Sinuraya, Rano K.
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Analisis Minimalisasi Biaya Antibiotik Pasien Sepsis Salah Satu Rumah Sakit Kota Bandung Purwanti, Okky S.; Sinuraya, Rano K.; Pradipta, Ivan S.; Abdulah, Rizky
Indonesian Journal of Clinical Pharmacy Vol 2, No 1 (2013)
Publisher : Universitas Padjadjaran

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Abstract

Terapi antibiotik empirik merupakan salah satu komponen penunjang keberhasilan terapi sepsis, khususnya sepsis sumber infeksi pernapasan. Ketidaktepatan pemilihan terapi antibiotik empirik akan menimbulkan dampak buruk berupa munculnya resistensi bakteri terhadap antibiotik, perawatan pasien menjadi lebih lama, kematian, biaya pengobatan menjadi lebih mahal dan bagi rumah sakit akan menurunkan kualitas pelayanan rumah sakit bersangkutan. Tujuan penelitian ini adalah untuk mengetahui kelompok kombinasi antibiotik empirik yang paling efisien secara biaya yang digunakan pada pasien sepsis sumber infeksi pernapasan yang dirawat di salah satu rumah sakit di Kota Bandung periode tahun 2010?2012. Penelitian ini merupakan studi observasional analisis dengan pengumpulan data secara retrospektif. Data diambil dari rekam medis pasien rawat inap sepsis sumber infeksi pernapasan dan mendapat terapi antibiotik empirik seftazidim-levofloksasin atau sefotaksim-eritromisin. Komponen biaya yang dikumpulkan meliputi biaya antibiotik empirik, biaya tindakan, biaya penunjang, biaya rawat inap, dan biaya administrasi. Hasil penelitian menunjukkan bahwa total biaya perawatan kombinasi antibiotik seftazidim-levofloksasin sebesar Rp 12.751.082,49 dan kombinasi sefotaksim-eritromisin sebesar Rp 21.641.678,02. Berdasarkan hasil penelitian dapat disimpulkan bahwa kombinasi antibiotik seftazidim-levofloksasin lebih efisien dibanding kombinasi sefotaksim-eritromisin.Kata kunci: Antibiotik empirik, infeksi pernapasan, minimalisasi biaya, farmakoekonomi, sepsis Cost Minimization Analysis of Antibiotic Used by Sepsis Patients at a Hospital in Bandung Empirical therapy is one of the important supporting therapies for successful sepsis management including, sepsis with respiratory infection. Inappropiate empirical antibiotic therapy leads to resistance of antibiotics which results increases length of stay, mortality and subsequently higher the cost of healthcare and decreases the quality of hospital?s service. This study?s objective was to determine which the antibiotic combination group used for the treatment of sepsis with respiratory infection is the most efficient in cost minimization at a hospital in Bandung. Observational analitycal study is conducted by retrospective data. Data were collected from medical record of inpatients sepsis with respiratory infection who received empirical antibiotic therapy of ceftazidime-levofloxacin or cefotaxime-erythromycin. Direct medical cost were calculated from empirical antibiotic costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The results showed that total cost of the combination of ceftazidime-levofloxacin is 12,751,082,49 IDR and cefotaxime-erythromycin is 21,641,678,02 IDR. It can be conclude that the combination of ceftazidime-levofloxacin is more efficientthan cefotaxime-erythromycin.Key words: Empirical antibiotics, respiratory infection, cost minimization, pharmacoeconomy, sepsis
Analisis Peresepan Obat Anak Usia 2–5 Tahun di Kota Bandung Tahun 2012 Pratiwi, Ami A.; Sinuraya, Rano K.
Indonesian Journal of Clinical Pharmacy Vol 3, No 1 (2014)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (554.821 KB) | DOI: 10.15416/ijcp.2014.3.1.18

