Handayani, Rini and , Prof. Dr. dr. EM Sutrisna, M.Kes and , Dr. Imronudin, S.E, M.Si., Ph.D (2026) Efektivitas Sistem Praotorisasi Peresepan Antibiotik Pasien Rawat Inap Di RSUD Bendan Kota Pekalongan. Thesis thesis, Universitas Muhammadiyah Surakarta.
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Abstract
Antimicrobial resistance (AMR) is a global threat that contributes to increased morbidity, mortality, and healthcare costs. One of the key strategies in the Antimicrobial Resistance Control Program (Program Pengendalian Resistensi Antimikroba/PPRA) is the implementation of antibiotic prescription pre-authorization, particularly for broad-spectrum and last-line antibiotics. However, empirical evidence regarding the effectiveness of electronic medical record (EMR)–based pre-authorization systems in type C/D hospitals remains limited. This study aimed to analyze the effectiveness of an EMR-based antibiotic prescription pre-authorization system in improving the rational use of antibiotics among hospitalized patients at RSUD Bendan Kota Pekalongan. This study employed a quasi-experimental design with a pretest–posttest approach without a control group. The sample consisted of 186 patients in the pre-implementation period and 189 patients in the post-implementation period (February–July 2025). The effectiveness of the system was evaluated using five indicators: quantity of antibiotic use based on Defined Daily Dose (DDD), quality of antibiotic use assessed by the Gyssens method, length of stay (LOS), incidence of multidrug-resistant organism (MDRO) infections, and antibiotic expenditure efficiency. Data analysis was performed using the Mann–Whitney test, independent t-test, and Chi-square test according to data distribution. The results showed that the mean quantity of antibiotic use (DDD) increased from 2.30 ± 2.32 before implementation to 2.50 ± 1.92 after implementation of the pre-authorization system, with a statistically significant difference (Mann–Whitney test, p = 0.044). The quality of antibiotic use improved significantly, as indicated by an increased proportion of rational antibiotic prescriptions (Gyssens category 0) after implementation of the pre-authorization system (Chi-square test, p < 0.05). The length of hospital stay decreased significantly following system implementation (Mann–Whitney test, p < 0.05). The incidence of MDRO infections also decreased after implementation of the pre-authorization system (Chi-square test, p < 0.05). From an economic perspective, the mean antibiotic expenditure decreased from IDR 6,873,485.33 ± 733,936.79 to IDR 6,322,673.67 ± 684,051.64; however, this reduction was not statistically significant (independent t-test, p = 0.395). In conclusion, the EMR-based antibiotic prescription pre-authorization system is effective in improving the quality and rational use of antibiotics, reducing length of hospital stay, and controlling MDRO incidence, although it has not yet demonstrated statistically significant antibiotic cost efficiency. This system has the potential to serve as a digital PPRA implementation model for regional hospitals.
| Item Type: | Thesis (Thesis) |
|---|---|
| Uncontrolled Keywords: | antibiotic pre-authorization, antimicrobial resistance, electronic medical record, PPRA |
| Subjects: | R Medicine > 1 Medicine (General) R Medicine > 1 Medicine (General) > Hospital R Medicine > 1 Medicine (General) > Hospital > Manajemen Rumah Sakit |
| Divisions: | Fakultas Kedokteran > S2 Administrasi Rumah Sakit |
| Depositing User: | RINI HANDAYANI |
| Date Deposited: | 26 Jan 2026 03:14 |
| Last Modified: | 26 Jan 2026 03:14 |
| URI: | http://eprints.ums.ac.id/id/eprint/140537 |
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