Evaluasi Penggunaan dan Cost-Effectiveness Antibiotika dalam Terapi Pneumonia Pasien Rawat Inap di Rumah Sakit Mitra Medika Medan

Abstract

The impact of irrational antibiotics usage in pneumonia patients is an increase in resistance, an increase in drug side effects, and a failure of therapy that causes patients health to deteriorate, lowering their quality of life and raising their treatment costs. The purpose of this study is to analyzed the level of rationally use of antibiotics and the cost of treatment of pneumonia patients in inpatient installations at Mitra Medika Medan Hospital. This study used a prospective observational design and descriptive data acquisition. Quantitative and qualitative assessments were conducted using the ATC/DDD and Gyssens methods. The CER (Cost Effective Ratio) and ICER (Incremental Cost Effective Ratio) methods, as well sensitivity analysis, were used to compare the costs of treating inpatients with pnemonia. The results of the quantitative assessment showed that the total use of antibiotics was 145,72 DDD/100 days of care. In the results of the quality assessment of antibiotics in category 0, there were 254 patients (91,37%) with rational use, while in categories I–VI, there were 24 patients (8,63%) with irrational use. The results of the evaluation of antibiotic costs show that the most cost-effective therapy is ceftriaxone, with a CER value of Rp 44.136, -. The combination of meropenem-levofloxacin antibiotics is the main choice of therapy with better effectiveness at a higher price, namely the ICER value of Rp 512.779. The results of the sesitivity analysis with an additional cost of 5%, 10%, and 15% obtained a CER value of ceftriaxone Rp 44.316, - Rp 44.496, - Rp 44.677, - and ICER meropenem-levofloxacin Rp 533.523,- Rp 552.937, and - Rp 575.011. Based on the finding of this study, it can be concluded that the use of antibiotics was not completely rational and the most cost effective is ceftriaxone, the combination of meropenem-levofloxacin is in quadrant I and sensitivity analysis shows that the additional cost of antibiotics can affect the CER and ICER values.