FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D) VI
V

1 PNEUMONIA CEFIXIME 100 MG E

2 PNEUMONIA CEFTRIAXONE INJ E
3 PNEUMONIA AZITHROMYCIN (ZYCIN)500 MG E
CEFIXIME(CEFSPAN)200 MG E
CEFTRIAXONE INJ E
4 FEVER(DHF) CEFIXIME(OPIXIME)KAP E v
CEFTRIAXONE(BIOXON) INJ E v
5 FEVER(DHF) CEFIXIME(CEFSPAN)200 MG E v
CEFTRIAXONE(BIOXON) INJ E v
6 FEVER(DHF) CEFIXIME(OPIXIME)KAP E v
CEFTRIAXONE INJ E v
7 FEVER(DHF) CEFIXIME 100 MG E v
CEFTRIAXONE INJ E
8 PNEUMONIA LEVOFLOXACIN(DIFLOXIN) 500 MG E
CEFTRIAXONE (BIOXON) INJ E
9 PNEUMONIA CEFIXIME 100 MG E
CEFTRIAXONE INJ E
ERYTROMYCIN 500 MG E
10 BRONCHITIS CEFIXIME(OPIXIME)KAP E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFTRIAXONE INJ

KATEGORI GYSSENS
VI 0 9
V 7
8
IV A 0
IV B 0 7
IV C 0 6
IV D 0
5
III A 4
III B 2 4
II A 3
II B 0
II C 0 2
I 0 1
0 8
0
1 2 3 4 5 6 7
2

0
1 2 3 4 5 6 7
 Kategori (Gyssens)
IV III II I
A B C D A B A B C

v
v
v

Column B
Column C

2 3 4 5 6 7 8 9 10 11 12 13
2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH
Tipe Terapi
0 No DIAGNOSA Nama Antibiotik (P/E/D)

v 1 ABDOMINAL PAIN CEFOTAXIME INJ P

METRONIDAZOLE INF E
v CLINDAMYCIN(PROLIC) 300 MG E
v 2 APENDICT CEFIXIME(CEPTIK) 200 MG E
v 3 GANGLION AMOXICILLIN(AMOXSAN) INJ P
4 LIPOMATOSIS, GANGLION AMOXICILLIN(AMOXSAN) INJ P
5 CIRCUMCISION AMOXICILLIN(OPIMOX) E
6 ABDOMINAL PAIN CEFIXIME 100 MG E
CLINDAMYCIN 300 MG E
CEFTRIAXONE E

v
v

v
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

v
v
II I 0
C
v
v

v
v
v

v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D) VI

1 FEVER (DHF) CEFIXIME 100 MG E

CEFTRIAXONE INJ E
2 ABDOMINALPAIN CEPOFERAZONE INJ E
METRONIDAZOLE INF E
LEVOFLOXACIN INF E
3 ACUTE CHOLECYTITIS LEVOFLOXACIN(DIFLOXIN) 500 MG E
CEFOPERAZONE INJ E
4 FEVER (DHF) CEFTRIAXONE(BIOXON)INJ E
AZITHROMYCIN(ZYCIN) 250MG E

5 FEBRILE NEUROTROPHILIC CEFTRIAXONE(BIOXON)INJ E

DERMATOSIS

6 FEVER (DHF) CEFTRIAXONE(BROADCED) INJ E

7 GASTROENTRITIS AND
CHOLIC OF INFECTIOUS LEVOFLOXACIN (DIFLOXIN) TAB E
LEVOFLOXACIN (DIFLOXIN) INF E
8 FEVER (DHF) AZITHROMYCIN (ZITROLIN) 500 TAB E
9 HYPERHYDROSIS CEFIXIME(OPIXIME) KAP E
CEFTRIAXONE(BIOXON)INJ E

KATEGORI GYSSENS
VI 0
7
V 6
IV A 0 6
IV B 0
IV C 0 5
IV D 0
III A 5 4
III B 1
3
II A 0
II B 0 2
II C 0
I 0 1
0 4
0
1 2 3 4 5
 Kategori (Gyssens)
IV III II
V
A B C D A B A B C
v
v

v
v
v

v
v

v
v

4
Column B
3 Column C

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

I 0 No DIAGNOSA Nama Antibiotik

1 GANGLION CEFIXIME 100 MG

CEFOTAXIME INJ
v 2 APENDICT CEFOTAXIME INJ
3 PHIMOSIS CEFOTAXIME INJ
CEFIXIME SYR
4 CIRCUMCISION AMOXICILLIN(OPIMOX) KAP
v AMOXICILLIN(AMOXSAN) INJ
5 LYMPHADENITIS CEFADROXIL(OPICEF) KAP
CEFOTAXIME INJ

6 OPEN WOUND OF LOWER LIMB CEFADROXIL (OPICEF) SYR

CEFOTAXIME INJ

7
v

v
 Tipe Terapi Kategori (Gyssens)
(P/E/D) VI IV III II
V
A B C D A B A
E
P
P
P
E
E
P
E
P v

P
 II I 0
B C
v
v
v
v
v
v
v
v

v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D) VI

1 FEVER (DHF) CEFIXIME(CEFSPAN) 200 MG E

AZITHROMYCIN(ZYCIN)500 MG E
MEROPENEM INJ E
FLUCONAZOLE INF E
2 FEVER (DHF) CEFIXIME(CEFSPAN) 200 MG E
CEFTRIAXONE (BROADCED) INJ E
3 ABDOMINAL PAIN LEVOFLOXACIN (DIFLOXIN) TAB E
CLINDAMYCIN 300 MG E
CEFTRIAXONE (BROADCED) INJ E
METRONIDAZOLE INF E
4 BACTERIAL PNEUMONIA CEFTRIAXONE(STARXON) INJ E
5 FEVER (DHF) CEFIXIME(CEPTIK) 200 MG E
CEFTRIAXONE INJ E
FEBRILE NEUTROPHILIC
6 CEFIXIME(OPIXIME)KAP E
DERMATOSIS
CEFTRIAXONE(BIOXON) INJ E
AZITHROMYCIN(ZYCIN)250 MG E
7 CONGENITAL PNEUMONIA CEFIXIME 100 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFTRIAXONE INJ E
8 CONGENITAL PNEUMONIA CEFTRIAXONE(BIOXON) INJ E
CEFIXIME(CEPTIK)200 MG E
AZITHROMYCIN(ZYCIN)500 MG E
9 FEBRILE CONVULSIONS CEFTRIAXONE INJ E
CEFIXIME 100 MG E

