Abstract

Unnecessary usage of antibiotics in patients at Emergency Department (ED) is one of important issues resulting in a number of adverse consequences, namely: the occurrence of antibiotics resistance, longer medication period, death risk, and the increase of medical costs. The purpose of this research was to conduct analysis on the usage and cost of antibiotics at ED’s patients who did not obtain further treatment inpatient wards. This observational research was conducted prospectively in one of Surabaya municipal hospital EDs. The research was conducted during November-December 2015. This research was conducted by observing the outpatients’ medical records to know the profile of antibiotics usage in ED. Patients’ diagnosis in this research would be differentiated into infection, infection-risk, and non-infection diagnosis. The analysis of the appropriateness of antibiotics usage was conducted by comparing the actual usage of antibiotics and the recommendations from therapeutic guidelines. Patients’ billing data was used as the reference of cost analysis. Among the 385 patients obtaining antibiotics at ED, female and adult patients (>18 years old) were the most discovered. The most frequently found infection diagnosis was acute gastroenteritis (32.47%) among 194 patients with infection. Diagnosis of risk of infection most frequently found was wound (57.78%) among 99 patients with the risk of infection. Single and combined antibiotics most frequently used were cefixime (32.01%) and cotrimoxazole-metronidazole (53.14%), respectively. The appropriateness of the usage of antibiotics in terms of type of antibiotics amounted to 56.98%. Medicine interaction which occured was merely between 2 pairs of medicine, namely ciprofloxacin-sucralfate and ciprofloxacin-zinc. On average, the cost spent on antibiotics amounted to Rp 38,286.00/patient. The practice of irresponsible usage of antibiotics was still found in the ED. Further research is required to be conducted to identify the cause of the irresponsible usage of antibiotics in ED setting

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