Evaluation of Antibiotic Appropriateness in Hospitalised Pediatric Pneumonia Patients at Ar-Rasyid Islamic Hospital Palembang: A Retrospective Gyssens-Based Study

Background: Pneumonia remains a leading cause of morbidity and mortality in children worldwide, particularly in developing countries, where irrational antibiotic use contributes to antimicrobial resistance and poorer clinical outcomes. Objective: This study aimed to evaluate the profile and rationality of antibiotic use in pediatric patients with hospital-acquired pneumonia at Ar-Rasyid Islamic Hospital, Palembang, during 2023-2024. Methods: A descriptive, observational, retrospective study was conducted on 100 medical records of pediatric patients aged 0-12 years who met the inclusion criteria; rationality was assessed using the Gyssens method. Results: The majority of patients are male (63%), with infants under 1 year of age comprising the largest age group (76%). The most frequently used antibiotic is injectable ceftazidime (49.40%). Gyssens' analysis reveals that only 35% of antibiotic prescriptions are classified as rational (Category 0), while 33% show inappropriate dosing (Category IIa), 10% are administered for too long (Category IIIa), and 22% for too short a duration (Category IIIb). Conclusion: These findings indicate that the rationality of antibiotic use in pediatric hospital-acquired pneumonia patients at this institution remains suboptimal, with dosing irregularities and inappropriate duration of therapy as the predominant issues. Implementation of an evidence-based Antimicrobial Stewardship Program is therefore essential to improve prescribing practices and reduce the risk of antimicrobial resistance in this vulnerable population.