KATEGORI GYSSENS
VI 0
14
V 6
IV A 0 12
IV B 0
IV C 2 10
IV D 0
III A 1 8

4
 10

8
III B 1
6
II A 0
II B 1 4
II C 0
I 0 2
0 13
0
1 2 3 4 5
 Kategori (Gyssens)
IV III II
V
A B C D A B A B C

v
v
v
v
v
v
v

v
v

14

12

10

8
Column B
6 Column C

4
10

8
Column B
6 Column C

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

I 0 No DIAGNOSA Nama Antibiotik

1 OPEN WOUND OF FRONT WALL CEFIXIME SYR

OF THORAX
CEFOTAXIME INJ
2 SOFT TSSUES DISORDER AMOXICILLIN(OPIMOX) SYR
3 ABSCESS OF ESTERNAL EAR CEFIXIME 100 MG
CEFOTAXIME INJ
4 CELLULITIS LEVOFLOXACIN(DIFLOXIN) INF
CLINDAMYCIN 300 MG
v
v
v
v

v
v
v

v
v
v

v
v
 Tipe Terapi Kategori (Gyssens)
(P/E/D) VI IV III II
V
A B C D A B A
E

P
E
E
P
P
E
 II I 0
B C
v

v
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 CONGENITAL TUBERCULOSIS CEFOTAXIME(BIOCEF) INJ E

2 PNEUMONIA, FEVER AZITHROMYCIN (ZYCIN) 500 MG E
CEFTRIAXONE INJ E
3 FEVER (DHF) CEFTRIAXONE INJ E

CEFIXIME(CEPTIK)200 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
4 FEVER (DHF) CEFIXIME(OPIXIME) KAP E
CEFTRIAXONE (BIOXON) INJ E
5 GASTROENTRITIS AND CHOLIC DOXYCYCLINE(SICLIDON) TAB E
6 CEFTRIAXONE(BIOXON) INJ E
CEFOPERAZONE INJ E
AZITHROMYCIN 500 TAB E

KATEGORI GYSSENS
VI 0
V 5
IV A 1
IV B 0
IV C 0
IV D 1
III A 0
III B 1
II A 0
II B 0
II C 0
I 0
0 4
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v
v
v
v

v
v

3 Column B
Column C
2

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
v 1 SNAKE VOME
v
v 2 APENDICT

3 ACQUIRED ABSENCES OF OTHER

ORGANS

4 HAEMORROIDS

5 HAEMORROIDS
v
 Tipe Terapi Kategori (Gyssen
Nama Antibiotik (P/E/D) VI IV
V
A B C D
AMOXICILLIN(OPIMOX) KAP E
CEFTRIAXONE INJ P
CEFADROXILE 500 MG E
CEFOTAXIME INJ P
CIPROFLOXACIN(TEQUINOL) E

CEFOTAXIME INJ P
CEFTRIAXONE INJ P
CEFADROXILE 500 MG E
CEFIXIME 100 MG E
CEFOTAXIME INJ P
Kategori (Gyssens)
III II I 0
A B A B C
v
v
v
v
v

v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 TYPHOID FEVER CEFIXIME(CEFSPAN)200 MG E

CEFTRIAXONE(BIOXON) INJ E
2 CARRIER OF TYPHOID CEFIXIME(CEFSPAN)200 MG E
CEFTRIAXONE(BROADCED) INJ E
3 ABDOMINAL PAIN LEVOFLOACIN(CRAVIT) 500 MG E
LEVOFLOXACIN(CRAVIT) INF E
4 CHOLELITHIASIS CEFIXIME(CEFSPAN)200 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFTRIAXONE (BIOXON)INJ E
5 CARRIER OF TYPHOID CEFIXIME 100 MG E
CEFOPERAZONE INJ E
6 PNEUMONIA CEFIXIME(CEFSPAN)200 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFTRIAXONE (BIOXON)INJ E
7 FEVER (DHF) CEIXIME(SPORETIK) 100 MG E
8 MUMPS ORCHITIS CEFTRIAXONE INJ E
AZITHROMYCIN 500 MG E
CEFIXIME 100 MG E
9 RHEUMATOID ARTHRITIS LEVOFLOXACIN(CRAVIT) 500 MG E

KATEGORI GYSSENS
VI 0
V 2
IV A 0
IV B 0
IV C 0
IV D 0
III A 5
III B 1
II A 0
II B 0
II C 0
I 0
0 11
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

12

10

6 Column B
Column C
4

0
1 2 3 4 5 6 7 8 9 10 11 12 13
2

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
v 1 ABDOMINAL PAIN
2 APENDICT
v
v 3 APENDICT
v

v
v

v
v

v
 Tipe Terapi Kategori (Gyssen
Nama Antibiotik (P/E/D) VI IV
V
A B C D
CEFOTAXIME INJ P
CEFOTAXIME INJ P
CEFIXIME(CEPTIK) 200 MG E
CEFIXIME(CEPTIK) 200 MG E
CEFOTAXIME(BIOCEF) INJ P
Kategori (Gyssens)
III II I 0
A B A B C
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 FEBRILE NEUTROPHILIC DERMATOSIS CEFIXIME(CEFSPAN) 200 MG E

CEFOPERAZONE INJ E
2 FEVER(DHF) CEFOPERAZONE INJ E
3 FEVER(DHF) LEVOFLOXACIN INF E
METRONIDAZOLE INF E
LEVOFLOXACIN 500 MG E
CIPROFLOXACIN INF E
4 GASTRITIS DOXYCYCLINE KAP E
5 CHOLECYSTITIS CEFTRIAXONE (BROADCED) INJ E
6 MYALGIA, FEVER CEFOPERAZONE INJ E
CEFIXIME 100 MG E
7 CHEST PAIN AZITHROMYCIN(ZITROLIN) 500 MG E
CEFTRIAXONE(BIOXON) INJ E
8 TYPHOID CEFTRIAXONE INJ E
CIPROFLOXACIN(BAQUINOR F) KAP E
9 FEVER(DHF) CEFIXIME(CEFSPAN) 200 MG E
CEFTRIAXONE(BIOXON) INJ E

KATEGORI GYSSENS
VI 0 8
V 7
IV A 1 7
IV B 0 6
IV C 0
IV D 0 5
III A 2 4
III B 1
II A 0 3
II B 0
2
II C 0
I 0 1
0 6
0
1 2 3
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v
v
v
v
v
v

v
v
v

4 Column B
Column C
3

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
v 1 PHIMOSIS

2 OTHER BENIGN MAMMARY

DYSPLASIAS

3 APENDICT

4 APENDICT

5 FIBROSCLEROSIS OF BREAST
v
v 6 ACUTE PAIN
v

v
v
 Tipe Terapi Kategori (Gyssen
Nama Antibiotik (P/E/D) VI IV
V
A B C D
AMOXICILLIN(AMOXSAN) INJ P

CEFOTAXIME INJ P

CEFIXIME KAP E
CEFOTAXIME INJ P
CEFIXIME(CEPTIK) 200 MG E
CEFIXIME(CEPTIK) 200 MG E
CEFOTAXIME(BIOCEF) INJ P
AMOXICILLIN(AMOXSAN) INJ P
AMOXICILLIN(OPIMOX) KAP E
CEFOTAXIME INJ P
Kategori (Gyssens)
III II I 0
A B A B C
v

v
v
v
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 FEVER (DHF) CEFTRIAXONE INJ E

CEFIXIME 100 MG E
2 PNEUMONIA AZITHROMYCIN(ZITROLIN) 500 MG E
CEFOPERAZONE INJ E
CEFIXIME (CEFSPAN) 100 MG E
3 DYSPNOEA CEFOPERAZONE INJ E
LEVOFLOXACIN(CRAVIT) INF E
4 STROKE NOT SPECIFIED AS CEFOPERAZONE INJ E
HAEMORRHAGE OR INFRACTION
CEFIXIME(CEFSPAN)200 MG E
FLUCONAZOLE(ZEMYC) 50 MG E
FLUCONAZOLE INF E
5 NUTRITIONAL ANAEMIAS CEFIXIME 200 MG E
LEVOFLOXACIN 500 MG E
6 CONGENITAL PNEUMONIA CEFTRIAXONE(BIOXON) INJ E
CEFIXIME(SPORETIK) 100 MG E
7 PNEUMONIA CEFTRIAXONE(BIOXON) INJ E
CEFIXIME(CEFSPAN)200 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFOPERAZONE INJ E
8 FEVER (DHF) CEFIXIME (SPORETIK)100 MG E
FLUCONAZOLE(ZEMYC) 50 MG E
9 FEBRILE NEUTROPHILIC DERMATOSIS CEFIXIME(OPIXIME) 100 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFTRIAXONE (BROADCED) INJ E
10 FEVER (DHF) CEFIXIME(CEPTIK) 200 MG E
CEFTRIAXONE INJ E
11 TYPHOID FLUCONAZOLE INF E
CEFOPERAZONE INJ E
12 FUNCTIONAL DIARRHOEA CEFIXIME(CEFSPAN)200 MG E
BIOXON INJ E

