Pradipta, Ivan S.
Indonesian Journal of Clinical Pharmacy

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Kultur Kuman dari Berbagai Pasien Sepsis Dewasa

Indonesian Journal of Clinical Pharmacy Vol 2, No 1 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Penelitian ini bertujuan memberikan informasi sumber infeksi sepsis dan hasil kultur mikroba dari berbagai spesimen pasien sepsis yang bermanfaat dalam meningkatkan ketepatan terapi antibiotik. Studi observasional prospektif dilakukan di bangsal rawat inap penyakit dalam, sebuah rumah sakit negeri di Yogyakarta, pada bulan September–November 2008. Populasi penelitian adalah pasien yang terdiagnosis sepsis yang dirawat inap pada periode dan tempat penelitian berlangsung, dengan kriteria pasien dewasa umur 15–60 tahun dan terdiagnosis sepsis. Hasil penelitian menunjukkan 42 pasien terdiagnosis sepsis, 26 pasien masuk ke dalam kriteria subjek penelitian. Perlakuan kultur bakteri dilakukan pada 22 subjek penelitian dan empat subjek penelitian tidak dilakukan. Jumlah perlakuan kultur sebanyak 46 perlakuan kultur dari berbagai spesimen, yaitu darah (27), pus (5), urin (4), sputum (3), cairan pleura (1), swab tenggorokan (1), swab ulkus (1) dan 4 perlakuan tidak dapat ditelusuri hasilnya. Hasil kultur menunjukkan 16 (34,8%) perlakukan kultur teridentifikasi mikroba dan 30 (66,2%) hasil kultur menunjukkan tidak teridentifikasi mikroba. Mikroba yang terdeteksi yaitu Staphylococcus coagulase negative, Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli, Proteus mirabilis, Streptococcus alfa. Staphylococcus coagulase negative merupakan organisme yang paling banyak terdeteksi pada spesimen pasien sepsis.Kata kunci: Sepsis, kultur bakteri, patogen sepsis, bakteremia Microbial Culture from Various Specimens of Adult Sepsis PatientsThis study aimed to provide information about pattern of microbial culture from the isolate adult sepsis patients that beneficial in identifying pathogen and antibiotics selection in septic patients. Observational prospective study from September–November 2008 was carried out in ward of internal mediciene at an Public Hospital, Yogyakarta, Indonesia. The population study were adult sepsis patients that hospitalized in research period. The criteria of subject population were sepsis adults patients aged 15–60 years that hospitalizad in research period. As many as 42 patients that found as septic patient, there were twenty six patients included as a subject population. As many as 22 patients get the microbial culture treatment wtih 46 episode microbial culture from the various specimens, i.e blood (27), pus (5), urine (4), sputum (3), pleura fluid (1), throat swab (1), ulcus swab (1) and not identified (4). Culture test showed that 16 (34,8%) culture test was positive results and 30 (66,2%) was negative results. There were Staphylococcus coagulase negative, Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli, Proteus mirabilis, Streptococcus alfa. Staphylococcus coagulase negative organism that detected in culture test from various specimens. Staphylococcus coagulase negative is the common organism which detected from the specimens of sepsis patients.Key words: Sepsis, microbial culture, sepsis pathogen, bacteremia

Identifikasi Pola Penggunaan Antibiotik sebagai Upaya Pengendalian Resistensi Antibiotik

Indonesian Journal of Clinical Pharmacy Vol 1, No 1 (2012)
Publisher : Indonesian Journal of Clinical Pharmacy

