Qualitative Evaluation of Antibiotic Use in Bacterial Meningitis Patients using the Gyssens Method

Bacterial meningitis is considered as neurologic emergency with high morbidity and mortality rates. Mortality can reach 34%, especially in infections caused by S. pneumoniae and L. meningitides, while morbidity in bacterial meningitis patients, namely long-term neurologic sequelae, can reach 50% amongst survivors. If antibiotics are used properly, they can lower mortality rates.On the other hand, the irrational use of antibiotic therapy will raise the likelihood of resistance, which raises morbidity, mortality, and costs for health care. This study aims to determine the quality of antibiotic use in bacterial meningitis patients using the Gyssens method. It is an observational study employing the retrospective cross-sectional method conducted at Fatmawati General Hospital, Jakarta. The research subjects were 24 patients with bacterial meningitis who met the inclusion criteria. In this study, 45.8% of the subjects had been administered appropriate antibiotics and 54.2% inappropriate ones, which were spread across several categories, namely category IVc for one subjects (4.2%); category IIIA for two subjects (8.3%); category IIIB for one subject (4.2%); category IIA for ten subjects (41.7%); and category IIB for two subjects (8.3%). The use of appropriate antibiotics based on evaluation using the Gyssens algorithm did not significantly affect patient outcomes (p=0.542). The independent variables (type of antibiotic therapy, number of antibiotics, duration of antibiotic use) and confounding ones (age, gender, number of comorbidities, type of comorbidities, length of treatment) also had no significant effect on the quality of antibiotic use, with a p value more than 0.05. Abstrak: Meningitis bakterial dianggap sebagai kasus kegawatdaruratan neurologik dengan angka morbiditas dan mortalitas yang tinggi. Mortalitas akibat meningitis bakterial dapat mencapai 34% terutama pada infeksi yang disebabkan oleh S. pneumoniae dan L. meningitidis. Sementara morbiditas pada pasien m