ANALISA KOMPARASI EFEKTIVITAS DAN BIAYA ANTARA MONOTERAPI CEFTRIAXONE I.V DAN CEFTRIAXONE I.V DITAMBAH CIPROFLOXACIN I.V SEBAGAI TERAPI EMPIRIS PNEUMONIA DI RUMAH SAKIT

One of the most important treatment in pneumonia is antibiotic. we have to consider not only rationale antibiotic therapy but also the pharmacoeconomic of the treatment. Wide variations in antimicrobial prescribing practices exist in hospitalized pneumonia. The objective of this study was to compare the effectiveness and cost ceftriaxone i.v monotherapy (CTX) vs combination therapy ceftriaxone i.v plus ciprofloxacin i.v (CTXCP) as empiric treatment hospitalized pneumonia in Hospital DR. Kariadi. This study was retrospective. Data was observed from medical record and payment note from patient with pneumonia in Hospital DR. Kariadi during Januari-Desember 2012. Data recruited by purposive sampling. Inclusion criterias of this study were adult patient hospitalized pneumonia (age>18 year) with CTX or CTXCP treatment. Exclusion criterias were aspiration pneumonia, immunocompromized patient (HIV/AIDS or malignancy), and patient with another infection. Effectiveness parameters of this study were LOS (length of stay), LOSAR (length of stay antibiotic related), success rate, and CFA (first line clinical failure avoided). Cost included acomodation, laboratorium, medical service, antibiotics, drugs, and total cost. Overall, 171 paients were recruited. Of these 65 patients received CTX and 106 patients received CTXCP. LOS and LOSAR were shorter in CTX group than CTXCP (11,32 vs 13,15 days, p=0,14 and 9,26 vs 12,09 days, p=0,000). Success rate and CFA in CTX group better than CTXCP (81,13% vs 66,15%, p=0,027 and CFA 71,79% vs 44,62%, p=0,000). Costs in CTXCP group were significantly higher than CTX in all components. In conclusion monotherapy ceftriaxone i.v is more cost effective than combination therapy ceftriaxone i.v plus ciprofloxacin i.v as empiric treatment of hospitalized pneumonia in Hospital DR. Kariadi