KATEGORI GYSSENS
VI 0 16

14

12
 16
V 2
IV A 5 14
IV B 1 12
IV C 0
IV D 0 10
III A 5 8
III B 2
II A 0 6
II B 0
4
II C 0
I 0 2
0 15
0
1 2 3 4
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B
v
v

v
v
v
v

v
v
v
v
v

16

14

12
16

14

12

10

8 Column B
Column C
6

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
1 INGUINAL HERNIA

v 2 CUTANEOUS ABSENCE OF BREAST

v
v
v

v
v

v
v
v
v
v

v
 Tipe Terapi Kategori (Gyssen
Nama Antibiotik (P/E/D) VI IV
V
A B C D
CEFIXIME(CEPTIK ) 200 MG E
CEFTRIAXONE(STARXON) INJ P
CEFIXIME 100 MG E
CEFOTAXIME INJ P
Kategori (Gyssens)
III II I 0
A B A B C
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 GASTROENTERITIS DAN COLITIS DOXYCYCLINE(SICLIDON) TAB E

2 ABDOMINAL PAIN CEFIXIME(SPORETIK)100 MG E
CEFTRIAXONE(BIOXON) INJ E
3 FEVER(DHF) CEFIXIME 100 MG E
CEFOPERAZONE INJ E
4 TYPHUS FEVER CEFIXIME(CEPTIK) 200 MG E
CEFOPERAZONE INJ E
5 FEVER(DHF) LEVOFLOXACIN(CRAVIT) TAB E

LEVOFLOXACIN(CRAVIT) INF E

KATEGORI GYSSENS
VI 0
V 4
IV A 0
IV B 0
IV C 0
IV D 0
III A 0
III B 1
II A 0
II B 0
II C 0
I 0
0 4
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

4.5

3.5

2.5
Column B
2 Column C
1.5

0.5

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
v 1 APENDICT

v 2 APENDICT

v
v 3 FIBRODENOSIS OF BREAST

4 HERPESVIRAL INFECTION OF
PERIANAL SKIN AND RECTUM

5 HAEMORROIDS
 Tipe Terapi Katego
Nama Antibiotik (P/E/D) VI IV
V
A B C
CEFTRIAXONE INJ P
CEFIXIME (CEFSPAN) 200 MG E
METRONIDAZOLE(METROLET) 500 MG E
CIPROFLOXACIN(TEQUINOL) 500 MG E v
CEFOTAXIME(RYCEF) INJ P
METRONIDAZOLE INF E
AMOXICILLIN(HUFANOXIL) TAB E
AMOXICILLIN (AMOXSAN) INJ P
LEVOFLOXACIN 500 MG E

CLINDAMYCIN 300 MG E
CEFOTAXIME INJ P
LEVOFLOXACIN 500 MG E
CEFADROXIL(OPICEF) KAP E
METRONIDAZOL INF E
CEFOPERAZONE INJ E
 Kategori (Gyssens)
IV III II I 0
D A B A B C
v
v
v

v
v
v
v
v

v
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 FEVER, HEADACHE CEFIXIME(CEFSPAN) 200 MG E

CEFTRIAXONE INJ E
LEVOFLOXACIN INF E
2 SUSPECTED TUBERCULOSIS CEFOTAXIME INJ E
3 ABDOMINAL PAIN CEFIXIME(CEFSPAN) 100 MG E
4 PNEUMONIA CEFOPERAZONE INJ E
AZITHROMYCIN 500 MG E
5 ABDOMINAL PAIN CEFOTAXIME INJ E
6 FEBRILE NEUTROPHILIC DERMATOSIS CEFADROXILE(OPICEF) KAP E
7 ABDOMINAL PAIN LEVOFLOXACIN(CRAVIT) INF E
CEFTRIAXONE(TERFACEF) INJ E
8 CHLOASMA CEFIXIME(CEFSPAN) 200 MG E
CEFOPERAZONE INJ E
9 BACTERIAL INFECTION CEFTRIAXONE (BIOXON) INJ E
CEFIXIME(OPIXIME) KAP E

KATEGORI GYSSENS 12
VI 0
V 3 10
IV A 0
IV B 0 8
IV C 0
IV D 0 6
III A 0
III B 3 4
II A 0
II B 0 2
II C 0
I 0 0
0 10 1 2 3
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B
v
v
v

12

10

6 Column B
Column C
4

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
1 CIRCUMCISION
2 SOFT TISSUE DISORDER

v 3 PHIMOSIS
v 4 HAEMORRHOIDS
v 5 PRE EXCITATION SYNDROME

v 6 INGUINAL HERNIA
v
v
v

v
v
v
 Tipe Terapi Katego
Nama Antibiotik (P/E/D) VI IV
V
A B C
AMOXICILLIN(OPIMOX) KAP E
CEFOTAXIME INJ P
CEFIXIME 100 MG E
CEFIXIME 100 MG E
CEFTRIAXONE INJ P
CEFOTAXIME(BIOCEF) INJ P
CIPROFLOXACIN(TEQUINOL) TAB E
CEFOTAXIME INJ P
CEFIXIME 100 MG E
 Kategori (Gyssens)
IV III II I 0
D A B A B C
v
v
v
v
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 PNEUMONIA LEVOFLOXACIN(CRAVIT) INF E

CEFOPERAZONE INJ E
2 TYPHUS FEVER CEFTRIAXONE(BIOXON) INJ E
3 INTRA ABDOMINAL ORGANS LEVOFLOXACIN INF E
LEVOFLOXACIN 500 MG E
4 TYPHUS FEVER LEVOFLOXACIN(DIFLOXIN) INF E
CEFIXIME(CEFSPAN) 200 MG E
5 DYSPALGHIA CEFOPERAZONE INJ E
6 FEBRIL CONVULSIONS LEVOFLOXACIN INF E
CEFOPERAZONE INJ E
CEFIXIME 200 MG E
7 GASTROENTERITIS AND COLITIS CIPROFLOXACIN 500 MG E

KATEGORI GYSSENS
VI 0 12
V 0
IV A 0 10
IV B 0
IV C 0 8
IV D 0
III A 1
6
III B 1
II A 0
4
II B 0
II C 0
2
I 0
0 10
0
1 2 3 4
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

12

10

6 Column B
Column C
4

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
1 CARCINOMA IN SITU OF CERVIX UTERI
v
v 2 CIRCUMCISION
v 3 SOFT TISSUE DISORDER
v 4 GANGLION
v
v 5 MALIGNANT NEOPLASM OF BREAST
v
v 6 GANGLION

v 7 GANGLION
v
 Tipe Terapi Katego
Nama Antibiotik (P/E/D) VI IV
V
A B C
CEFOTAXIME INJ P