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AbstrakPenelitian ini bertujuan untuk menetapkan jumlah dan pola penggunaan antibiotik pada pasien rawat inap di salah satu rumah sakit swasta di Bandung. Data penggunaan antibiotik diperoleh dari instalasi farmasi pada Februari–September 2011. Data diolah dengan metode ATC/DDD dan DU90%. Terdapat 390,98 DDD/100 hari rawat dan 381,34 DDD/100 hari rawat pada total penggunaan antibiotik tahun 2009 dan 2010. Sebanyak 39 jenis antibiotik dikonsumsi pada tahun 2009 dan terdapat 11 jenis antibiotik yang masuk segmen 90% penggunaan (seftriakson, amoksisilin, sefotaksim,  iprofloksasin, levofloksasin, metronidazol, sefiksim, doksisiklin, tiamfenikol, sefodoksim, sefaleksin). Tahun 2010 terdapat 44 jenis antibiotik yang dikonsumsi, 18 jenis antibiotik yang masuk segmen 90% penggunaan (seftriakson, siprofloksasin, amoksisilin, sefiksim, levofloksasin, sefadroksil, sefotaksim, metronidazol, tiamfenikol,doksisiklin, klindamisin, kloramfenikol, amikasin, sulbaktam, gentamisin, streptomisin, sefoperazon, kanamisin). Terdapat penurunan penggunaan antibiotik yang diikuti penurunan jumlah hari rawat pada tahun 2009–2010, tetapi jenis dan jumlah antibiotik yang masuk ke dalam segmen 90% penggunaan meningkat.Kata kunci: Penggunaan antibiotik, ATC/DDD, DU90%, resistensi antibiotikIdentification of Antibiotic Use Pattern as an Effort to ControlAntibiotic ResistanceAbstractThe objective of this study is to determine quantity and pattern of antibiotic use in hospitalized patients at one of Bandung’s private hospital that can give benefit in control of antibiotic resistance andprocurement planning of antibiotic. Data of antibiotic consumption were obtained from hospital pharmacy department on February–September 2011. Data were processed using the ATC/DDD and DU90% method. There were 390,98 DDD/100 bed days and 381,34 DDD/100 bed days total of an-tbiotic use in 2009 and 2010. Thirty nine antibiotic were consumed in 2009 within 11 kind of antibiotics in DU90% segment (ceftriaxone, amoxicillin, cefotaxime, ciprofloxacin, levofloxacin, metronidazole, cefixime, doxycycline, thiamphenicol, cefodoxime, cefalexin) and 44 antibiotic were consumed in 2010 within 18 kind of antibiotics in DU90% segment (ceftriaxone, ciprofloxacin, amoxicillin, cefixime, levofloxacin, cefadroxil, cefotaxime, metronidazole, thiamphenicol, doxycycline, clindamycin, chloramphenicol, amikacin, sulbactam, gentamycin, streptomycin, cefoperazone, canamycin). There were decline of antibioticuse that followed decline number of bed days/year in 2009–2010, but in both antibiotic kind and quantity of DU90% antibiotic group were increased.Key words: Antibiotic utilization, ATC/DDD, DU90%, antibiotic resistance

Hubungan Persepsi terhadap Perilaku Swamedikasi Antibiotik: Studi Observasional melalui Pendekatan Teori Health Belief Model

