Analisis Efektivitas Biaya Penggunaan Antibiotik pada Pasien Penyakit Paru Obstruktif Kronik di Rumah Sakit Prof. Dr. Chairuddin P. Lubis

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a non-communicable disease with high global morbidity and mortality. One of the causes of COPD is bacterial infection, which requires antibiotic therapy. Misuse of antibiotics can cause resistance, increase treatment costs, and worsen the patient's condition. Therefore, cost-effectiveness analysis (CEA) is needed to assess treatment efficiency. Objective: This study analyzed the antibiotic therapy models provided to hospitalized COPD patients and identified the most cost-effective antibiotic at Prof. Dr. Chairuddin P. Lubis Hospital. Methods: This cost-effectiveness analysis applied a retrospective Cohort design based on the medical records of hospitalized COPD patients (n=60) from January 2023 to December 2024, from the hospital’s perspective. The clinical outcome analyzed was the reduction of white blood cell (WBC) within a maximum of 7 days, analyzed using the Cost Effectiveness Ratio (CER) and Incremental Cost Effectiveness Ratio (ICER). Results: The majority (78%) were male. The study identified five antibiotic therapy models which included ceftriaxone injection 1g/12 hours, levofloxacin injection 750 mg/24 hours, ceftriaxone injection 1 g/12 hours + azithromycin 500 mg/24 hours, levofloxacin injection 750 mg/24 hours + ceftriaxone injection 1 g/12 hours, and levofloxacin injection 750 mg/24 hours + ampicillin sulbactam injection 1,5 g/6 hours with the most cost-effective antibiotic therapy was ceftriaxone 1 g/12 hours combined with azithromycin 500 mg /24 hours, with the lowest CER value of Rp12,555. Conclusion: This study found that the most cost-effective antibiotic was combination of ceftriaxone 1 g/12 hours and azithromycin 500 mg/24 hours.