The Relationship Between Appropriateness of Antibiotic Use Based on the Gyssens Algorithm and Mortality: A Retrospective Cohort Study in Indonesian Tertiary Hospital

Abstract

Background: Some studies have reported that antibiotic use as therapy and prophylaxis in hospitals is inappropriate in approximately 9% to 64% of cases. The Gyssens algorithm is used for qualitative evaluation by assessing the appropriate antibiotic use. This study aimed to determine and evaluate the quality of antibiotic use in inpatients at Dr. M. Djamil Central General Hospital using the Gyssens algorithm. Methods: This was a retrospective cohort study at Dr. M. Djamil Central General Hospital from January to December 2021. We collected data from the medical records of inpatients who received antibiotics using a random sampling technique, and the number of patients from each department was calculated through a preliminary survey. Results: There were three hundred and sixty samples from the population that met the inclusion criteria, adults (59.4%), patients treated for >14 days (38.9%), patients discharged with improvement (66.9%), and patients diagnosed with pneumonia (49.5%). Most antibiotics were appropriate (56.5%), with ceftriaxone being the most commonly used antibiotic (199 cases). Appropriate antibiotic use (Gyssens 0) is mostly found in the Internal Medicine Department Meanwhile, antibiotic use without indications (Gyssens V) is mostly found in the Surgery Department. A significant correlation was found betweenthe appropriateness of antibiotic administration and patient outcomes after discharge from the hospital (p<0.05). There was an increase in the risk of death in inappropriate antibiotic use (Gyssens I-IV) and antibiotic use without indications (Gyssens V) by 1.96 and 4.05 times, respectively. Conclusion: There are many cases of inappropriate antibiotic use in Dr. M. Djamil Central General Hospital; therefore, education regarding appropriate antibiotic use is necessary