Agung Dwi Wahyu Widodo
Department of Microbiology, Faculty of Medicine/Airlangga University, Soetomo Hospital, Surabaya.

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COMPARISON OF FOSFOMYCIN TROMETAMOL WITH CIPROFLOXACIN FOR UNCOMPLICATED UTI DUE TO E.COLI IN WOMEN budiono, heri; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Soebadi, Doddy M; Widodo, Agung Dwi Wahyu; Budiono, Budiono
Indonesian Journal of Urology Vol 22, No 1 (2015)
Publisher : Indonesian Urological Association

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Abstract

Objective: To compare clinical therapeutic effects (frequency, dysuria, and pyuria), microbiology, pharmacokinetics index Cmax/MIC Fosfomycin Trometamol 3 gr single dose with Ciprofloxacin 2 x 500 mg/12 hours for 5 days in the treatment of uncomplicated UTI in women due to Escherichia coli (E.Coli). Materials & Methods: Experimental observational design from February until July 2013. Twenty two women with uncomplicated UTI due to E.Coli performed clinical and microbiological examination. Pharmacokinetics index (Cmax/MIC) is looked for. Patients are divided 2 group, Ciprofloxacin 500 mg/12 hours 5 days and Fosfomycin Trometamol single dose. Repeat clinical and microbiological evaluation is performed in 7 days after therapy. Statistic analysis use Chi Square test, Paired T test, and Independent T test. Results: In the treatment of uncomplicated UTI in women, Fosfomycin Trometamol single dose therapy provides clinical cure (dysuria 81.2%, p = 0.338, frequency 90.9%, p = 0.004, pyuria 90.9%, p = 0.009) much better than Ciprofloxacin 500 mg/12 hours 5 days. Fosfomycin Trometamol single dose therapy also provides bacteriological eradication (100%) better than Ciprofloxacin 500 mg/12 hours 5 days (p = 0.035). Fosfomycin Trometamol single dose had a higher pharmacokinetics index (Cmax/MIC) compared to Ciprofloxacin 500 mg/12 hours (p = 0.035). Conclusion: Fosfomycin Trometamol single dose therapy is superior to Ciprofloxacin 500 mg/12 hours 5 days in the treatment of uncomplicated UTI in women. Keywords: Therapeutic effect, fosfomycin trometamol, ciprofloxacin, uncomplicated UTI, Escherichia coli.
Empirical Antibiotic Therapy Assessment of Patients diagnosed with Sepsis in Intermediate Care Ward of Internal Medicine Department of Dr. Soetomo General Hospital according to Gyssens Method Adiwinoto, Ronald Pratama; Sustini, Florentina; Hardiono, Hardiono; Widodo, Agung Dwi Wahyu; Hidajat, Boerhan; Hadi, Usman
Oceana Biomedicina Journal Vol 1, No 2 (2018): Oceana Biomedicina Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/obj.v1i2.17

