Efektivitas Implementasi RASPRO terhadap Pola Resistensi dan Biaya Antibiotik di RSUD Kabupaten Bekasi

The increasing use of antibiotics over recent decades has significantly affected global public health, primarily through the emergence of antimicrobial resistance (AMR), which contributes to higher morbidity, mortality, and economic burden. As a regional referral hospital, Bekasi Regency General Hospital faces substantial challenges related to high resistance rates, with multidrug-resistant organisms (MDROs) showing MRSA at 22.22% and ESBL at 40% in 2024. This study evaluated the implementation of the Prospective System Antimicrobial Regulation Program (RASPRO) in relation to resistance patterns, antibiotic cost efficiency, and supporting roles of governance, human resources, and monitoring systems. A quantitative prospective cohort design was applied, analyzing inpatient data before and after RASPRO implementation. Antibiotic utilization was assessed using Defined Daily Dose (DDD), therapeutic rationality was evaluated using the Gyssens method, and procurement cost efficiency was examined. The results showed improved rational antibiotic use and reduced consumption of broad-spectrum antibiotics (third/fourth-generation cephalosporins, meropenem, levofloxacin, ciprofloxacin, vancomycin), while narrow-spectrum antibiotics (cefazolin, cefotaxime, gentamicin, metronidazole) increased as definitive therapy. However, procurement costs for certain antibiotics increased. The effectiveness of RASPRO relies heavily on management commitment and collaboration within the Antimicrobial Stewardship Team (PPRA), supported by consistent prospective audits. While RASPRO improves rational antibiotic use, further evaluation of procurement cost efficiency is needed for program sustainability.