• ATIKA WAHYU PUSPITASARI Clinical Pharmacy Laboratory, Faculty of Pharmacy, Universitas Indonesia, Depok, Jawa Barat 16424, Indonesia
  • OLYVA CESSARI LARAS SERUNI Clinical Pharmacy Laboratory, Faculty of Pharmacy, Universitas Indonesia, Depok, Jawa Barat 16424, Indonesia
  • LINA NADHILAH Tebet Subdistrict Health Center, Jakarta 12820, Indonesia


Objective: Acute respiratory tract infection (ARTI) is common and has the highest death rate in children, especially in growing countries such as
Indonesia. The aim of the research is to identify drug-related problems (DRPs) in pediatric ARTI patients based on the DRP classification by Cipolle,
Strand, and Morley, which included categories such as unnecessary drug therapy, need additional therapy, ineffective drug, dosage adjustments such
as too low or too high, and adverse drug reaction which is drug interaction.
Methods: The design of the study was cross-sectional and descriptive with a retrospective method. The sample of the study was the overall prescriptions
to upper respiratory tract infection patients in Tebet Subdistrict Health Center from July to December 2018 that fulfilled all of the inclusion criteria,
using the total sampling method. Total samples that were analyzed were from 179 sheets of prescription with a total of 498 prescriptions.
Results: The results of the research based on each parameter were inaccurate drug selection (9.5%), inaccurate indication (12.8%), mismatched dose
(79.9%), and drug interaction (0.6%).
Conclusion: DRPs in ARTI pediatric patients resulted in a high-risk condition so that the health facilities need to improve their prescribing pattern and
monitor and manage each therapy as well as do a routine prescription assessment to minimize the incidence of DRPs and achieve a rational drug usage.

Keywords: Acute respiratory tract infection, Drug-related problems, pediatric, Tebet subdistrict health center, Cipolle


