Evaluation of the Use of Tigecycline Antibiotics Based on Lexicomp and the Gyssens Method at Dr. Mohammad Hoesin Palembang in 2022

Abstract

Tigecycline was singled out in 2021 as the antibiotics with highest procurement costs (Rp. 1,519,256,277). Our guideline stipulated that tigecycline is only used when the bacteria in question is only sensitive to tigecycline. In that sense, tigecycline is classified as reserve antibiotics, used only for multiresistant bacterial infections (MDRO). This research aims to find out trend ofe use and to evaluate the effective use of Lexicomp via a qualitative method to elucidate the impact of pharmacists’ interventions and recommendations on the use of tigecycline. Medical record data from January to June, 2024 were evaluated in addition to prospectively evaluating medical records during the period of November 2024 to evaluate the use of tigecycline at RSUP Dr. Mohammad Hoesin Palembang 2022. From the results of retrospective research, the most culture results were obtained with bacteria, namely Acinetobacter baumannii as many as 29 cultures (55.8%). 31 patients (59.6%) did not fall into the FDA category, 84% of patients had pneumonia, 16% had other diagnoses such as Covid 19, AKI and CKD. In prospective research, namely Acinetobacter baumannii as many as 12 cultures (63.2%). 12 patients (63.2%) did not fall into the FDA category, Pneumonia Infection was 66.6%. Other diagnoses such as AKI, CKD were 33.33%. Duration of Tigecycline use (Lexicomp 5 to 14 days), Tigecycline administration therapy was too short, retrospective study was 13 patients (25%), prospective study was 2 patients (10.5%). The duration was too long (>14 days) in retrospective studies in 6 patients (11.5%), in prospective studies in 3 patients (15.8). Appropriate and rational use of antibiotics in retrospective studies was 55.8%, prospective studies was 73.7%. Increased appropriate and rational use of antibiotics by 17.9%. Retrospective study, incorrect dose of Tigecycline was given in 4 patients (7.7%), the dose used was Tigecycline with initial dose 50mg/12 hours is continued until the next day, without any difference in the initial and subsequent doses. In prospective studies, 100% of patients took the correct dose. Interventions carried out in prospective research increased the quality of Tigecycline use by 15.8%.