Analysis Of Antibiotic Usage In Patients With Bacteremia In The Icu Unit Of Dr. Soetomo Hospital Surabaya

Bacteremia is one of major nosocomial infection happen in intensive care unit (ICU). It will increase patient’s hospitalization rate and mortality. Inappropriate usage of antibiotic also can increase morbidity, mortality, cost and antibiotic resistance. The qualitative evaluation about the appropriateness of the choice, dosage and the duration of antibiotic therapy will be assessed using Gyssen's category. This study is to identified the pattern of bacterial causing bacteremia and their sensitivity to antibiotics, and to analyze antibiotic usage at Intensive Care Unit at Dr. Soetomo Teaching Hospital with qualitative method using Gyssens's category. This is a descriptive observational cohort, prospective study. Patients who have positive blood culture during observation in ICU, were evaluated from January-March 2013. From May-November 2012 period, retrospectively, the most frequently isolated microorganism was negative-gram bacteria, mostly Acinetobacter followed by gram-positive bacteria, mostly CoNS- Staphylodcoccus coagulase negative. Twenty two patients, with positive blood culture were analyzed prospectively from January- March 2013. The major empirical antibiotic treatment used in ICU were sefoperazon sulbactam and meropenem. The antibiotic usage qualitative evaluation using Gyssens’s category, on eleven patients receiving definitive therapy, shows that 45% considered definitely appropriate; 27% were inappropriate regarding choice; 27% were inappropriate regarding dosage or duration. The empirical antibiotics used in ICU, meropenem and cefoperazone sulbactam, is already adequate according to the sensitivity pattern. The antibiotic usage qualitative evaluation using Gyssens’s category, on eleven patients receiving definitive therapy, still shows inappropriateness regarding choice, dosage, or duration. (FMI 2014;50:254-261