1. Ministry of Health. Decree of the Minister of Health of the Republic of
Indonesia No. HK 02.02/MENKES/514/2015 about Clinical Practice
Guidelines for Doctors in First-level Health Care Facilities. Jakarta:
Ministry of Health; 2015.
2. World Health Organization. World Health Statistics 2018: Monitoring
Health for the SDGs. Switzerland: World Health Organization; 2018.
3. World Health Organization. WHO Model Formulary for Children.
Jenewa, Switzerland: World Health Organization; 2010.
4. Ministry of Health. Integrated Management Chart for Sick Children.
Jakarta: Ministry of Health; 2015.
5. Dipiro J, Talbert R, Yee G, Matzke G, Welss B, Posey M. Pharmacotherapy:
A pathophysiologic approach. Amerika Serikat: McGraw Hill Companies;
2017. p. 10.
6. Department of Health of the Republic Indonesia. Guidelines for
Pharmaceutical Services for Pediatric Patients. Jakarta: Ditjen Bina
Kefarmasian dan Alat Kesehatan Departemen Kesehatan Republik
Indonesia; 2009.
7. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care Practice: The
Patient-centered Approach to Medication Management Services. 3rd ed.
Minnesota, Amerika Serikat: McGraw-Hill Education; 2012. p. 3.
8. Suryani D, Bahtiar A, Andrajati R. Pharmacist involvement to decrease
drug-related problems among geriatric patients in Indonesian primary
health centers. Asian J Pharm Clin Res 2017;10:102-7.
9. Björkman IK, Sanner MA, Bernsten CB. Comparing 4 classification
systems for drug-related problems: Processes and functions. Res Social
Adm Pharm 2008;4:320-31.
10. Sari NI, Ardianti A. Relationship between Age and sex to the Incidence
of Acute Respiratory Infections of Toddler at Tembilahan Hulu Public
Health Center. Nigeria: An-Nadaa; 2017. p. 26-30.
11. Maharani D, Yani FF, Lestari Y. Profile of toddlers with acute upper
respiratory tract infections in pediatric clinics at RSUP Dr. M. Djamil
Padang in 2012-2013. J Kesehatan Andalas 2017;6:152-7.
12. Misnadiarly M. Various Diseases in Children. Jakarta: EGC; 2008.
13. Febrianto W, Mahfoedz I, Mulyanti M. Nutritional status is related to
the incidence of ARI in infants at Wonosari I Gunungkidul in 2014.
J Gizi Dietetik Indones 2015;2:113-8.
14. Mar’atus SN, Susanti R, Untari EK. Overview of treatment and direct
medical costs of pediatric ARI patients. J Manajemen Pelayanan Farm
15. Erlangga ME, Sitanggang RH, Bisri T. Comparison of the administration
of dexamethasone 10 mg with 15 mg intravenously as an analgesic
adjuvant to the scale of postoperative pain in patients undergoing
modified radical mastectomy. J Anestesi Perioratif 2015;3:146-154.
16. Lintang AM. Adequacy of Fe and Vitamin C Intake in Malnourished
Children under Five in Joho Village, Mojolaban District, Sukoharjo
Regency, Dissertation. Surakarta: Faculty of Public Health Universitas
Muhammadiyah; 2017.
17. Linnisa UH, Wati SE. The rationality of prescribing expectorant and
antitussive cough medicines in the teak medika pharmacy. Indones J
Med Sci 2014;1:30-9.
18. Wahyono D, Hapsari I, Astuti IW. The pattern of treatment of acute
respiratory tract infections under five years old children (toddlers)
outpatient at Purwareja Klampok Banjarnegara Regency public health
center in 2004. Majalah Farm Indones 2008;19:20-4.
19. Gern JE. Viral respiratory infection and the link to asthma. Pediatr
Infect Dis J 2008;27:S97-103.
20. Cotton M, Innes S, Jaspan H, Madide A, Rabie H. Management of upper
respiratory tract infection in children. S Afr Farm Pract 2004;50:6-12.
21. Hamid R, Noorrizka G, Wijaya IN, Yuda A. Profile of the use of antacid
drugs obtained by self-medication. J Farm Komunitas 2014;1:49-52.
22. Fujiastuti G. Evaluation of Drug Related Problems (DRPs) of Acute
Respiratory in Fections (ARI) in Pediatric Patients in Inpatient
Installations, Dissertation. Jakarta: Fakultas Kedokteran dan Ilmu
Kesehatan UIN Syarif Hidayatullah; 2017.
23. Theresia M, Hadinegoro SR. Acyclovir therapy in children with
varicella without complications. Sari Pediatr 2010;11:440-47.
24. Widyaswari R, Wiedyaningsih C. Evaluation of Prescription Drug
Profile and Availability of Drug Formulas for Children at Province
Public Health Care Center Yogyakarta, Dissertation. Yogyakarta:
Universitas Gadjah Mada; 2012.
25. Wiedyaningsih C. The Driving Factor for Prescribing Concoctions for
Outpatient Pediatric Patients, Dissertation. Yogyakarta: Universitas
Gadjah Mada; 2013.
26. Setyaningrum N, Khamsani H, Mulywati R. The use of off-label drugs
in outpatient pediatric patients in Pratama Swasta Clinic at Sleman
Yogyakarta. J Sains Farm Klinis 2019;6:37-45.
27. Abdulkadir W. Evaluate the rational use of antibiotics in Gorontalo
Hospital with the gyssens category method. J Sainstek 2015;8:11-8.
28. Sauriasari R, Aulia AA, Swastika A. Evaluation of the suitability of
prescription writing in non-pneumonia ARI cases at MTBS public
health care center, Cengkareng Jakarta. Pharm Sci Res 2017;4:81-7.
29. Oktaviana E, Hidayati IR, Pristianty L. The influence of knowledge on
rational use of paracetamol in self-medication (study on housewives
at Sumberpoh village, Maron Kabupaten Probolinggo. J Farm Ilmu
Kefarmasian Indones 2017;4:44.
30. Pandiangan CP, Carolia N, Suwandi JF, Tarigan A. The relationship of
drug related problems (DRPs) in the category of anti-hypertensive drug
dosage with blood pressure at RSUD Jendral Ahmad Yani Metro 2014.
Artikel Penelitian 2017;4:293-300.
31. Cahyani IW. Identification of Drug Related Problems (DRPs) in the
Category of Overdoses and Subdoses in Prescribing Anti-tuberculosis
(OAT) Adult Patients, Dissertation. Surakarta: Faculty of Mathematics
and Sciences Universitas Sebelas Maret; 2014.
32. Sun XJ, Li ZH, Zhang Y, Zhou G, Zhang JQ, Deng JM, et al. Combination
of erythromycin and dexamethasone improves corticosteroid sensitivity
induced by CSE through inhibiting PI3K-?/Akt pathway and increasing
GR expression. Am J Physiol Lung Cell Mol Physiol 2015;309:L139-46.
33. Puspitasari AW, Azizahwati A, Hidayat AR. Analysis of potential drugs
interaction on antihypertension drugs prescription in community health
center of Sukmajaya district in period of June-November 2015. Asian J
Pharm Clin Res 2017;10:61-5.
172 Views | 147 Downloads
How to Cite
Original Article(s)