/ijcp.2015.4.4.280

Rindang Andarsari, M., Norachuriya, Z., Mahmudatun Nabila, S., Aryani, T., & Nur Rosyid, A. (2022). Assessment of Antibiotic Use in ICU Patients with Pneumonia Using ATC/DDD as a Quantitative Analysis Method.

Saepudin, S., Sendysagita, C., & Yuniarti, E. (2022). Drug Utilization 90% Profile of Antibiotics Use during the Period of 2013–2017 at a Private Teaching Hospital in Yogyakarta. Jurnal Farmasi Sains Dan Komunitas (Journal of Pharmaceutical Sciences and Community), 19(1), 8–14.

Shafi, M. K., Shah, A. A., Khan, M. A., Faisal, S., Iqbal, S., Shafi, M. K., Shah, A. A., & Khan, M. A. (2024). The assessment and efficiency of cefixime in upper respiratory tract infections: Insights and perspectives. Cureus, 16(7).

Shi, Z., Zhang, J., Tian, L., Xin, L., Liang, C., Ren, X., & Li, M. (2023). A comprehensive overview of the antibiotics approved in the last two decades: Retrospects and prospects. Molecules, 28(4), 1762.

Sous, M. M. J. A., Houri, H. N. A., Safiah, M. H., Alazrak, S. O., & Akwan, R. R. (2023). Antibiotic prescription patterns for acute upper respiratory tract infections in an outpatient population with health insurance in Syria—A retrospective cross-sectional study. IJID Regions, 7, 66–71. https://doi.org/10.1016/j.ijregi.2023.02.010

Van Houten, C. B., Cohen, A., Engelhard, D., Hays, J. P., Karlsson, R., Moore, E., Fernández, D., Kreisberg, R., Collins, L. V., De Waal, W., De Winter-de Groot, K. M., Wolfs, T. F. W., Meijers, P., Luijk, B., Oosterheert, J. J., Heijligenberg, R., Sankatsing, S. U. C., Bossink, A. W. J., Stubbs, A., … Bont, L. J. (2019). Antibiotic misuse in respiratory tract infections in children and adults—A prospective, multicentre study (TAILORED Treatment). European Journal of Clinical Microbiology & Infectious Diseases, 38(3), 505–514. https://doi.org/10.1007/s10096-018-03454-2

Vaughn, V. M., Gandhi, T. N., Petty, L. A., Patel, P. K., Prescott, H. C., Malani, A. N., Ratz, D., McLaughlin, E., Chopra, V., & Flanders, S. A. (2021). Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with coronavirus disease 2019 (COVID-19): A multi-hospital cohort study. Clinical Infectious Diseases, 72(10), e533–e541.

WHO, W. H. O. (2020). WHO Collaborating Centre for Drug Statistics Methodology. WHO.

WHO, W. H. O. (2021). Metodologi ATC/DDD. WHO. https://www.who.int/tools/atc-ddd-toolkit/methodology

WHO, W. H. O. (2023). AWaRe classification of antibiotics for evaluation and monitoring of use, 2023. https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2023.04

Wu, T., Li, T., Guo, H., Zhu, B., Zhang, Y., & Zhao, Z. (2025). Trends of antibiotic use for acute upper respiratory infections in Chinese emergency departments and the impact of COVID-19: A cross-sectional study. Antimicrobial Resistance & Infection Control, 14(1), 51.

Yuniarti, E., Rani, A. M., & Handayani, E. W. (2021). Evaluasi Penggunaan Antibiotika Pada Infeksi Saluran Kemih Dengan Metode ATC/DDD DI RSUD Dr. Soedirman Kebumen. Jurnal Farmasi Klinik Dan Sains, 1(1), 6–10.