ANALYSIS OF THE INCIDENCE OF SWITCH THERAPY FROM INTRAVENOUS TO ORAL ANTIBIOTICS IN TYPHOID FEVER PATIENTS AT RSUD PROF. DR. MARGONO SOEKARJO PURWOKERTO
Syefi Nuraeni Fitriana, Gita Amanda Afriyanti Putri, Tunggul Adi Purwonugroho, Masita Wulandari Suryoputri, Dewi Latifatul Ilma, Hening Pratiwi, Nurina Mayasari

Pharmacy Department of the Faculty of Health Sciences, Jenderal Soedirman University

Abstract

Background : Converting antibiotic therapy from intravenous (IV) to oral administration can accelerate patient discharge, reduce hospital stay, lower IV-related complications, and decrease costs. However, early antibiotic conversion for hospitalized patients is still rarely implemented in Indonesia, particularly among typhoid fever cases.
Purpose : This study aims to evaluate the implementation of IV-to-oral antibiotic conversion in typhoid fever patients at Prof. Dr. Margono Soekarjo General Hospital, Purwokerto, during the period of January-December 2023, and to analyze the potential cost savings if oral antibiotic conversion were applied to clinically eligible patients.
Methods: This retrospective study analyzed medical records of adult typhoid fever patients at Prof. Dr. Margono Soekarjo General Hospital, Purwokerto, from January to December 2023. A total of 201 patients were included. Data were analyzed using the Mann-Whitney and Chi-square tests. Cost-saving analysis was performed descriptively by comparing IV and oral antibiotic prices.
Results: Only 3 patients (7.14%) underwent IV-to-oral antibiotic conversion. A total of 31 patients (79.5%) were clinically eligible for conversion but did not undergo it. Statistical analysis showed no significant association between patient characteristics and conversion implementation (p > 0.05). Cost analysis indicated that implementing conversion could result in a 37.3% reduction in antibiotic costs.
Conclusion: The implementation of IV-to-oral antibiotic conversion in typhoid fever patients at Prof. Dr. Margono Soekarjo General Hospital remains very low, despite a high proportion of clinically eligible patients. Adoption of clinical guidelines, increased healthcare provider education, and hospital policies supporting antibiotic stewardship are needed to improve rational antibiotic use. Further prospective studies with more comprehensive cost analyses are recommended.

Keywords: Typhoid fever, therapy conversion, antibiotics, cost savings

Topic: Pharmaceutical Sciences and Clinical Pharmacy