Abstract

Rational empirical antimicrobial therapy is an important component of sepsis patient management. This study aimed to assess the rationality of empirical antimicrobial therapy in patients diagnosed with sepsis admitted in intermediate care ward of internal medicine department (RPI) of Dr. Soetomo General Hospital from January 2016 to July 2017. Medical records of 91 patients diagnosed with sepsis were collected and studied retrospectively in period from July 2017 to November 2017. 91 (85.05%) medical records from 107 sepsis patients were evaluated. Cultures and antimicrobial sensitivity tests were carried out in 21 (23.07%) patients. 14 patients yielded positive culture results, 9 of which were MDRO positive with ESBL as resistant marker. Empirical antibiotic therapies for these patients were reviewed according to Gyssens method.73 (80.2%) of 91 patients were deemed receiving appropriate empirical antibiotic therapies. Ceftriaxone IV injection as monotherapy or combination therapy were the most common empirical antibiotic therapies (82 in 91 patients, 90.1%), despite local microbiologic flora and antibiogram show most pathogens were resistant to ceftriaxone. Mortality rate in this study was high, 92.3% (84 patients died) despite rational empirical antibiotic therapies were high. This study concluded that empirical antibiotic therapies in sepsis patients according to guidelines adopted in Soetomo General Hospital, albeit deemed rational, was no longer appropriate according to local antibiogram issued by microbiological department of Soetomo General Hospital. Keywords: Empirical Antibiotics Therapy, Gyssens criteria, Intermediate Care Ward, Sepsis, Septic Shock
Distribusi dan Antibiogram MRSA dari Spesimen Darah selama Empat Semester di RSUD Dr. Soetomo Surabaya Sutandhio, Silvia; Widodo, Agung Dwi Wahyu; Wasito, Eddy Bagus
JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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MRSA bloodstream infection is hospital-acquired problem that is difficult to treat. Bacteria spread to body organs, create multiple loci of infection, and survive in the presence of beta-lactam antibiotics. Study of distribution and antibiogram of MRSA from blood specimens was done in four semesters; i.e. July–December 2014, January–June 2015, July–December 2015, and January–June 2016. Blood of patients suspected for bloodstream infection was drawn aseptically, transferred into liquid medium, and sent to Clinical Microbiology Laboratory of Dr. Soetomo General Hospital. Medium with microbial growth was subcultured on solid medium, and incubated for 18-24 hours in aerobic condition. Identification and susceptibility test were done with BD Phoenix, and interpreted based on Clinical and Laboratory Standards Institute 2015. Of total 107 MRSA isolates; 23 isolates (22%) were collected on July–December 2014, 12 isolates (11%) on January–June 2015, 25 isolates (23%) on July–December 2015, and 47 isolates (44%) on January–June 2016. MRSA mostly isolated from internal disease wards (45%). Isolates are sensitive to linezolid (91%), quinupristin-dalfopristin (83%), fosfomycin (82%), and vancomycin (80%). Trend of MRSA bloodstream infection is increasing. Although antibacterial agents against MRSA are available, it is best to prevent MRSA transmissions and infections.
Perbandingan Distribusi Dan Pola Kepekaan Acinetobacter baumannii Terhadap Antimikroba Di RSUD Dr. Soetomo Surabaya Periode Januari–Maret 2015, April–Juni 2015, dan Januari–Maret 2016 Sutandhio, Silvia; Widodo, Agung Dwi Wahyu; Alimsardjono, Lindawati; Wasito, Eddy Bagus
JURNAL WIDYA MEDIKA Vol 4, No 1 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Acinetobacter baumannii is an environmental bacteria that can cause opportunistic infections such as ventilator-associated pneumonia, burn wound infection, urinary tract infection, and sepsis in immunocompromised patients. A. baumannii infections are troublesome because the bacteria resistance to many antimicrobial agents. Surveillance of distribution and sensitivity pattern of A. baumannii is best to be done frequently in hospitals.Venous blood as much as 10 milliliters was drawn aseptically and transferred into liquid medium Bactec® to be sent to Clinical Microbiology Laboratory of Dr. Soetomo General and Teaching Hospital. Medium that showed bacterial growth was subcultured on Blood Agar Plate and MacConkey Agar, and incubated for 18-24 hours in aerobic condition. Identification and susceptibility test were done with semi-automated system BD Phoenix, and interpreted based onClinical and Laboratory Standards Institute 2015.A. baumannii collected on trimester January-March 2015 were 30 isolates, with 19 isolates being Multidrug Resistant(MDR) A. baumannii (63%) and 6 isolatesPandrug Resistant(PDR)A. baumannii (20%). Isolates from trimester April-June 2015 were 32 isolates, with 21 isolates being MDR A. baumannii (66%) and 2 isolates PDR A. baumannii (6%). Isolates from trimester January-March 2016 were 40 isolates, with 22 isolates being MDR A. baumannii (55%) and 2 isolates PDR A. baumannii (5%).A. baumannii mostly isolated from Intensive Care Unit, followed by Internal medicine ward, Pediatric ward, Surgery ward and Emergency Department. High sensitivity of A. baumanniion trimester January-March 2016 was to imipenem (50%), meropenem (50%), amikacin (53%), cotrimoxazole (53%), dan cefoperazone-sulbactam (55%).. MDRA. baumannii mostly isolated from ICU, which reflects high burden of antimicrobial use. At this moment, antimicrobial agents that can be used as empirical therapy for A. baumannii infection are imipenem, meropenem, amikacin, cotrimoxazole, and cefoperazone-sulbactam. The entire hospital member must implement the Infection Control and Prevention and Antimicrobial Stewardship Program to preventnosocomial infections byA. baumanniiand the emergence of MDRA. baumannii.