Indonesian Journal of Clinical Pharmacy Vol 4, No 2 (2015)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Tingginya perilaku swamedikasi antibiotik dapat meningkatkan peluang penggunaan antibiotik yang tidak rasional sehingga berdampak pada peningkatan resistensi antibiotik. Perubahan perilaku swamedikasi antibiotik diperlukan untuk menurunkan penggunaan antibiotik yang irasional. Penelitian ini bertujuan untuk mengetahui hubungan persepsi masyarakat terhadap praktik swamedikasi antibiotik yang bermanfaat untuk mengembangkan model intervensi dalam rangka menurunkan praktik swamedikasi antibiotik (SMA). Studi observasional analitik dilakukan pada bulan November–Desember 2014 kepada masyarakat yang berkunjung ke fasilitas kesehatan primer di Kota Bandung. Wawancara terstruktur dengan menggunakan kuesioner tervalidasi dilakukan untuk melihat variabel perilaku swamedikasi serta variabel persepsi ancaman, keuntungan, hambatan, dan kemamampuan bertindak berdasarkan teori perubahan perilaku health belief model (HBM). Wawancara dilakukan terhadap 506 responden dewasa yang diambil secara acak di 43 puskesmas dan 8 apotek. Data yang diperoleh dianalisis dengan menggunakan statistik deskriptif dan regresi logistik (CI 95%, α=5%).Validitas kuesioner dinyatakan dengan koefisien korelasi >0,3 dan nilai reabilitas alpha-cronbach sebesar 0,719. Terdapat 29,45% responden yang melakukan swamedikasi antibiotik selama 6 bulan terakhir. Tidak terdapat hubungan signifikan antara variabel HBM (persepsi ancaman, keuntungan, hambatan, dan kemampuan bertindak) dengan perilaku swamedikasi antibiotik (p>0,05). Persepsi ancaman, keuntungan, hambatan, dan kemauan bertindak berdasarkan teori HBM menunjukkan hubungan yang lemah terhadap perilaku swamedikasi antibiotik. Mudahnya akses dalam membeli antibiotik secara bebas diduga menjadi faktor dalam perilaku SMA sehingga regulasi yang ketat diperlukan sebagai dasar intervensi dalam menurunkan perilaku SMA.Kata kunci: Antibiotik, health belief model, swamedikasiAssociation between Perceived Value and Self-Medication with Antibiotics: An Observational Study Based on Health Belief Model TheoryHigh prevalence of self medication with antibiotics can increase the probability of irrational use of antibiotics which may lead antibiotics resistance. Thus, shifting of behavior is required to minimize the irrational use of antibiotics. This study was aimed to determine the association between public perceivedvalue and self-medication with antibiotics which can be used to develop an intervention model in order to reduce the practice of self-medication with antibiotics. An observational study was conducted during the period of November–December 2014.The subjects were patients who visit primary health care facilities in Bandung. A structured-interview that has been validated was used to investigate the association between perceived value and self-medication behavior based on the Health Belief Model theory (perceived susceptibility, benefits, barrier, and cues to action). Approximately 506 respondents were drawn randomly from 43 community healthcare centers and 8 pharmacies. Data was analyzed by using descriptive statistics and logistic regression (CI 95%, α = 5%). Validity and reliability of the questionnaire were shown with a correlation coefficient of >0.3 and a cronbach-alpha value of 0.719, respectively. We found that 29.45% of respondents practiced self-medication with antibiotics over the last six months. Additionally, there was no significant association between the perceived susceptibility, benefits, barrier, and cues to action with self-medication behavior (p>0.05). Easiness to access antibiotics without prescription was presumed as a factor that contribute to self-medication with antibiotics, therefore strict regulation in antibiotics use is very needed as a basic intervention to decrease self-medication with antibiotic.Key words: Antibiotics, health belief model, self-medication

Monitoring Penggunaan Antibiotik dengan Metode ATC/DDD dan DU90% di RSUD Abepura Jayapura, Indonesia

Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Tingginya penggunaan antibiotik akan meningkatkan potensi penggunaannya yang tidak rasional dan berdamPak pada tingkat mortalitas, biaya, dan resistensi khususnya dalam lingkungan rumah sakit. Studi observasi dengan data retrospektif telah dilakukan untuk mengevaluasi penggunaan antibiotik dari April 2013–Maret 2014 menggunakan metode ATC/DDD dan DU 90%. Hasil penelitian menunjukkan antibiotik yang masuk ke dalam segmen DU 90% pada periode I adalah kotrikmoksazol 480 mg tablet(40,34 DDD/kunjungan) dan amoksisilin 500 mg tablet (4,53 DDD/kunjungan), periode II adalah sefiksim sirup kering (0,68 DDD/kunjungan), amoksisilin 500 mg tablet (0,41 DDD/kunjungan), siproflokasain 500 mg tablet (0,31 DDD/kunjungan), doksisiklin 100 mg (0,26 DDD/kunjungan), sefiksim 100 mg kapsul (0,15 DDD/kunjungan), sefadroksil 500 mg kapsul (0,12 DDD/kunjungan),seftriakson 1 gr injeksi (0,08 DDD/kunjungan), dan periode III adalah kotrimoksazol 480 mg tablet (74,85 DDD/kunjungan). Tingginya penggunaan antibiotik setiap kunjungan pada penggunaan kotrimoksasol merupakan sebuah tanda ketidakrasionalan dalam penggunaan antibiotik. Diperlukan studi kualititaf untuk mengetahui pola ketidakrasionalan dalam penggunaan antibiotik pada rumah sakit tersebut danmengembangkan model intervensi yang tepat.Kata kunci: Antibiotik, ATC/DDD, DU 90%, rumah sakitMonitoring Use of Antibiotics with ATC/DDD and DU90% Method in Abepura Hospital Jayapura, IndonesiaThe high use of antibiotics will increase its irrational use, affect the mortality rates, costs and resistance, especially in a hospital. We conducted an observational study with retrospective data to evaluate the use of antibiotics from April 2013–March 2014 using the ATC/DDD and DU90% methods. The results showed the antibiotic included DU 90% segment in the first 4 months period were cotrimoxazole tablets 480 mg (40.34 DDD per encounter) and amoxicillin tablets 500 mg (4.53 DDD per encounter), in the second period were cefixime dry syrup (0.68 DDD per encounter), amoxicillin tablets 500 mg (0.41 DDD per encounter), ciprofloxacin tablets 500 mg (0.31 DDD per encounter), doxycycline tablets 100 mg (0.26 DDD per encounter), cefixime tablets 100 mg capsules (0.15 DDD per encounter), cefadroxil tablets 500 mg capsule (0.12 DDD per encounter), ceftriaxone injection 1 g (0.08 DDD per encounter), and during the third period was cotrimoxazole tablets 480 mg (74.85 DDD per encounter). The data showed that cotrimoxazole has the highest rate of utilization per visit which is a signal for irrational use. Qualitative study is needed to describe irrational use of antibiotics in the hospital and to find the appropriate intervention model.Key words: Antibiotics, ATC/DDD, DU 90%, hospital