Abstract

Penggunaan obat yang tidak rasional dapat menyebabkan kesalahan dalam pengobatan atau timbulnya efek samping yang tidak diinginkan. Kebijakan Obat Nasional (KONAS) telah mengembangkan kebijakan obat umum yang mengikat semua pelaku farmasi di Indonesia agar penggunaan obat dapat dilakukan secara rasional. Untuk mengembangkan strategi yang efektif dalam mengatasi penggunaan obat tidak rasional, maka perlu diketahui sejauh mana tingkat masalahnya, salah satunya melalui Indikator Peresepan yang telah ditetapkan oleh World Health Organization (WHO). Penelitian ini bertujuan untuk mengetahui pola peresepan obat pada anak usia 2 hingga 5 tahun di 14 Apotek Kota Bandung periode 2012 melalui indikator peresepan. Data yang digunakan sebanyak 2.195 lembar resep dari 14 Apotek Kota Bandung diambil secara retrospektif dan diolah berdasarkan indikator peresepan WHO. Hasil penelitian menunjukkan bahwa jumlah obat rata-rata dalam setiap lembar resep 3,54 item; persentase pasien yang menerima obat injeksi 0%; persentase pasien yang menerima antibiotik 75%;persentase obat yang diresepkan dengan nama generik 8,13% dan persentase obat yang diresepkan sesuai dengan Daftar Obat Esensial Nasional (DOEN) adalah 32,9%. Dengan demikian dapat disimpulkan pola peresepan obat anak usia 2?5 tahun di Kota Bandung pada tahun 2012 adalah jumlah item obat rata-rata yang diresepkan masih tinggi jika dibandingkan dengan standar WHO dan KONAS; peresepan injeksi di apotek tidak ada; persentase pasien yang menerima antibiotik jauh lebih tinggi dengan data WHO untuk penggunaan antibiotik di negara berkembang; peresepan obat generik lebih rendah daripada data WHO; dan peresepan obat yang sesuai dengan DOEN masih lebih rendah daripada data KONAS.Kata kunci: Indikator peresepan, pediatrik, penggunaan obat rasionalPrescribing Analysis for 2?5 Years Old Children in Bandung During Year 2012Despite the fact that irrational use of drugs will give medication errors effect or cause the unwanted side effects. The National Drug Policy (KONAS) has developed drug policies that involve all stake-holders in Indonesia in order to minimize the irrational drug use. This study aims to analyze drug prescribing for 2?5 years old children in 14 pharmacies in Bandung during 2012. Approximately 2,195 prescription sheets from 14 pharmacies in Bandung were collected and analyzed by using prescribing indicators from the World Health Organization (WHO). We found an average number of 3.54 drugs in a prescriptionsheet. We also found that 75% and 0% of all patients received antibiotics and injection, respectively. In particular, approximately 8% and 33% of all prescribed drugs were included in generic drug list and National List of Essential Medicines (DOEN), respectively. Based on data from the WHO and KONAS, it can be interpreted that the average number of drugs in a prescription-sheet is still high and the use of antibiotics is significantly higher compared to the use of antibiotics in other developing countries. Also,we summarized that the use of drugs according to generic drug list and DOEN are still low.Key words: Pediatric, prescribing indicators, rational use of medicine
Analisis Efektivitas Biaya Penggunaan Antibiotik Pasien Sepsis di Rumah Sakit di Bandung Rahayu, Cherry; Purwanti, Okky S.; Sinuraya, Rano K.; Destiani, Dika P.
Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Universitas Padjadjaran

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Abstract

Tujuan penelitian ini adalah untuk mengetahui kelompok kombinasi antibiotik empirik yang paling efektif secara biaya (cost effectiveness) yang digunakan pada sepsis sumber infeksi pernapasan yang dirawat di salah satu rumah sakit di kota Bandung periode tahun 2010?2012. Penelitian merupakan studi analisis observasional dengan pengumpulan data secara retrospektif. Data diambil dari rekam medis pasien rawat inap sepsis sumber infeksi pernapasan dan mendapat terapi antibiotik empirik sefotaksimmetronidazol dan sefotaksim-eritromisin. Komponen biaya yang dikumpulkan meliputi biaya antibiotik empirik, biaya tindakan, biaya penunjang, biaya rawat inap, dan biaya administrasi. Hasil Incremental Cost Effectiveness Ratio (ICER) menunjukkan rasio nilai biaya langsung terhadap pasien yang selamat sebesar Rp 3.301.090,00 untuk kombinasi sefotaksim- metronidazol yang dibandingkan dengan antibiotik empirik lain, sedangkan perbandingan kombinasi sefotaksim-eritromisin dengan antibiotik lain terhadap biaya dan pasien yang selamat sebesar Rp 2.227.366,89. Dapat disimpulkan bahwa kombinasi antibiotik sefotaksim-eritromisin lebih efektif secara biaya dibanding kombinasi sefotaksim-metronidazol.Kata kunci: Antibiotik empirik, cost effectiveness, farmakoekonomi, sepsis Cost Effectiveness Analysis of Antibiotic Used among Sepsis Patients in Hospital in BandungThe aim of this study was to determine the antibiotic combination group that were the most effective in cost (cost effectiveness) used as sepsis with respiratory infections treatment at one of hospital in Bandung. Observational study was conducted by retrospective data. Data were collected from medical record from inpatients sepsis with respiratory infection and received empirical therapy cefotaximemetronidazole or cefotaxime-erythromycin. Direct medical cost is collected from empirical antibiotic costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The results of Incremental Cost Effectiveness Ratio (ICER) showed that ratio of direct medical cost and survived patients is 3.301.090,00 IDR for cefotaxime-metronidazole that compared to other empirical antibiotic, and 2.227.366,89 IDR for cefotaxime-erythromycin. It can be conclude that the combination of cefotaxime-erythromycin is more cost effective than cefotaxime-metronidazole.Key words: Empirical therapy, cost effectiveness, pharmacoeconomic, sepsis
Economic Evaluation of the Use of Cefotaxime and Ceftazidime in the Treatment of Pneumonia in Pediatric Patients Ruterlin, Valen; Sinuraya, Rano K.; Halimah, Eli; Barliana, Melisa I.; Hartini, Sri
Pharmacology and Clinical Pharmacy Research Vol 2, No 1
Publisher : Universitas Padjadjaran, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (229.785 KB) | DOI: 10.15416/pcpr.v2i1.15741

