Pneumonia is a lower respiratory tract infection caused by bacteria that results in the alveoli becoming filled with fluid. This study aimed to determine the pattern of antibiotic use and analyze differences in the effectiveness of injectable Azithromycin and Levofloxacin in adult pneumonia patients hospitalized at dr. Abdul Aziz Regional Hospital, Singkawang, from January 2023 to September 2025. This analytical observational study used a retrospective cohort approach. Data were obtained from medical records of 175 patients who met the inclusion and exclusion criteria and were selected using purposive sampling. Data were analyzed using the Mann–Whitney U test in SPSS version 26. Most patients were aged >60 years (61.14%), were male (58.3%), and received injectable Levofloxacin (53.14%). Significant differences were found in leukocyte count (p = 0.007) and therapy duration (p = 0.002). No significant differences were found in body temperature (p = 0.825), pulse rate (p = 0.051), respiratory rate (RR) (p = 0.804), or oxygen saturation (SpO₂) (p = 0.302).
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