AMOXICILLIN(OPIMOX) SYR E
CEFTRIAXONE INJ P
CEFOTAXIME INJ P
CEFADROXILE KAP E
CEFTRIAXONE INJ P
CEFIXIME 100 MG E
AMOXICILLIN(AMOXASN) INJ P
CEFIXIME(OPIXIME)KAP E
AMOXICILLIN(AMOXSAN) INJ P
AMOXICILLIN(OPIMOX)KAP E
 Kategori (Gyssens)
IV III II I 0
D A B A B C
v

v
v
v
v
v
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 ABDOMINAL PAIN LEVOFLOXACIN(CRAVIT) INF E

2 DIARRHOEA CEFTRIAXONE INJ E
3 ACUTE PAIN LEVOFLOXACIN INF E
LEVOFLOXACIN 500 MG E

4 DHF CEFOPERAZONE INJ E

5 GASTRODUODENITIS CIPROFLOXACIN TAB E
6 ACUTE PAIN AZITHROMYCIN(ZYCIN) 500 MG E
CEFTRIAXONE(BIOXON) INJ E
CEFIXIME(CEFSPAN) 200 MG E
7 FEVER CEFTRIAXONE(BIOXON) INJ E
8 TYPHUS FEVER CEFTRIAXONE INJ E
9 TYPHUS FEVER LEVOFLOXACIN(CRAVIT) INF E
LEVOFLOXACIN(CRAVIT) TAB E
10 CHEST PAIN CEFTRIAXONE INJ E
AZITHROMYCIN(ZYCIN) 500 MG E
11 TYPHUS FEVER LEVOFLOXACIN(CRAVIT) INJ E
12 PYOGENIC ARTHRITIS LEVOFLOXACIN INF E
LEVOFLOXACIN 500 MG E

KATEGORI GYSSENS
VI 0 14
V 2
IV A 0 12
IV B 0
10
IV C 0
IV D 0 8
III A 0
III B 4 6
II A 0
II B 0 4
II C 0
2
I 0
0 12 0
1 2 3 4
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

14

12

10

8
Column B
6 Column C

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
v 1 APENDICT
v
v 2 HAEMORRHOIDS
v
3 OPEN WOUND OF WRIST AND HAND
PART
v
4 APENDICT
v

5 PHIMOSIS
v 6 BURN INVOLVING
v
v
v

v
 Tipe Terapi Katego
Nama Antibiotik (P/E/D) VI IV
V
A B C
CEFOTAXIME(RYCEF) INJ P
CEFIXIME(CEPTIK)SYR E
CEFTRIAXONE INJ P
METRONIDAZOLE INF E
AMOXICILLIN(AMOXSAN) INJ P

CEFIXIME(CEPTIK)200 MG E
CEFOPERAZONE INJ P
METRONIDAZOLE INF E
LEVOFLOXACIN 500 MG E
CEFIXIME SYR E
CEFTRIAXONE INJ P
 Kategori (Gyssens)
IV III II I 0
D A B A B C
v
v
v
v
v

v
v
v
v
v
v
FORM REVIEW GYSSENS

Rekapitulasi evaluasi kualitas penggunaan antibiotik

INTERNA
Tipe Terapi
No DIAGNOSA Nama Antibiotik (P/E/D)

1 FEBRILE CONVULSIONS LEVOFLOXACIN(CRAVIT) 500 MG E

LEVOOFLOXACIN(CRAVIT) 750 MG INF E
2 FEBRILE CONVULSIONS CEFTRIAXONE INJ E
3 TYPHUS FEVER CEFIXIME(CEFSPAN) 100 MG E
CEFOPERAZONE INJ E
4 DHF CEFOPERAZONE INJ E
5 OEDEMA CEFOTAXIME INJ E
LEVOFLOXACIN 500 MG E
6 DHF CEFOPERAZONE INJ E
7 FEBRILE NEUTROPHILIC DERMATOSIS CEFIXIME 200 MG E
CEFTRIAXONE(BIOXON) INJ E
8 TYPHUS FEVER LEVOFLOXACIN(CRAVIT) 500 MG E
LEVOFLOXACIN(CRAVIT) 500 MG INF E
9 DHF LEVOFLOXACIN(CRAVIT) 500 MG E
LEVOFLOXACIN(CRAVIT) 500 MG INF E
10 ABDOMINAL PAIN CEFIXIME 200 MG E
CEFTRIAXONE INJ E
11 CHLOASMA CEFIXIME(CEFSPAN) 200 MG E
AZITHROMYCIN(ZYCIN) 500 MG E
CEFOPERAZONE INJ E
12 ISK CIPROFLOXACIN(BAQUINOR FORTE) KAP E
LEVOFLOXACIN(CRAVIT) TAB E
CEFTRIAXONE(BIOXON) INJ E

KATEGORI GYSSENS
16
VI 0
V 4 14
IV A 0
IV B 0 12
IV C 0 10
IV D 0
III A 2 8
III B 3 6
II A 0
II B 0 4
II C 0 2

0
1 2 3 4
 6

2
I 0
0 15 0
1 2 3 4
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

v
v
v

16

14

12

10

8 Column B
Column C
6

0
1 2 3 4 5 6 7 8 9 10 11 12 13
6

0
1 2 3 4 5 6 7 8 9 10 11 12 13
 BEDAH

II I 0 No DIAGNOSA
C
v 1 OTHER SOFT TISSUE DISORDER

v
v 2 GANGLION
v
v 3 INGUINAL HERNIA
v

v
v
v

v
v
v

v
v

v
 Tipe Terapi Katego
Nama Antibiotik (P/E/D) VI IV
V
A B C
AMOXICILLIN 500 MG E
CLINDAMYCIN 300 MG E
AMOXICILLIN(AMOXSAN) INJ P
AMOXICILLIN(OPIMOX) KAP E
AMOXICILLIN(AMOXSAN) INJ P
CEFIXIME SYR E
CEFOTAXIME INJ P
 Kategori (Gyssens)
IV III II I 0
D A B A B C
v
v
v
v
v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D) VI

