COST EFFECTIVENESS ANALYSIS PENGOBATAN PASIEN DEMAM TIFOID PEDIATRIK MENGGUNAKAN CEFOTAXIME DAN CHLORAMPHENICOL DI INSTALASI RAWAT INAP RSUD PROF. DR. MARGONO SOEKARJO

Abstract

ABSTRAK Di Indonesia insiden demam tifoid banyak dijumpai pada populasi yang berusia 3-19 tahun. Resistensi luas antibiotik aktif terhadap Salmonella typhi banyak ditemui salah satunya chloramphenicol. Chloramphenicol adalah antibiotik pilihan pertama untuk tifoid pediatrik di RSUD Prof. Dr. Margono Soekarjo Purwokerto. Telah dilakukan penelitian cost effectiveness analysis menggunakan metode observasional analitik dengan rancangan cross sectional, pengambilan data menggunakan pendekatan retrospektif melalui penelusuran rekam medik pasien. Terdapat 87 pasien yang masuk dalam penelitian ini, 64 pasien mendapatkan chloramphenicol dan 23 pasien mendapatkan cefotaxime. Total biaya rata-rata pasien demam tifoid pediatrik yang mendapat chloramphenicol sebesar Rp1.453.618,00 sedangkan pada pasien yang mendapat cefotaxime sebesar Rp1.319.413,00. Berdasarkan waktu bebas demam pasien, nilai ACER chloramphenicol sebesar Rp983.969,00 per hari bebas demam, sedangkan cefotaxime sebesar Rp761.917,00 per hari bebas demam dengan nilai ICER sebesar Rp-527.535,00 per hari bebas demam. Untuk lama rawat pasien, nilai ACER chloramphenicol sebesar Rp299.098,00 per hari rawat sedangakan cefotaxime sebesar Rp297.835,00 per hari rawat dengan nilai ICER sebesar Rp312.104,00 per hari pengurangan lama rawat. Sehingga cefotaxime lebih cost effective dibandingkan dengan chloramphenicol. Kata kunci: demam tifoid pediatrik, cefotaxime, chloramphenicol. ABSTRACT In Indonesia, incidences of typhoid fever were commonly identified among the population of 3 to 19 years. There is a wide resistance of active antibiotics to Salmonella Typhi, one of which is chloramphenicol. The first option of antibiotics for pediatric typhoid in a local hospital of Purwokerto is chloramphenicol. The method applied was analytical observation using cross-sectional design. The data collection was done using retrospective approach through examining patient’s medical record. Among 87 patients taken as the data, 64 patients were given chloramphenicol and 23 patients took cefotaxime. The average cost of chloramphenicol medication was Rp1.453.618,00, and that of cefotaxime was Rp1.319.413,00. Based their fever –free time, the value of ACER among the patients treated with chloramphenicol was Rp983.969,00 at the fever-free day, that of cefotaxime was Rp761.917,00 at the fever-free day, with ICER value of Rp-527.535,00 per fever-free day. In terms of their treatment period, ACER value of chloramphenicol was Rp299.098,00 per day in hospitalization. Meanwhile, the value of cefotaxime was Rp297.835,00 per day in hospitalization with ICER value of Rp312.104,00 per day of reduction in hospitalization. So cefotaxime more cost effective than chloramphenicol. Key words: pediatric typhoid fever, cefotaxime, chloramphenicol