Analisis Rasionalitas Dan Efektivitas Klinis Antibiotik Empiris Pada Keratitis Bakterialrawat Jalan Di Klinik Mata Teluk Kuantan Tahun 2024-2025

Abstract

Bacterial keratitis is a corneal infection that may cause visual impairment and blindness if not appropriately treated. Empirical antibiotic therapy is the primary treatment initiated before microbiological results become available. At Teluk Kuantan Eye Clinic, not all patients return for follow-up visits; therefore, appropriate empirical antibiotic therapy at the initial treatment is an important factor in achieving successful clinical outcomes. This study aimed to analyze the rationality of empirical antibiotic use using the Gyssens method, describe clinical effectiveness, and analyze the association between the rationality of empirical antibiotic use and clinical effectiveness in outpatients with bacterial keratitis at Teluk Kuantan Eye Clinic. This analytical observational study employed a retrospective design with a cross-sectional approach. A total of 106 medical records meeting the inclusion criteria were selected using total sampling. The rationality of empirical antibiotic use was evaluated using the Gyssens method, while the association between the rationality of empirical antibiotic use and clinical effectiveness was analyzed using Fisher's Exact Test. The results showed that 5 patients (5%) received rational empirical antibiotic therapy, whereas 101 patients (95%) received irrational empirical antibiotic therapy. The most common category of irrationality was Gyssens category IVC, followed by categories IVA, IIIA, IIIB, and V. Thirty-six patients (34%) showed clinical improvement, whereas 70 patients (66%) showed no clinical improvement. It was concluded that most empirical antibiotic use in outpatients with bacterial keratitis at Teluk Kuantan Eye Clinic was irrational, and the rationality of empirical antibiotic use was significantly associated with clinical effectiveness.