10/4/2018 DHF CEFTRIAXONE INJ E

LENA 10/5/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E

OPEN WOUND OF
RAI WRIST AND HAND PART AMOXICILLIN 500 MG E

SEDANI 10/9/2018 GANGLION AMOXSAN INJ P

AMOXICILLIN 500 MG E
PUGER 10/10/2018 FEBRILE CONVULSIONS LEVOFLOXACIN 500 MGE
JANJI 10/10/2018 ABDOMINAL PAIN LEVOFLOXACIN(CRAVIT)E
SUNARTI 10/10/2018 HAEMORROIDS CEFTRIAXONE INJ P
METRONIDAZOLE 500 E
ANGELINA 10/11/2018 APENDICT AMOXSAN INJ P
JOKRI 10/12/2018 PNEUMONIA CEFOTAXIME INJ E
AZITHROMYCIN(ZYCIN) E
WERTI 10/12/2018 DYSPEPSIA LEVOFLOXACIN 500 MGE
YUNITA 10/14/2018 ABDOMINAL PAIN CEFOTAXIME INJ E
HARMEN 10/14/2018 HAEMORROIDS CEFTRIAXONE INJ P
METRONIDAZOLE 500 E
PICA 10/14/2001 ABDOMINAL PAIN CEFOTAXIME INJ E
CIPROFLOXACIN 500 M E
ASTAWA 10/14/2018 PNEUMONIA CEFOPERAZONE INJ E
SUDARMI 10/14/2018 DYSPEPSIA CEFOTAXIME INJ E
ARYA 10/15/2018 APENDICT AMOXICILLIN 500 MG E
AYUNINGSIH 10/15/2018 GANGLION AMOXSAN INJ P
JOKO 10/17/2018 HAEMORROIDS CEFTRIAXONE INJ P
EKA 10/17/2018 DHF CEFOPERAZONE INJ E
RIA 10/18/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
HAWA 10/18/2018 PNEUMONIA CEFOPERAZONE INJ E
ANA 10/18/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
ADI 10/18/2018 DHF CEFTRIAXONE INJ E
ALIT 10/19/2018 DHF CEFOPERAZONE INJ E
AGUSTINI 10/19/2018 ASTHMA STARXON INJ E
ZYCIN 500 MG E
KELEMIK 10/19/2018 PNEUMONIA DAN DIABETCEFTRIAXONE INJ E
METRONIDAZOLE 500 E
CEFIXIME 100 MG E
SARI 10/19/2018 ABDOMINAL PAIN CEFOTAXIME INJ E
PRIATI 10/20/2018 ABDOMINAL PAIN CEFTRIAXONE INJ E
 CEFIXIME 100 MG E
SURYA 10/22/2018 APENDICT CEFTRIAXONE INJ E
CORNELIS 10/23/2018 APENDICT AMOXSAN INJ P
AMOXICILLIN 500 MG E
TAMBUN 10/23/2018 GANGLION AMOXSAN INJ P
RAKA 10/23/2018 PNEUMONIA TERFACEF INJ E
SUWARNI 10/23/2018 ASTHMA CEFOTAXIME INJ E
ZITROLIN TAB E
ARYANI 10/24/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
ARNASIH 10/24/2018 HAEMORROIDS CEFOTAXIME INJ P
METRONIDAZOLE FLS E
SALI 10/26/2018 PNEUMONIA DAN DIABETCEFTRIAXONE INJ E
LEVOFLOXACIN 500 MGE
SRIGATI 10/26/2018 DHF CEFTRIAXONE INJ E
MARIANI 10/26/2018 DHF CEFTRIAXONE INJ E
DENI 10/27/2018 SOFT TISSUE DISORDER CEFTRIAXONE INJ P
SUARNADI 10/29/2018 TYPHUS LEVOFLOXACIN 500 MGE
SARMADANA 10/30/2018 DHF CEFTRIAXONE INJ E
DIANINGSIH 10/30/2018 GANGLION AMOXSAN INJ P

KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH

VI 0 TOTAL PASIEN RAWAT INAP 65
V 7
IV A 9 30
IV B 0
IV C 0
25
IV D 0
III A 0
20
III B 17
II A 0
15
II B 0
II C 0
10
I 0
0 28
5

0
1 2 3 4 5 6 7 8 9 10
5

0
1 2 3 4 5 6 7 8 9 10
 Kategori (Gyssens)
IV III II
V
A B C D A B A B C
v v

v
v

v
v
v
v

v
v
v

v
v

v
v
v

v
v
v
 v

v
v
v

v
v
v

v
v

Column A
Column B

4 5 6 7 8 9 10 11 12 13
4 5 6 7 8 9 10 11 12 13
I 0

v
v

v
v
v

v
v
v
v

v
v
v

v
v
v
v
v

v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D) VI

10/4/2018 DHF CEFTRIAXONE INJ E

LENA 10/5/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
OPEN WOUND OF
RAI WRIST AND HAND AMOXICILLIN 500 MG E
PART
SEDANI 10/9/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
PUGER 10/10/2018 FEBRILE CONVULSIONSLEVOFLOXACIN 500 MG E
JANJI 10/10/2018 ABDOMINAL PAIN LEVOFLOXACIN(CRAVIT) INJ E
SUNARTI 10/10/2018 HAEMORROIDS CEFTRIAXONE INJ P
METRONIDAZOLE 500 MG E
ANGELINA 10/11/2018 APENDICT AMOXSAN INJ P
JOKRI 10/12/2018 PNEUMONIA CEFOTAXIME INJ E
AZITHROMYCIN(ZYCIN) 500 MG E
WERTI 10/12/2018 DYSPEPSIA LEVOFLOXACIN 500 MG E
YUNITA 10/14/2018 ABDOMINAL PAIN CEFOTAXIME INJ E
HARMEN 10/14/2018 HAEMORROIDS CEFTRIAXONE INJ P
METRONIDAZOLE 500 MG E
PICA 10/14/2001 ABDOMINAL PAIN CEFOTAXIME INJ E
CIPROFLOXACIN 500 MG E
ASTAWA 10/14/2018 PNEUMONIA CEFOPERAZONE INJ E
SUDARMI 10/14/2018 DYSPEPSIA CEFOTAXIME INJ E
ARYA 10/15/2018 APENDICT AMOXICILLIN 500 MG E
AYUNINGSIH 10/15/2018 GANGLION AMOXSAN INJ P
JOKO 10/17/2018 HAEMORROIDS CEFTRIAXONE INJ P
EKA 10/17/2018 DHF CEFOPERAZONE INJ E
RIA 10/18/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
HAWA 10/18/2018 PNEUMONIA CEFOPERAZONE INJ E
ANA 10/18/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
ADI 10/18/2018 DHF CEFTRIAXONE INJ E
ALIT 10/19/2018 DHF CEFOPERAZONE INJ E
AGUSTINI 10/19/2018 ASTHMA STARXON INJ E
ZYCIN 500 MG E
KELEMIK 10/19/2018 PNEUMONIA DAN DIABCEFTRIAXONE INJ E
METRONIDAZOLE 500 MG E
CEFIXIME 100 MG E
SARI 10/19/2018 ABDOMINAL PAIN CEFOTAXIME INJ E
PRIATI 10/20/2018 ABDOMINAL PAIN CEFTRIAXONE INJ E
 CEFIXIME 100 MG E
SURYA 10/22/2018 APENDICT CEFTRIAXONE INJ E
CORNELIS 10/23/2018 APENDICT AMOXSAN INJ P
AMOXICILLIN 500 MG E
TAMBUN 10/23/2018 GANGLION AMOXSAN INJ P
RAKA 10/23/2018 PNEUMONIA TERFACEF INJ E
SUWARNI 10/23/2018 ASTHMA CEFOTAXIME INJ E
ZITROLIN TAB E
ARYANI 10/24/2018 GANGLION AMOXSAN INJ P
AMOXICILLIN 500 MG E
ARNASIH 10/24/2018 HAEMORROIDS CEFOTAXIME INJ P
METRONIDAZOLE FLS E
SALI 10/26/2018 PNEUMONIA DAN DIABCEFTRIAXONE INJ E
LEVOFLOXACIN 500 MG E
SRIGATI 10/26/2018 DHF CEFTRIAXONE INJ E
MARIANI 10/26/2018 DHF CEFTRIAXONE INJ E
DENI 10/27/2018 SOFT TISSUE DISORDERCEFTRIAXONE INJ P
SUARNADI 10/29/2018 TYPHUS LEVOFLOXACIN 500 MG E
SARMADANA 10/30/2018 DHF CEFTRIAXONE INJ E
DIANINGSIH 10/30/2018 GANGLION AMOXSAN INJ P

KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH

VI 0 30
V 7
IV A 8 25
IV B 0
IV C 0 20
IV D 0
III A 0 15
III B 17
II A 0 10
II B 0
II C 0 5
I 0
0 28 0
1 2 3 4 5 6 7 8 9 10
 Kategori (Gyssens)
IV III II
V
A B C D A B A B C
v v

v
v

v
v
v
v

v
v
v

v
v

v
v
v

v
v
v
 v

v
v
v

v
v
v

v
v

Column A
Column B
Column C

5 6 7 8 9 10 11 12 13
I 0

v
v

v
v
v

v
v
v
v

v
v
v

v
v
v
v
v

v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D)

MULIARTI 12/1/2018 ASTHMA LEVOFLOXACIN INF E

TONNY 12/1/2018 HAEMORROIDS CEFTRIAXONE INJ P
METRONIDAZOLOE INF E
ASEANTA 12/2/2018 APENDICT CEFTRIAXONE INJ E
HALIM 12/3/2018 HAEMORROIDS CEFTRIAXONE INJ P
SUCI 12/5/2018 ABDOMINAL PAIN LEVOFLOXACIN INF E
ENNY 12/5/2018 ABDOMINAL PAIN LEVOFLOXACIN INF E
DARMIASIH 12/6/2018 DHF CEFOTAXIME INJ E
MOKLOK 12/6/2018 BRONCHITIS CEFIXIME CAP E
WENA 12/7/2018 APENDICT CEFTRIAXONE INJ P
ARSADANA 12/8/2018 THYPUS CEFTRIAXONE INJ E
SRI 12/10/2018 TYPHUS CEFTRIAXONE INJ E
YULIYANI 12/11/2018 GASTROENTERITIS CEFOTAXIME(BIOCEF) INJ E
MENIK 12/12/2018 HAEMORROIDS CEFOTAXIME(RYCEF) INJ P
CEPTIK(CEFIXIME) 200 MG E
SUTARMI 12/13/2018 GANGLION CEFTRIAXONE INJ P
SINCIA 12/14/2018 GANGLION CEFTRIAXONE INJ P
OPICEF KAP E
CATTAYA 12/16/2018 HAEMORROIDS CEFTRIAXONE INJ P
DAFID 12/16/2018 HAEMORROIDS CEFTRIAXONE INJ P
DIAN 12/16/2018 APENDICT AMOXSAN INJ P
RENDY 12/17/2018 DHF BROADCED INJ E
ESTER 12/18/2018 GANGLION CEFTRIAXONE INJ P
SITI 12/19/2018 APENDICT AMOXSAN INJ P
KANTA 12/24/2018 GASTROENTERITIS CEFOTAXIME INJ E
DANTRI 12/25/2018 HIPERTENSI CEFOTAXIME(BIOCEF) INJ E
OKA 12/26/2018 ASTHMA CEFTRIAXONE INJ E
TAMBUN 12/26/2018 HAEMORROIDS LEVOFLOXACIN INF P
SARIANI 12/27/2018 DHF CEFOPERAZONE INJ E
ANITA 12/28/2018 GANGLION CEFTRIAXONE INJ P
RAI 12/30/2018 DHF CEFTRIAXONE(BIOXON) INJ E
ADRIANTA 12/31/2018 HAEMORROIDS CEFTRIAXONE INJ P
KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH 25
VI 0
V 4 20
IV A 1
IV B 0
IV C 0 15
IV D 0
III A 1 10

5
 15

10
III B 5
II A 0
II B 0 5
II C 0
I 0 0
0 21 1 2 3 4 5 6 7 8 9 10
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

v
v

v
v
Column A
Column B
Column C
 Column A
Column B
Column C

4 5 6 7 8 9 10 11 12 13
II I 0
C
v
v

v
v

v
v

v
v

v
v
v

v
v
v
v
v

v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D)

RASTI 1/1/2019 BRONKITIS CEFOPERAZONE INJ E

LESTARI 1/3/2019 GANGLION CEFTRIAXONE INJ P
CEFIXIME 100 MG E
SUARTAMA 1/3/2019 HAEMORROIDS CEFTRIAXONE INJ E
SUMERTINI 1/3/2019 APENDICT AMOXSAN INJ E
NANDRI 1/7/2019 PNEUMONIA CEFOPERAZONE INJ E
TEGEG 1/8/2019 APENDICT CEFTRIAXONE INJ P
KORNA 9/11/2019 BRONKITIS CEFOPERAZONE INJ E
ZITROLIN TAB E
DEPIANA 1/11/2019 HAEMORROIDS CEFTRIAXONE INJ P
MANUABA 1/12/2019 APENDICT AMOXICILLIN TAB E
EKA 1/12/2019 OPEN WOUND CEFIXIME 100 MG E
BILAL 1/14/2019 APENDICT CEFTRIAXONE INJ P
SUARTINI 1/17/2019 GANGLION CEFTRIAXONE INJ P
MUNDRA 1/17/2019 GANGLION AMOXSAN INJ P
RATNA 1/20/2019 HAEMORROIDS CEFOTAXIME INJ P
GUNTURAN 1/21/2019 APENDICT CEFTRIAXONE INJ P

REBREB 1/23/2019 OPEN WOUND AND DIABATES AMOXSAN INJ P

ENY 1/24/2019 GANGLION CEFTRIAXONE INJ P
WIRADIANA 1/29/2019 APENDICT CEFTRIAXONE INJ P
WIDIARCA 1/30/2019 APENDICT CEFTRIAXONE INJ P
KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH
VI 0 20
V 0 18
IV A 1
16
IV B 0
IV C 0 14
IV D 0 12
10
8
6
 16
14
12
III A 0 10
III B 1 8
II A 0
6
II B 0
II C 0 4
I 0 2
0 19 0
1 2 3 4 5 6 7 8 9
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
Column A
Column B
Column C
 Column A
Column B
Column C

3 4 5 6 7 8 9 10 11 12 13
II I 0
C
v
v

v
v
v
v
v
v
v
v
v
v
v
v
v
v

v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D)

IDAYANTI 2/4/2019 DHF CEFOPERAZONE INJ E

AZITHROMYCIN TAB E
MOLU 2/5/2019 TYPHOID CEFTRIAXONE(BIOXON) E
DARWATA 2/5/2019 CEFOTAXIME INJ P
YUSNI 2/7/2019 DHF CEFOPERAZONE INJ E
ARNAWA 2/7/2019 CEFTRIAXONE(BIOXON) P
ASA 2/8/2019 CEFOTAXIME INJ P
PARWATA 2/10/2019 HAEMORROIDS AMOXICILLIN TAB E
SARAS 2/10/2019 TYPHUS CEFTRIAXONE INJ E
WULAN 2/11/2019 APENDICT CEFOTAXIME INJ P
SUDARMI 2/13/2019 DYSPEPSIA CEFOTAXIME INJ E
ARYA 2/14/2019 APENDICT AMOXICILLIN 500 MG E
AYUNINGSIH 2/16/2019 GANGLION AMOXSAN INJ P
JOKO 2/16/2019 HAEMORROIDS CEFTRIAXONE INJ P
ZAHRA 2/17/2019 GANGLION CEFTRIAXONE INJ P
DIAN 2/18/2019 HAEMORROIDS CEFTRIAXONE INJ P
SURYAWAN 2/18/2019 OPEN WOUND LEVOFLOXACIN TAB E
SUBANI 2/19/2019 APENDICT CEFTRIAXONE INJ P
SUARTANA 2/20/2019 APENDICT CEFTRIAXONE INJ P
SUJADANA 2/20/2019 APENDICT BIOXON INJ P
MARTINI 2/21/2019 GANGLION CEFTRIAOXONE INJ P
SURA 2/21/2019 APENDICT CEFTRIAXONE INJ P
HENDRYATNO 2/21/2019 CEFTRIAXONE INJ P
MULIYANYA 2/22/2019 CEFTRIAXONE INJ P
DEWI 2/22/2019 CEFOTAXIME INJ P
JYOTE 2/26/2019 AMOXSAN INJ P
SANDI 2/27/2019 CEFTRIAXONE INJ P
SINDHU 2/28/2019 CEFTRIAXONE INJ P
KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH
VI 0
25
V 3
IV A 2
IV B 0 20
IV C 0
IV D 0
15
III A 1

