{"title":"万隆哈桑-萨迪金博士综合医院重症监护室 COVID-19 患者使用抗生素的合理性；一项队列研究","authors":"Indriasari, Ezra Oktaliansah, Rikda Irham Munazat","doi":"10.35975/apic.v28i1.2384","DOIUrl":null,"url":null,"abstract":"Background and Objectives: Nearly three-quarters of the patients with COVID-19 received antibiotic therapy despite the bacterial coinfection being only less than 10% in many studies and ranging from 8-22% in ICU patients. The use of broad-spectrum antibiotics in COVID-19 patients has not been proven effective. Overuse of antibiotics may be associated with side effects and antibiotic resistance. The purpose of this study was to determine the antibiotic rationality in COVID-19 patients in the ICU of Dr. Hasan Sadikin Hospital, Bandung, Indonesia. \nMethodology: This descriptive, retrospective cohort study was carried out by analyzing medical records of COVID-19 patients admitted in the ICU of Dr. Hasan Sadikin Hospital from January-June 2021. \nResults: There were 138 patients who met the inclusion criteria. A total of 126 (91.3%) patients received antibiotics. A total of 12 (8.7%) severe/critical patients did not receive antibiotics and 79 (62.70%) received inappropriate antibiotic duration. Inappropriate regimen was found in 59 patients (74.68%) with COVID-19 without HAP/VAP and 15 patients (31.92%) with HAP/VAP. The primary issue identified was the inappropriate regimen of antibiotics, Gyssens category 4a. \nConclusion: This study concludes that 23.02% patients used rational empirical antibiotics and 45.98% used rational definitive antibiotics in COVID-19 patients in the ICU at RSUP Dr. Hasan Sadikin Bandung during January-June 2021. \nAbbreviations: ACE- Angiotensin Converting Enzyme; ICU- Intensive Care Unit; HAI- Hospital-Associated Infections; HAP- Hospital-Acquired Pneumonia; IDSA- Infectious Diseases Society of America VAP- Ventilator-Associated Pneumonia \nKey words: Antibiotics; Antimicrobial Resistance; COVID-19; Intensive Care Units; Prescribing Pattern \nCitation: Indriasari, Oktaliansah E, Munazat RI. Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung; a cohort study. Anaesth. pain intensive care 2024;28(1):115−125. \nDOI: 10.35975/apic.v28i1.2384 \nReceived: November 20, 2023; Reviewed: December 03, 2023; Accepted: December 26, 2023","PeriodicalId":108815,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":"19 11","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital, Bandung; a cohort study\",\"authors\":\"Indriasari, Ezra Oktaliansah, Rikda Irham Munazat\",\"doi\":\"10.35975/apic.v28i1.2384\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background and Objectives: Nearly three-quarters of the patients with COVID-19 received antibiotic therapy despite the bacterial coinfection being only less than 10% in many studies and ranging from 8-22% in ICU patients. The use of broad-spectrum antibiotics in COVID-19 patients has not been proven effective. Overuse of antibiotics may be associated with side effects and antibiotic resistance. The purpose of this study was to determine the antibiotic rationality in COVID-19 patients in the ICU of Dr. Hasan Sadikin Hospital, Bandung, Indonesia. \\nMethodology: This descriptive, retrospective cohort study was carried out by analyzing medical records of COVID-19 patients admitted in the ICU of Dr. Hasan Sadikin Hospital from January-June 2021. \\nResults: There were 138 patients who met the inclusion criteria. A total of 126 (91.3%) patients received antibiotics. A total of 12 (8.7%) severe/critical patients did not receive antibiotics and 79 (62.70%) received inappropriate antibiotic duration. Inappropriate regimen was found in 59 patients (74.68%) with COVID-19 without HAP/VAP and 15 patients (31.92%) with HAP/VAP. The primary issue identified was the inappropriate regimen of antibiotics, Gyssens category 4a. \\nConclusion: This study concludes that 23.02% patients used rational empirical antibiotics and 45.98% used rational definitive antibiotics in COVID-19 patients in the ICU at RSUP Dr. Hasan Sadikin Bandung during January-June 2021. \\nAbbreviations: ACE- Angiotensin Converting Enzyme; ICU- Intensive Care Unit; HAI- Hospital-Associated Infections; HAP- Hospital-Acquired Pneumonia; IDSA- Infectious Diseases Society of America VAP- Ventilator-Associated Pneumonia \\nKey words: Antibiotics; Antimicrobial Resistance; COVID-19; Intensive Care Units; Prescribing Pattern \\nCitation: Indriasari, Oktaliansah E, Munazat RI. Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung; a cohort study. Anaesth. pain intensive care 2024;28(1):115−125. \\nDOI: 10.35975/apic.v28i1.2384 \\nReceived: November 20, 2023; Reviewed: December 03, 2023; Accepted: December 26, 2023\",\"PeriodicalId\":108815,\"journal\":{\"name\":\"Anaesthesia, Pain & Intensive Care\",\"volume\":\"19 11\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaesthesia, Pain & Intensive Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.35975/apic.v28i1.2384\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia, Pain & Intensive Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.35975/apic.v28i1.2384","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital, Bandung; a cohort study
Background and Objectives: Nearly three-quarters of the patients with COVID-19 received antibiotic therapy despite the bacterial coinfection being only less than 10% in many studies and ranging from 8-22% in ICU patients. The use of broad-spectrum antibiotics in COVID-19 patients has not been proven effective. Overuse of antibiotics may be associated with side effects and antibiotic resistance. The purpose of this study was to determine the antibiotic rationality in COVID-19 patients in the ICU of Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Methodology: This descriptive, retrospective cohort study was carried out by analyzing medical records of COVID-19 patients admitted in the ICU of Dr. Hasan Sadikin Hospital from January-June 2021.
Results: There were 138 patients who met the inclusion criteria. A total of 126 (91.3%) patients received antibiotics. A total of 12 (8.7%) severe/critical patients did not receive antibiotics and 79 (62.70%) received inappropriate antibiotic duration. Inappropriate regimen was found in 59 patients (74.68%) with COVID-19 without HAP/VAP and 15 patients (31.92%) with HAP/VAP. The primary issue identified was the inappropriate regimen of antibiotics, Gyssens category 4a.
Conclusion: This study concludes that 23.02% patients used rational empirical antibiotics and 45.98% used rational definitive antibiotics in COVID-19 patients in the ICU at RSUP Dr. Hasan Sadikin Bandung during January-June 2021.
Abbreviations: ACE- Angiotensin Converting Enzyme; ICU- Intensive Care Unit; HAI- Hospital-Associated Infections; HAP- Hospital-Acquired Pneumonia; IDSA- Infectious Diseases Society of America VAP- Ventilator-Associated Pneumonia
Key words: Antibiotics; Antimicrobial Resistance; COVID-19; Intensive Care Units; Prescribing Pattern
Citation: Indriasari, Oktaliansah E, Munazat RI. Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung; a cohort study. Anaesth. pain intensive care 2024;28(1):115−125.
DOI: 10.35975/apic.v28i1.2384
Received: November 20, 2023; Reviewed: December 03, 2023; Accepted: December 26, 2023
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