Volume 7 Nomor 4 – Desember 2017 168 p-ISSN: 2088-8139 e-ISSN: 2443-2946 PERBANDINGAN POLA TERAPI ANTIBIOTIK PADA COMMUNITY- ACQUIRED PNEUMONIA (CAP) DI RUMAH SAKIT TIPE A DAN B PATTERN OF ANTIBIOTIC IN COMMUNITY-ACQUIRED PNEUMONIA (CAP) RATIO IN TYPE A AND B HOSPITAL Ika Puspita Sari 1 , Titik Nuryastuti 2 , Rizka Humardewayanti Asdie 3 , Anton Pratama 4,5 , Endang Estriningsih 4,6 1 Dept of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 2 Dept of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta 3 Dept of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta 4 Magister of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta 5 RSUD H.Abdul Moeloek Bandar Lampung 6 Stikes Bhakti Mandala Husada Slawi ABSTRAK Pneumonia masih merupakan ancaman bagi semua Negara. Penanganan CAP di rumah sakit biasanya menggunakan terapi antibiotik secara empirik dengan pedoman IDSA/ATS. Penelitian ini bertujuan membandingkan terapi antibiotik empirik pasien CAP di rumah sakit tipe A dan B, menganalisis variasi yang terjadi serta membandingkan outcome terapinya. Penelitian dilakukan secara retrospektif dengan mengumpulkan data dari rekam medik pasien yang didiagnosis utama CAP. Kriteria inklusi dalam penelitian ini adalah pasien rawat inap dewasa pria dan wanita dengan usia ≥ 18 tahun yang memiliki data rekam medis yang lengkap. Pasien menerima terapi antibiotik empiric yang menjalani rawat inap di bangsal rawat inap (non ICU) rumah sakit tipe A dan tipe B. Data dari rumah sakit tipe A (RS A) diambil dalam rentang waktu Januari 2014-Desember 2016, sedangkan dari rumah sakit tipe B (RS B) diambil pada Januari 2013-Desember 2016. Jumlah pasien penderita CAP di RS A berjumlah 72, sedangkan di RS B berjumlah 34. Pasien dengan keganasan dan imunokompromise dikeluarkan dari penelitian ini. Dalam penelitian ini juga dipetakan kuman yang ditemukan di RS A, sementara di RS B tidak dilakukan pemeriksakan/kultur kuman. Outcome pasien adalah perbaikan respon terapi setelah 5-7 hari pemberian antibiotik empiris yang ditunjukkan dengan adanya perbaikan klinis menurut dokter dan/atau perbaikan pada hasil x-ray thorax. Data demografi pasien dan pola terapi antibiotik dianalisis secara deskriptif. Outcome terapi pasien dianalisis menggunakan statistic Chi kuadrat dengan taraf kepercayaan 95%. Hasil penelitian menunjukkan bahwa terapi antibiotik secara empiric pada pasien CAP di rumah sakit tipe A sebagian besar sesuai dengan pedoman IDSA/ATS, sedangkan di RS B sebaliknya. Outcome terapi pasien di RS A dan B menunjukkan perbaikan pasien sekitar 76%. Di RS A penyebab CAP sebagian besar adalah bakteri Gram negative yang masih sensitive terhadap sefalosporin/karbapenem (cefpirom, ceftasidim, cefepim, dan imipenem) dan aminogikosida (amikasin, netilmisin, dan tobramisin). Kata kunci: CAP, terapi empiric, outcome terapi. ABSTRACT Pneumonia is a threat to all States. CAP treatment in hospitals typically uses empirical antibiotic therapy with IDSA/ATS guidelines.This research aimed to compare empirical antibiotic therapy of CAP patients in types A and B hospital, analyze the variations that occur and compare the outcome of the therapy. The research was conducted retrospectively by collecting data from the medical records of patients diagnosed with CAP.The inclusion criteria in this research were male and female adult patients aged ≥18 years who had complete medical record data. Patients who underwent inpatient care in the in-patient wards (non ICU) of type A and B hospital received empirical antibiotic therapy. Data from type A hospital (RS A) were taken within the period of January 2014-December 2016, while data from type B hospital (RS B) were taken in January 2013-December 2016.The number of patients with CAP in hospital A is 72, whereas in hospital B, it is 34. Patients with malignancy and immunocompromise were excluded from this research. In this research, germs found in hospital A were mapped, while no gynecologic examination/culture was performed in hospital B. The outcome of the treatment was an improvement in response 5-7 days after empirical antibiotics was given, as reported by a physician and/or by an improvement in the x-ray thorax results. Patient demographic data and antibiotic therapy pattern were analyzed descriptively. Outcome of patient therapy was analyzed using Chi square statistics with 95% confidence level.The results showed that empirical antibiotic therapy in CAP patients in type A hospital were largely based on IDSA/ATS guidelines, whereas in it is the opposite for type B hospital. Outcomes of patient therapy in A and B hospitals showed patient improvement of about 76%. In type A hospital, the cause of CAP is largely negativeGram bacteria which are still sensitive to cephalosporin/carbapenem (cefpirom, ceftasidim, cefepim, and imipenem) and aminogicosida (amikacin, netilmisin, and tobramisin). Keywords: CAP, empirical therapy, outcome therapy.