10

5
 20

15

III B 2
II A 0 10
II B 0
II C 0
5
I 0
0 20
0
1 2 3 4 5 6 7 8 9 10
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B
v
v
v

v
v

v
Column A
Column B
Column C
 Column A
Column B
Column C

4 5 6 7 8 9 10 11 12 13
II I 0
C

v
v

v
v
v
v
v

v
v
v
v
v
v
v
v
v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D) VI

WASITA 3/3/2019 CEFOTAXIME INJ P

MAYUNI 3/4/2019 GANGLION AMOXSAN INJ P
PUTRI 3/4/2019 HAEMORROIDS CEFTRIAXONE INJ P
YASA 3/5/2019 APENDICT CIPROFLOXACIN TAB E
WIJAYA 3/5/2019 CEFTRIAXONE INJ P
SUTAMA 3/9/2019 CEFTRIAXONE INJ P
METRONIDAZOLE TAB E
SUKADANA 3/9/2019 CEFOTAXIME INJ P
INDAH 3/9/2019 CEFTRIAXONE INJ P
SUASTIKA 3/13/2019 CEFTRIAXONE INJ P
AYU 3/14/2019 GANGLION CEFTRIAXONE INJ P
HENDRAWATI 3/15/2019 AMOXSAN INJ P
ARYA 3/18/2019 APENDICT AMOXICILLIN 500 MG E
AYUNINGSIH 3/20/2019 GANGLION AMOXSAN INJ P
JOKO 3/22/2019 HAEMORROIDS CEFTRIAXONE INJ P
ZAHRA 3/24/2019 GANGLION CEFTRIAXONE INJ P
DIAN 3/26/2019 HAEMORROIDS CEFTRIAXONE INJ P
SURYAWAN 3/28/2019 OPEN WOUND LEVOFLOXACIN TAB E
KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH
VI 0
V 0 Chart Ti
IV A 1 18
IV B 0 16
IV C 0 14
IV D 0 12
III A 0 10
III B 0
8
II A 0
6
II B 0
4
II C 0
2
I 0
0
0 17 1 2 3 4 5 6 7
Col umn A Col umn
 Kategori (Gyssens)
IV III II
V
A B C D A B A B C

v
 Chart Title

3 4 5 6 7 8 9 10 11 12 13
Col umn A Col umn B Col umn C
I 0

v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
 PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik

TONNY 4/1/2019 HAEMORROIDS CEFTRIAXONE INJ

METRONIDAZOLOE INF
ASEANTA 4/3/2019 APENDICT CEFTRIAXONE INJ
HALIM 4/5/2019 HAEMORROIDS CEFTRIAXONE INJ
SUCI 4/7/2019 ABDOMINAL PAIN LEVOFLOXACIN INF
ENNY 4/9/2019 ABDOMINAL PAIN LEVOFLOXACIN INF
DARMIASIH 4/11/2019 DHF CEFOTAXIME INJ
YULIYANI 4/14/2019 GASTROENTERITIS CEFOTAXIME(BIOCEF) INJ
MENIK 4/16/2019 HAEMORROIDS CEFOTAXIME(RYCEF) INJ
CEPTIK(CEFIXIME) 200 MG
SUTARMI 4/19/2019 GANGLION CEFTRIAXONE INJ
SINCIA 4/20/2019 GANGLION CEFTRIAXONE INJ
OPICEF KAP
CATTAYA 4/22/2019 HAEMORROIDS CEFTRIAXONE INJ
DAFID 4/24/2019 HAEMORROIDS CEFTRIAXONE INJ
WIRADIANA 4/26/2019 APENDICT CEFTRIAXONE INJ
WIDIARCA 4/29/2019 APENDICT CEFTRIAXONE INJ
KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH
VI 0
V 0 Chart
IV A 0 14
IV B 0
12
IV C 0
IV D 0 10
III A 0 8
III B 4
6
II A 0
II B 0 4
II C 0 2
I 0
0
0 12 1 2 3 4 5 6
Col umn A Col u
 Tipe
Terapi
Kategori (Gyssens)
(P/E/D) VI IV III II
V
A B C D A B A
P
E v
E
P
E v
E
E v
E
P
E v
P
P
E v
P
P
P
P
 Chart Title

2 3 4 5 6 7 8 9 10 11 12 13
Col umn A Col umn B Col umn C
 II I 0
B C
v

v
v

v
v

v
v

v
v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D)

SRI 5/1/2019 APENDICT AMOXICILLIN INJ P

AMOXICILLIN TAB E
EKO 5/5/2019 OPEN WOUND CEFTRIAXONE INJ P
METRONIDAZOLE TAB E
RATNA 5/8/2019 APENDICT CEFOPERAZONE INJ E
YANI 5/11/2019 GANGLION CEFTRIAXONE INJ P
SUNERTI 5/12/2019 HAEMORROIDS AMOXSAN INJ P
SRIANI 5/14/2019 DHF CEFOTAXIME INJ E
ANGGIE 5/16/2019 APENDICT AMOXICILLIN INJ P
ARTINI 5/18/2019 GANGLION AMOXICILLIN TAB E
SRIANI 5/20/2019 GANGLION CEFOTAXIME INJ P
ARKI 5/22/2019 APENDICT CEFOTAXIME INJ P
CEFIXIME CAP E
PRIATI 5/23/2019 ABDOMINAL PAIN CEFTRIAXONE INJ E
CEFIXIME 100 MG E
SURYA 3/26/2019 APENDICT CEFTRIAXONE INJ E
CORNELIS 5/27/2019 APENDICT AMOXSAN INJ P
AMOXICILLIN 500 MG E
TAMBUN 5/28/2019 GANGLION AMOXSAN INJ P
RAKA 5/30/2019 PNEUMONIA TERFACEF INJ E
KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH
14
VI 0
V 1 12
IV A 1
IV B 0 10
IV C 0
8

4
 12

10

IV D 0 8
III A 0
6
III B 6
II A 0 4
II B 0
II C 0 2
I 0
0 13 0
1 2 3 4 5 6 7 8 9 10
 Kategori (Gyssens)
VI IV III II
V
A B C D A B A B

v
v

v
Column A
Column B
Column C
 Column A
Column B
Column C

4 5 6 7 8 9 10 11 12 13
II I 0
C
v

v
v

v
v
v
v

v
v

v
 PASIEN TGL/BULAN DIAGNOSA

NANDRI 6/1/2019 PNEUMONIA

TEGEG 6/3/2019 APENDICT
KORNA 6/6/2019 BRONKITIS

WULAN 6/9/2019 APENDICT

SUDARMI 6/12/2019 DYSPEPSIA
ARYA 6/16/2019 APENDICT
AYUNINGSIH 6/20/2019 GANGLION
JOKO 6/22/2019 HAEMORROIDS
ZAHRA 6/25/2019 GANGLION
DIAN 6/27/2019 HAEMORROIDS
SURYAWAN 6/29/2019 OPEN WOUND
AYU 6/30/2019 GANGLION

KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH

VI 0
V 0
IV A 1
IV B 0
IV C 0
IV D 0
III A 0
III B 1
II A 0
II B 0
II C 0
I 0
0 11
 Tipe
Terapi
Kategori (Gyssens)
Nama Antibiotik
(P/E/D) VI IV
V
A B C D
CEFOPERAZONE INJ E
CEFTRIAXONE INJ P
CEFOPERAZONE INJ E
ZITROLIN TAB E
CEFOTAXIME INJ P
CEFOTAXIME INJ E
AMOXICILLIN 500 MG E
AMOXSAN INJ P
CEFTRIAXONE INJ P
CEFTRIAXONE INJ P
CEFTRIAXONE INJ P
LEVOFLOXACIN TAB E v
CEFTRIAXONE INJ P

Chart Title
12

10

0
1 2 3 4 5 6 7 8 9 10 11 12 13
Col umn A Col umn B Col umn C
4

0
1 2 3 4 5 6 7 8 9 10 11 12 13
Col umn A Col umn B Col umn C
Kategori (Gyssens)
III II I 0
A B A B C
v
v
v
v
v
v
v
v
v
v
v

v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D) VI

WASITA 7/1/2019 CEFOTAXIME INJ P

MAYUNI 7/5/2019 GANGLION AMOXSAN INJ P
PUTRI 7/8/2019 HAEMORROIDS CEFTRIAXONE INJ P
YASA 7/11/2019 APENDICT CIPROFLOXACIN TAB E
WIJAYA 7/13/2019 CEFTRIAXONE INJ P
SUTAMA 7/15/2019 CEFTRIAXONE INJ P
DENI 7/18/2019 SOFT TISSUE DISORDER CEFTRIAXONE INJ P
SUARNADI 7/20/2019 TYPHUS LEVOFLOXACIN 500 MG E
SARMADA 7/22/2019 DHF CEFTRIAXONE INJ E
DIANINGSI 7/23/2019 GANGLION AMOXSAN INJ P
SUNERTI 7/25/2019 HAEMORROIDS AMOXSAN INJ P
SRIANI 7/27/2019 DHF CEFOTAXIME INJ E
ANGGIE 7/28/2019 APENDICT AMOXICILLIN INJ P
ARTINI 7/30/2019 GANGLION AMOXICILLIN TAB E
SRIANI 7/30/2019 GANGLION CEFOTAXIME INJ P
ARKI 7/31/2019 APENDICT CEFOTAXIME INJ P

KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH

VI 0
V 2 Chart Title
IV A 0 14

12

10

8
 Chart Title
14
IV B 0
12
IV C 0
IV D 0 10

III A 0 8
III B 1
6
II A 0
II B 0 4

II C 0 2
I 0
0
0 13 1 2 3 4 5 6 7 8
Col umn A Col umn B Col
 Kategori (Gyssens)
IV III II
V
A B C D A B A B C

v
v

Chart Title
 Chart Title

5 6 7 8 9 10 11 12 13
ol umn A Col umn B Col umn C
I 0

v
v
v
v
v
v
v

v
v

v
v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D) VI
V

PAMUJI 8/2/2019 AMOXSAN INJ P

CEFADROXIL TAB E
SUDARTA 8/3/2019 BRONKITIS CEFTRIAXONE INJ P
ANDYKA 8/3/2019 CEFTRIAXONE INJ P
KARMINI 8/13/2019 AMOXICILLIN INJ P
ANSHORI 8/26/2019 CEFTRIAXONE INJ P
SUKA 8/26/2019 CEFTRIAXONE INJ P
METRONIDAZOL TAB E
ISMA 8/26/2019 CEFOTAXIME INJ P
SUTARMA 8/27/2019 BACTESYN INJ P
IIN 8/27/2019 BACTESYN INJ P
METRONIDAZOL TAB E
INTAN 8/27/2019 CEFTRIAXONE INJ P
SUNATRI 8/27/2019 CEFADROXIL TAB E
CEKI 8/27/2019 CEFTRIAXONE INJ P
NATHAN 8/30/2019 CEFTRIAXONE INJ P
METRONIDAZOLE INJ E

KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH

VI 0 Chart Title
V 0 18
IV A 0 16
IV B 0 14
IV C 0 12
IV D 0 10
III A 0 8
6
4
2
0
 14
12
10
8
III B 0 6
II A 0
4
II B 0
2
II C 0
0
I 0 1 2 3 4 5 6 7 8
0 17 Col umn A Col umn
 Kategori (Gyssens)
IV III II I
A B C D A B A B C

Chart Title
3 4 5 6 7 8 9 10 11 12 13
Col umn A Col umn C
 0

v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
v
 Tipe
Terapi
PASIEN TGL/BULAN DIAGNOSA Nama Antibiotik
(P/E/D) VI
V

SUDIBIA 9/1/2019 BACTESYN INJ P

SERGIUS 9/1/2019 CEFTRIAXONE INJ P
SUARTINI 9/2/2019 CEFTRIAXONE INJ P
PURIASIH 9/3/2019 CEFTRIAXONE INJ P
METRONIDAZOLE E
TOPAN 9/3/2019 CEFTRIAXONE INJ P
METRONIDAZOLE E
RATNATA 9/4/2019 CEFOTAXIME P
RAGA 9/5/2019 AMOXSAN INJ P
CANDRA 9/8/2019 BACTESYN INJ P
AZITROMYCIN E
CEFIXIME E
GUNIATI 9/8/2019 BACTESYN INJ P
ARIANI 9/9/2019 CEFOTAXIME P
BANGUN 9/10/2019 AMOXICILLIN INJ P
AMBARA 9/11/2019 BACTESYN INJ P
AINI 9/12/2019 BACTESYN INJ P
RANU 9/15/2019 CEFOTAXIME P
SUWARNO 9/16/2019 CEFTRIAXONE INJ P
WINDA 9/17/2019 CEFOTAXIME P
WARNA 9/20/2019 BACTESYN INJ P
AGUNG 9/22/2019 CEFTRIAXONE INJ P
HADI 9/24/2019 METRONIDAZOLE E
JUNI 9/27/2019 CEFOTAXIME P
MARNI 9/29/2019 AMOXSAN INJ P

KATEGORI GYSSENS PENYAKIT DALAM DAN BEDAH

VI 0
V 0 25
IV A 0
IV B 0 20

15
 25

20
IV C 0
IV D 0
15
III A 2
III B 1
II A 0 10
II B 0
II C 0
5
I 0
0 21
0
1 2 3 4 5 6 7 8 9 1
 Kategori (Gyssens)
IV III II I
A B C D A B A B C

v
v

Column A
Column B
 Column A
Column B
Column C

3 4 5 6 7 8 9 10 11 12 13
 0

v
v
v
v
v
v
v
v
v
v

v
v

v
v
v
v
v

v
v
v
v