Analisis Minimalisasi Biaya Penggunaan Antibiotik Empirik Pasien Sepsis Sumber Infeksi Pernapasan

Indonesian Journal of Clinical Pharmacy Vol 3, No 1 (2014)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Terapi antibiotik empirik merupakan salah satu penunjang keberhasilan dalam pengobatan sepsis. Penelitian ini bertujuan untuk mengetahui kombinasi antibiotik empirik yang paling efisien secara biaya (cost minimization) di antara sefotaksim-eritromisin dan sefotaksim-metronidazol yang digunakan pada sepsis sumber infeksi pernapasan yang dirawat di salah satu rumah sakit di Kota Bandung. Penelitian ini merupakan studi observasional dengan pengumpulan data secara retrospektif tahun 2010–2012. Data diambil dari rekam medis pasien rawat inap sepsis sumber infeksi pernapasan yang mendapat terapi antibiotik empirik sefotaksim-metronidazol atau sefotaksim-eritromisin dan daftar biaya dari bagian akuntansi rumah sakit. Biaya dihitung dari mulai pasien masuk rumah sakit dengan diagnosis sepsis sumber infeksi pernapasan sampai pasien sembuh dari sepsis. Antibiotik efotaksimmetronidazoldan sefotaksim-eritromisin diasumsikan memiliki efek yang sebanding. Pasien dengan terapi empirik sefotaksim-metronidazol memiliki waktu tinggal di rumah sakit lebih lama (25 ibanding11) dan memiliki total biaya rata-rata terapi lebih murah (Rp16.641.112,04 dibandingkan dengan Rp21.641.678,02) daripada pasien dengan terapi empirik sefotaksim-eritromisin. Hasil ini menunjukkan bahwa kombinasi antibiotik sefotaksim-metronidazol lebih efisien secara biaya dibandingkan dengan kombinasi sefotaksim-eritromisin.Kata kunci: Antibiotik empirik, cost minimization, eritromisin, metronidazol, sefotaksim, sepsisCost Minimization Analysis of Empiric Antibiotic Used by Sepsis Patient Respiratory Infection SourceEmpirical antibiotics plays an important role in the therapy of sepsis. The aims of this study was to estimate and compare the cost of treating inpatient sepsis with respiratory infection, with cefotaximemetronidazole or cefotaxime-erythromycin antibiotics. Observational study of cost minimization analysis was conducted by retrospective data from 2010 until 2012. Data were collected from medical records of inpatients sepsis with respiratory infection and received empirical therapy cefotaximemetronidazole or cefotaxime-erythromycin and treatment’s pricelist from department of accounting. Direct medical cost was calculated from empirical antibiotic costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The study considered the cost from preadmission because sepsis until the patient was fully recovered of sepsis. Cefotaxime-metronidazole and cefotaxime-erythromycin are assumed to have equivalent efficacy. Patients with empirical cefotaxime -metronidazole were found have longer length of stay (25 versus 11) and average total cost of treatmentwas cheaper (16.641.112,04 IDR versus 21.641.678,02 IDR). The findings demonstrate that combination of empirical antibiotic of cefotaxime–metronidazole is more efficient than cefotaxime-erythromycin.Key words: Cost minimizing, cefotaxime, empirical antibiotic erythromycin, metronidazole, sepsis

