Quality Assesment of Antibiotic Prescription for Sepsis Treatment in Intensive Care Unit at Top Referral Hospital in West Java, Indonesia
Abstract: Sepsis is a common
disease in intensive care unit (ICU) with high mortality rate. Administration
of antibiotic has an important role to determine the outcome of sepsis patient.
This study aimed to evaluate the quality of antibiotic prescription for sepsis
treatment in intensive care unit (ICU).
Methods: This descriptive study was conducted by retrieving data from 48
medical records of patients with sepsis, severe sepsis, and septic shock
admitted to ICU Dr. Hasan Sadikin
General Hospital (RSHS) in 2013. The study was conducted from August to October
2014. Empiric therapy in the ICUat RSHS and Surviving Sepsis Campaign (SSC)
guidelines in 2012 were used as a standard for antibiotic prescription. The quality
of antibiotic prescription was assessed then categorized based on Gyssens
criteria. The collected data were analyzed in the form of frequency and
percentage and presented in tables.
Results: This study discovered that most of the patients had severe
sepsis and septic shock. Based on Gyssens criteria, 35% antibiotic uses were
included into category 0 (proper); 1.4% category I (improper timing); 10.5%
category IIA (improper dosage); 9.1% category IIB (improper interval); 3.5%
category IIC (improper route); 12.6% category IIIA (improper duration; too
long); 1.4% category IIIB (improper duration; too short); 16.8% category IVA
(improper; other antibiotics were more effective); 4.2% category IVD (improper;
other antibiotics had narrower spectrum); and 5.6% category V (improper; no
indication).
Conclusions: There are still improper uses of antibiotic for sepsis,
severe sepsis, and septic shock patients in the ICU.
Keywords: Antibiotic, Glyssens
criteria, sepsis, septic shock, severe sepsis
Author: Shadrina Dinan Adani,
Ardi Zulfariansyah, Putri Teesa Radhiyanti Santoso
Journal Code: jpkedokterangg170129
