Evaluation of antibiotic use rationality in typhoid fever patients at TK IV 02.07.04 Hospital, Bandar Lampung, using the Gyssens method
DOI:
https://doi.org/10.32734/idjpcr.v9i01.24614Keywords:
antibiotic, ceftriaxone, gyssens, typhoid feverAbstract
Typhoid fever, an infection caused by Salmonella typhi, remains an endemic public health problem in Indonesia, with an estimated 11–20 million cases reported globally each year. Antibiotics are the mainstay of treatment; however, irrational use may lead to bacterial resistance and increased complications. This study aimed to evaluate the rationality of antibiotic use in patients with typhoid fever at TK IV 02.07.04 Hospital, Bandar Lampung, in 2023 using the Gyssens method. An analytical observational study with a cross-sectional design was conducted using 121 medical records of typhoid fever patients from 2023, selected through purposive sampling based on predefined inclusion criteria. Data were analyzed descriptively using the Gyssens method to classify the rationality of antibiotic use (categories 0–VI) and processed using Microsoft Excel. The majority of patients were male (71%), aged 20–35 years (83%), and had a body weight of 61–90 kg (69%). Ceftriaxone was administered to all patients (100%), predominantly at a dose of 1 gram every 12 hours (98%) and for a duration of 5–6 days (76%). Gyssens evaluation revealed that 75% of antibiotic use was classified as rational (category 0), while 25% was irrational, mainly due to excessively short duration of therapy (24%, category IIIB) and inappropriate dosing (1%, category IIA). The use of ceftriaxone was generally consistent with the Indonesian Ministry of Health Regulation No. 28 of 2021; however, deviations related to treatment duration of less than five days and suboptimal dosing frequency contributed to irrational use. Male patients exhibited a higher risk, potentially associated with increased outdoor activities and lower hygiene practices. These findings highlight the need for stricter monitoring to minimize antimicrobial resistance and optimize therapeutic outcomes. In conclusion, most antibiotic use in typhoid fever patients was rational (75%); nevertheless, a substantial proportion (25%) remained irrational due to noncompliance with recommended duration and dosing. Enhanced adherence to national guidelines and improved hygiene education are recommended to support prevention efforts and control bacterial resistance.
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