Abstract

The prevalence of pneumonia is particularly high among pediatric patients. Appropriate antibioticsselection is required to reduce mortality and morbidity rates associated with thesediseases. However, information on cost-effectiveness of empirical antibiotics treatment forpneumonia was limited. This study was aimed to evaluate cost-effectiveness of cefotaximeand ceftazidime for pneumonia in pediatric patients. This study was a retrospective crosssectional study conducted at a hospital in Bandung during January-December 2012. Datawere derived from medical records of pediatric pneumonia inpatients during study period.Cost was calculated based on direct medical cost, i.e., inpatient care, medical support, andmedicines that were used from admission until hospital discharge. The results showed thatthere was no statistical difference in the average medical cost of the treatment using cefotaxime(1,197,017 IDR) and ceftazidime (2,245,748 IDR). Incremental cost effectivenessratio (ICER) showed that cefotaxime is more cost effective than ceftazidime with greaterreduction of leukocytes level (576 IDR/mm3 ). The use of cefotaxime is recommended forthe treatment of pnuemonia in pediatric patients.Keywords: cost minimization, cost effectiveness, cefotaxime, ceftazidime, pneumonia
Evaluation of Medication Use Patterns among Geriatric Patients using World Health Organization Prescribing Indicators Puspitasari, Irma M.; Hanifah, Ani; Sinuraya, Rano K.
Pharmacology and Clinical Pharmacy Research Vol 4, No 2
Publisher : Universitas Padjadjaran, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (19.166 KB) | DOI: 10.15416/pcpr.v4i2.24527

Abstract

Geriatrics patients are paticularly suceptible to medication error due to complex clinical problems and multiple treatment. World Health Organization (WHO) published a set of prescribing indicators to promote rationale use of drug. This study aimed to evaluate medicine use pattern in geriatric patients at a primary care facility in Bandung, Indonesia, using WHO indicators. This research was conducted using cross sectional design with retrospective data collection. Medical presciption from geriatric patients aged 60-74 years old visiting primary care facility during 2013-2015 were selected. A total of 103.292 prescriptions were obtained in this study. The average number of drugs per encounter  was 2.1 (optimal range=1.6-1.8).   Vast majority (99.41%) of the drugs prescribed were generic drugs (optimal value=100%). The encounters with an antibiotics prescribed were 7.4% (optimal range=20.0-26.8%). Very few parenteral drugs were prescribed in this study setting (0.04%) (optimal range=13.4-24.1%). The drugs prescribed from essential drug list were 72.83% (optimal value=100%).  The most commonly prescribed drugs were paracetamol 500 mg, chlorpheniramine maleat 4 mg, amlodipine 5 mg, vitamin B complex, and glyceryl guaiacolat. The most frequently prescribed antibiotics were amoxicillin, cloramphenicol, cyprofloxacin, clindamycin, and oxytetracyclin.  In conclusion,  the medication use pattern in this study was below the WHO requirement. This finding called for a strategy to promote rational prescribing of medicines.  Keywords: geriatrics, WHO prescribing indicators, drug use patterns