Penggunaan Obat Penginduksi Kerusakan Hati pada Pasien Rawat Inap Penyakit Hati

Indonesian Journal of Clinical Pharmacy Vol 1, No 2 (2012)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Kerusakan hati yang disebabkan oleh obat merupakan masalah kesehatan manusia yang serius. Penggunaan obat penginduksi kerusakan hati pada pasien penyakit hati dapat meningkatkan risiko kerusakan hati. Penelitian observasional ini dilakukan untuk mengetahui profil penggunaan obat-obat yang dapat menginduksi kerusakan hati pada pasien rawat inap penderita penyakit hati di salah satu rumah sakitdi Kota Tasikmalaya. Data dikumpulkan secara retrospektif pada periode 2010–2011 dari rekam medis pasien. Total dari 52 subjek penelitian diketahui sebanyak 50 pasien (96%) menggunakan obat penginduksi kerusakan hati dan sebanyak 2 pasien (4%) tidak menggunakannya. Obat penginduksi yang paling banyak digunakan yaitu Ranitidin (31,3%), seftriakson (23,1%), dan parasetamol (16,4%). Tingkat penggunaan obat penginduksi kerusakan hati pada pasien penderita penyakit hati masih tergolong tinggi yaitu sebesar 96%. Diperlukan penelitian lebih lanjut untuk mengetahui pengaruh penggunaan obat penginduksi kerusakan hati terhadap fungsi hati.Kata kunci: Obat penginduksi kerusakan hati, penyakit hati, retrospektifAdministration of Drug Induce Liver Injury to the Inpatients with Liver DiseaseAbstractDrug induced liver injury is a serious human health problems. Pre-existing liver diseases are risk factorof liver injury by the drugs. The study was conducted to evaluate the use of drug induced liver injury in patients hospitalized with liver disease at one hospital in Kota Tasikmalaya. Informations were collected retrospectively in the period 2010-2011 from the patient’s medical record. A total of 52 patients research subjects were discovered 50 patients (96%) using drug induced liver injury and 2 patients (4%) did not use it. Drug induced liver injury most widely used were ranitidine (31.3%), ceftriaxone (23.1%), and paracetamol (16.4%). Level of the DILI usage in patient with liver disease was relative high (96%). Further research is needed to determine the effect of the drug induced liver injury to liver injury.Key words: Drug induced liver injury, liver disease, retrospective

Monitoring Penggunaan Antibiotik dengan Metode ATC/DDD dan DU 90%: Studi Observasional di Seluruh Puskesmas Kabupaten Gorontalo Utara

