vi

DAFTAR ISI

HALAMAN JUDUL ................................................................................................ i

HALAMAN PENGESAHAN ................................................................................. ii

SURAT PERNYATAAN....................................................................................... iii

PRAKATA ............................................................................................................. iii

DAFTAR ISI .......................................................................................................... vi

DAFTAR SINGKATAN ....................................................................................... ix

DAFTAR GAMBAR .............................................................................................. x

DAFTAR TABEL .................................................................................................. xi

DAFTAR LAMPIRAN ......................................................................................... xii

INTISARI ............................................................................................................. xiii

BAB I PENDAHULUAN .................................................................................. 1

1.1. Latar Belakang ................................................................................. 1

1.2. Perumusan Masalah ......................................................................... 3

1.3. Tujuan Penelitian ............................................................................. 3

1.3.1. Tujuan Umum ........................................................................ 3

1.3.2. Tujuan Khusus ....................................................................... 3

1.4. Manfaat Penelitian ........................................................................... 3

1.4.1. Manfaat Praktisi ..................................................................... 3

1.4.2. Manfaat Teoritis ..................................................................... 4

BAB II TINJAUAN PUSTAKA ......................................................................... 5

2.1. Antibiotik ......................................................................................... 5

2.1.1. Definisi ................................................................................... 5

2.1.2. Klasifikasi Antibiotik ............................................................. 5

2.1.3. Faktor yang mempengaruhi Kuantitas Antibiotik ................ 12

2.1.4. Dampak penggunaan antibiotik yang tidak rasional ............ 13

2.1.5. Evaluasi antibiotik................................................................ 15

2.2. BPJS .............................................................................................. 19

vii

2.3. Pneumonia ..................................................................................... 20

2.3.1. Definisi Pneumonia .............................................................. 20

2.3.2. Manifestasi Klinik Pneumonia ............................................. 20

2.3.3. Klasifikasi ............................................................................ 21

2.3.4. Guideline Antibiotik ............................................................ 22

2.4. Hubungan Antar Variabel .............................................................. 23

2.5. Kerangka Teori ............................................................................. 24

2.6. Kerangka Konsep .......................................................................... 24

2.7. Hipotesis ........................................................................................ 24

BAB III METODE PENELITIAN ..................................................................... 25

3.1. Jenis Penelitian dan Rancangan Penelitian .................................... 25

3.2. Variabel dan Definisi Operasional ................................................ 25

3.2.1. Variabel Penelitian ............................................................... 25

3.2.2. Definisi Operasional ............................................................ 25

3.3. Populasi dan Sampel ...................................................................... 26

3.3.1. Populasi ................................................................................ 26

3.3.2. Sampel .................................................................................. 26

3.4. Instrumen dan Bahan Penelitian .................................................... 28

3.5. Cara Penelitian ............................................................................... 28

3.6. Alur Penelitian ............................................................................... 30

3.7. Tempat dan Waktu Penelitian ....................................................... 31

3.8. Analisa Hasil ................................................................................. 31

BAB IV HASIL PENELITIAN DAN PEMBAHASAN .................................... 32

4.1. Hasil Penelitian .............................................................................. 32

4.1.1. Karakteristik Sampel Penelitian ........................................... 32

4.1.2. Jenis antibiotik pada pneumonia .......................................... 33

4.1.3. Kuantitas penggunaan antibiotik dalam DDD (define daily

doses) ................................................................................... 35

viii

4.2. Pembahasan ................................................................................... 35

BAB V KESIMPULAN DAN SARAN ............................................................ 39

5.1. Kesimpulan .................................................................................... 39

5.2. Saran .............................................................................................. 39

DAFTAR PUSAKA .............................................................................................. 40

LAMPIRAN .......................................................................................................... 43

ix

DAFTAR SINGKATAN

ATC : Anatomical Theraupetic Chemical Classification

BPJS : Badan Penyelenggara Jaminan Sosial Kesehatan

CDC : Centers for Disease Control and Prevention

DDD : Define Daily Dosed

DNA : Deoxyribonucleic Acid

ICD : International Statistical Classification of Diseases and Related

Health Problems

PBI : Penerima Bantuan Iuran

PPRA : Pencegahan Pengendalian Resistensi Antimikroba

RNA : Ribonucleic Acid

s.d.a : Sama Dengan Atas

WHO : World Health Organization

x

DAFTAR GAMBAR

Gambar 2. 1. Mekanisme kerja antibiotik .............................................................. 6

Gambar 2. 2. Alur penilaian kualitas penggunaan antibiotik dengan metode

Gyssens (Permenkes, 2011) ............................................................ 17

Gambar 2. 3. Rumus perhitungan kuantitas penggunaan antibiotik

(Permenkes, 2011) .......................................................................... 18

Gambar 4. 1. Jenis antibiotik yang diberikan pada pasien pneumonia ................ 33

xi

DAFTAR TABEL

Tabel 2. 1. Daftar antibiotik sefalosporin golongan pertama-keempat

(Depkes,2005) .................................................................................. 8

Tabel 2. 2. Antibiotik yang dapat dipilih pada Pneumonia (Glover dan

Reed, 2001; ICSI, 2005; Mandell dkk, 2003) ................................ 22

Tabel 4. 1. Karakteristik sampel penelitian ...................................................... 32

Tabel 4. 2. Hasil Uji T-Test .............................................................................. 34

Tabel 4. 3. Kuantitas penggunaan antibiotik DDD/100 hari lama rawat inap .. 35

xii

DAFTAR LAMPIRAN

Lampiran 1. Daftar Antibiotik Yang Ditanggung Oleh Bpjs Berdasarkan

Formularium Nasional Tahun 2016 (Kemenkes, 2016). ................ 43

Lampiran 2. Tabel Hasil Pengamatan Rekam Pemberian Antibiotik Pasien

BPJS ............................................................................................... 50

Lampiran 3. Tabel Hasil Pengamatan Rekam Pemberian Antibiotik Pasien

non BPJS ........................................................................................ 51

Lampiran 4. Tabel Hasil Pengolahan SPSS ........................................................ 52

Lampiran 5. Foto Pengambilan Sampel .............................................................. 53

Lampiran 6. Surat Ijin Penelitian ........................................................................ 55

Lampiran 7. Ethical Cleareance ......................................................................... 57