Evaluation of Drug Related Problems (DRPs) Antibiotic in Sepsis Patients in Hospital X at Yogyakarta
Abstract
Sepsis is a manifestation of the most severe acute infections that can lead to the various organ failure generally ends with death in 30-50% of cases. The number of sepsis deaths in developed countries can be reduced to 11-15%, but in developing countries it was reported above 45%. Proper and adequate use of empirical antibiotics may decrease the risk of death in sepsis and may at least shorten patient duration of care in the hospital. Aim to this study was determine the pattern of antibiotic use, the incidence of Drug Related Problems (DRPs) and clinical outcomes in septic patients in hospital X at Yogyakarta. An observational study was carried out during the period of January-December 2015 in hospital X at Yogyakarta. Data were collected retrospectively among patients with sepsis, age > 15 years old, hospitalized during the the study period. From 632 cases, 162 patients were diagnosed as sepsis and met the inclusion criteria of the study. The antibiotics used were cephalosporin (42.58%), quinolone (17.46%), carbapenem (10.77%), aminoglycoside (9.33%), imidazole (8.85%) and macrolide (4.88%). Poor clinical outcomes associated with DRPs (64.29%) were greater than those that showed good clinical outcomes (35.71%). The incidence of DRPs in sepsis treatment is still high (60.49%), and is generally associated with antibiotic needs, the inappropriate selection of antibiotics, inadequate dosage and the presence of antibiotic interactions.
References
2. Harbarth S, Garbino J, Pugin J, Romand JA, Lew D, Pittet D. Innapropriate initial antimicrobial therapy and its eff ect on survival in a clinical trial of immunomodulating therapy for severe sepsis. The American Journal of Medicine. 2003. 115:529-35.
3. Heenen S, Jacobs F, Vincent JL. Antibiotic strategies in severe nosocomial sepsis: why do we not de-escalate more often. Crit Care Med. 2012.40(4):1404-9.
4. Palomba H, Corrêa TD, Silva E, Pardini A, Cesarde Assuncao MS. Comparative analysis of survival between elderly and non-elderly severe sepsis and septic shock resuscitated patients. Einstein; 2015.13(3):357-63.
5. Kumar G, Kumar N, Taneja A, Kaleekal T, Tarima S, McGinley E, Jimenez E, Mohan A, Khan RA, Whittle J, et al. Milwaukee initiative in critical care outcomes research group of investigators. nationwide trends of severe sepsis in the 21st century (2000-2007). Chest. 2011.140:1223–31.
6. Torio CM, Andrews RM. Agency for Healthcare Research and Quality. HCUP statistical brief 160. National inpatient hospital costs: the most expensive conditions by Payer, 2011. Aug. 2013 http://www. hcup-us.ahrq.gov/reports/statbriefs/sb160.pdf . diakses 15 Desember, 2015.
7. Armen SB, Freer CF, Showalter, JW, Crook T, Whitener CJ, West C, Terndrup, TE, Grifasi, M, DeFlitch, CJ and Hollenbeak, CS. Am J Med Qual. 2016.31(1):56–63.
8. Birken SLK and DiPiro JT. Septis and septic shock. In: JT DiPiro RL, Talbert GC, Yee GR, Matzke, BG, Wells LM, Posey (Eds). Pharmacotherapy A pathophysiologic approach. 6 th edition. New York: McGraw-Hill; 2005. 2131-42. 9. Russell JA. Management of sepsis. N Engl J Med. 2006.355(16):1699-1712.
10. World Health Organization. The evolving threat of antimicrobial resistance. Options for actions. 2012. Available at: http://www.who.int/patientsafety/ implementation/amr/publication/ en/index.html.
11. Bochud YP, Glauser PPM, Chalandra T. Antibiotics in sepsis. Intensv Care Med. 2001.27:S33-S48.
12. Mouton JW, Ambrose PG, Cantón R, Drusano GL, Harbarth S, MacGowan A, et al. Conserving antibiotics for the future: new ways to use old and new drugs from a pharmacokinetic and pharmacodynamic perspective. Drug Resist Updat. 2011;14:107-17.
13. Kyle A, Weant, Stephanie N, Baker. Emergency medicine pharmacist and sepsis management. Journal of Pharmacy Practice. 2012.
14. Fleischmann C, Thomas–Rueddel DO, Hartmann M, Hartog CS, Welte T, Heublein S, Dennler U, Reinhart K. Hospital incidence and mortality rates of sepsis. An Analysis of Hospital Episode (DRG) Statistics in Germany From 2007 to 2013 Dtsch Arztebl Int. 2016.113: 159–66.
15. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically Ill patients in Australia and New Zealand. JAMA. 2014. 311(13):1308-16.
16. Tsertsvadze A, Royle P, Seedat F, Cooper J, Crosby R and McCarthy N. Community-onset sepsis and its public health burden: a systematic review. BMC. 2016.5:81.
17. Walkey AJ and Wiener RS. Hospital case volume and outcomes among patients hospitalized with severe sepsis. Am J Resp Crit Care Med. 2014. 189(5):548-55.
18. Jones SL, Ashton CM, Kiehne L, Gigliotti E, Bell- Gordon C, Disbot M, Masud F, Shirkey BA, Wray NP. Jt Comm J Qual Patient Saf. 2015. 41(11):483–91.
19. Cipolle R, Strand L, dan Morley PC. Pharmaceutical care practise: The clinician’s guide. New York: McGraw –Hill, Health Professions Division; 1998.
20. Cipolle R, Strand L, dan Morley PC. Pharmaceutical care practise: The clinician’s guide. Second edition. new York: McGraw –Hill Companies, Incorporated. 2004.
21. Lacy FP, Amtrong LL, Goldmann PM, Lance LL. Drug information handbook. 14th edition. Ohio: Lexi-comp. Hudson; 2006.
Licencing
All articles in Jurnal Ilmu Kefarmasian Indonesia are an open-access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which permits unrestricted non-commercial used, distribution and reproduction in any medium.
This licence applies to Author(s) and Public Reader means that the users mays :
- SHARE:
copy and redistribute the article in any medium or format - ADAPT:
remix, transform, and build upon the article (eg.: to produce a new research work and, possibly, a new publication) - ALIKE:
If you remix, transform, or build upon the article, you must distribute your contributions under the same license as the original. - NO ADDITIONAL RESTRICTIONS:
You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
It does however mean that when you use it you must:
- ATTRIBUTION: You must give appropriate credit to both the Author(s) and the journal, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
You may not:
- NONCOMMERCIAL: You may not use the article for commercial purposes.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.