Indonesian Journal of Clinical Pharmacy Vol 4, No 4 (2015)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Penggunaan antibiotik yang tidak rasional dapat menyebabkan peningkatan morbiditas dan mortalitas. Monitoring penggunaan antibiotik diperlukan dalam mendukung program pemerintah khususnya Dinas Kesehatan yang menyatakan penggunaan antibiotik untuk penyakit ISPA non-pneumonia adalah kurang dari 20%. Evaluasi penggunaan antibiotik ini menggunakan metode ATC/DDD dan DU 90%. Antibiotik yang digunakan untuk ISPA non-pneumonia adalah sebanyak 9 jenis dan antibiotik yang masuk dalam DU90% sebanyak 3 jenis yaitu amoksisilin 500 mg (2,723 DDD/1000 pasien-hari), siprofloksasin (0,378 DDD/1000 pasien-hari) dan sefadroksil (0,202 DDD/1000 pasien-hari). Analisis data secara kuantitatif menggunakan ATC/DDD menunjukkan bahwa antibiotik yang banyak digunakan adalah amoksisilin (500 mg) 2723 DDD/1000 pasien-hari dan yang paling sedikit yaitu amoksisilin (125 mg/5 ml) 1,5 DDD/1000 pasien-hari. Efek peresepan penggunaan antibiotik jangka pendek pada pelayanan pengobatan dasar dapat meningkatkan kejadian resistensi. Diperlukan studi kualitatif untuk mengetahui pola ketidakrasionalan penggunaan antibiotik di pusat pelayanan kesehatan masyarakat tersebut dan mengembangkan model intervensinya.Kata kunci: ATC/DDD, DU 90%, ISPA non-pneumonia antibiotikMonitoring the Use of Antibiotics by the ATC/DDD Method and DU 90%: Observational Studies in Community Health Service Centers in North Gorontalo DistrictIrrational use of antibiotics may lead to increase morbidity and mortality. Monitoring of antibiotics was required to support government programs, especially The Department of Health stating the use of antibiotics for non-respiratory diseases pneumonia was less than 20%. The evaluation of antibiotics use in this research applied ATC / DDD methods and DU 90%. The antibiotic used for non-pneumonia ARI were 9 types and the antibiotics contained DU 90% were three types namely amoxicillin 500 mg (2,723 DDD/1000 patients-year), ciprofloxacin (0,378 DDD/1000 patients-day) and cefadroxil (0,202 DDD/1000 patients-day). Quantitative data analysis using the ATC / DDD indicated that the most used antibiotic was amoxicillin (500 mg) 2723 DDD / 1000 patients-day and the least was amoxicillin (125 mg / 5 ml) 1.5 DDD / 1000 patients-day. The effects of short-term use of antibiotic prescribing in primary medical care could increase the resistance. Qualitative studies were needed to determine the pattern of irrational antibiotic use in community health service center and to develop the intervention model.Keywords: ARI non-pneumonia antibiotics, ATC/DDD, DU 90%

Peresepan Obat-obat Off-Label pada Pasien Anak Usia 0 Hingga 2 Tahun di Apotek Kota Bandung

Indonesian Journal of Clinical Pharmacy Vol 2, No 2 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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Abstract

Obat off-label merupakan obat yang diresepkan tetapi tidak sesuai dengan informasi resmi obat seperti indikasi obat yang tidak sesuai dengan yang dinyatakan oleh izin edar serta dosis, umur pasien, dan rute pemberian yang tidak sesuai. Penelitian ini dilakukan untuk mengetahui persentase jumlah resep pasien dokter spesialis anak yang mengandung obat off-label pada pasien anak usia 0 hingga 2 tahun di Apotek Kota Bandung serta mengetahui pola penggunaannya melalui studi observasional dengan pengambilan data secara retrospektif. Identifikasi obat yang diresepkan termasuk kategori off-label atau tidak berdasarkan Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH) 2012, British National Formulary (BNF) 2009, MIMS USA 2013, MIMS Indonesia 2013, dan ISO 2012–2013. Berdasarkan hasil penelitian diperoleh 542 lembar resep off-label (19,77%) dari 2741 total lembar resep, serta sebanyak 699 (7,89%) item obat off-label dari 8861 obat, dengan persentase kategori off-label usia 70,53%, off-label dosis 19,74% dan off-label kontraindikasi 9,73%. Penelitian ini menunjukkan bahwa potensi peresepan obat off-label di apotek di Kota Bandung pada tahun 2012 tinggi sehingga perlu pemilihan obat yang tepat serta pengawasan dalam penggunaan obat pada anak.Kata kunci: Obat off-label, pediatri, peresepan, Bandung The Prescription of Off-Label Drugs towards 0–2 Years Old Pediatric Patients in Community Pharmacy in Bandung CityOff-label drug is a drug which is not prescribed in accordance with official drug information, including patient age, drug indications didn’t match with the marketing authorization, dosage and route ofadministration are not appropriate. This study was conducted to determine the percentage of patients pediatrician who prescribed with containing drugs off-label in pediatric patients aged 0 to 2 years at pharmacy in Bandung and determine the pattern of use through an observational study with retrospective data collection. Identification of medications that are prescribed off-label category or not based on the Pediatric Dosage Handbook 2007, Drug Information Handbook (DIH) in 2012, the British NationalFormulary (BNF) in 2009, MIMS USA 2013, MIMS Indonesia in 2013, and ISO 2012–2013. Based on the results obtained 542 pieces of off-label prescriptions (19.77%) of the 2741 total pieces recipes, as well as 699 (7.89%) of off-label drug items from 8861 drug, the percentage of off-label age category 70.53%, off-label doses of 19.74% and off-label contraindication 9.73%. The results of this study indicate that the uses of off-label drugs for children is high at Pharmacy in Bandung. This study is expected to be basicconsideration in examining the efficacy and safety in off-label drug uses for children aged 0 to 2 years.Key words: Off-label drug, pediatric, prescription, Bandung

