Analysis of Antibiotic Use in Outpatient Pneumonia Patients at X Blitar Health Center using the Gyssens Method and the Defined Daily Dose

Abstract

Pneumonia is one of the respiratory infections that is still a public health problem and requires appropriate antibiotic therapy. However, irrational use of antibiotics has the potential to increase resistance and worsen patient clinical outcomes. This study aims to analyze antibiotic use in outpatient pneumonia patients at the X Blitar Health Center using the Defined Daily Dose (DDD) and Gyssens methods. This study employed a cross-sectional approach, utilizing secondary data from 109 medical records and prescriptions for pneumonia patients (ICD-10 codes J12-J18) from February 2024 to May 2025. Quantitative analysis was conducted using the DDD/1,000 patients per day method, while qualitative analysis of prescriptions was performed using the Gyssens method. The results showed that Amoxicillin (J01CA04) was the most widely used antibiotic, namely 232.42 DDD/1,000 patients per day, followed by Cefadroxil (87.04 DDD/1,000 patients per day), Ciprofoxacin (18.35 DDD/1,000 patients per day), and Azithromycin (15.29 DDD/1,000 patients per day). Gyssens' analysis revealed that most prescriptions fell into categories IIA (33.94%), IVA (29.36%), and V (27.52%). Inaccurate dosage and suboptimal antibiotic selection were the leading causes of irrational antibiotic use. Additionally, 30 pneumonia patients were identified who did not receive antibiotics despite having clinical indications for them. The results of this study emphasize the need for rationalization training in therapy, prescription audits, and the strengthening of clinical guidelines implementation in primary care facilities.