Analisis Minimalisasi Biaya Antibiotik Pasien Sepsis Salah Satu Rumah Sakit Kota Bandung

Indonesian Journal of Clinical Pharmacy Vol 2, No 1 (2013)
Publisher : Indonesian Journal of Clinical Pharmacy

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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

Hubungan Persepsi terhadap Perilaku Swamedikasi Antibiotik: Studi Observasional melalui Pendekatan Teori Health Belief Model

Indonesian Journal of Clinical Pharmacy Vol 4, No 2 (2015)
Publisher : Universitas Padjadjaran

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Abstract

Tingginya perilaku swamedikasi antibiotik dapat meningkatkan peluang penggunaan antibiotik yang tidak rasional sehingga berdampak pada peningkatan resistensi antibiotik. Perubahan perilaku swamedikasi antibiotik diperlukan untuk menurunkan penggunaan antibiotik yang irasional. Penelitian ini bertujuan untuk mengetahui hubungan persepsi masyarakat terhadap praktik swamedikasi antibiotik yang bermanfaat untuk mengembangkan model intervensi dalam rangka menurunkan praktik swamedikasi antibiotik (SMA). Studi observasional analitik dilakukan pada bulan November–Desember 2014 kepada masyarakat yang berkunjung ke fasilitas kesehatan primer di Kota Bandung. Wawancara terstruktur dengan menggunakan kuesioner tervalidasi dilakukan untuk melihat variabel perilaku swamedikasi serta variabel persepsi ancaman, keuntungan, hambatan, dan kemamampuan bertindak berdasarkan teori perubahan perilaku health belief model (HBM). Wawancara dilakukan terhadap 506 responden dewasa yang diambil secara acak di 43 puskesmas dan 8 apotek. Data yang diperoleh dianalisis dengan menggunakan statistik deskriptif dan regresi logistik (CI 95%, α=5%).Validitas kuesioner dinyatakan dengan koefisien korelasi >0,3 dan nilai reabilitas alpha-cronbach sebesar 0,719. Terdapat 29,45% responden yang melakukan swamedikasi antibiotik selama 6 bulan terakhir. Tidak terdapat hubungan signifikan antara variabel HBM (persepsi ancaman, keuntungan, hambatan, dan kemampuan bertindak) dengan perilaku swamedikasi antibiotik (p>0,05). Persepsi ancaman, keuntungan, hambatan, dan kemauan bertindak berdasarkan teori HBM menunjukkan hubungan yang lemah terhadap perilaku swamedikasi antibiotik. Mudahnya akses dalam membeli antibiotik secara bebas diduga menjadi faktor dalam perilaku SMA sehingga regulasi yang ketat diperlukan sebagai dasar intervensi dalam menurunkan perilaku SMA.Kata kunci: Antibiotik, health belief model, swamedikasiAssociation between Perceived Value and Self-Medication with Antibiotics: An Observational Study Based on Health Belief Model TheoryHigh prevalence of self medication with antibiotics can increase the probability of irrational use of antibiotics which may lead antibiotics resistance. Thus, shifting of behavior is required to minimize the irrational use of antibiotics. This study was aimed to determine the association between public perceivedvalue and self-medication with antibiotics which can be used to develop an intervention model in order to reduce the practice of self-medication with antibiotics. An observational study was conducted during the period of November–December 2014.The subjects were patients who visit primary health care facilities in Bandung. A structured-interview that has been validated was used to investigate the association between perceived value and self-medication behavior based on the Health Belief Model theory (perceived susceptibility, benefits, barrier, and cues to action). Approximately 506 respondents were drawn randomly from 43 community healthcare centers and 8 pharmacies. Data was analyzed by using descriptive statistics and logistic regression (CI 95%, α = 5%). Validity and reliability of the questionnaire were shown with a correlation coefficient of >0.3 and a cronbach-alpha value of 0.719, respectively. We found that 29.45% of respondents practiced self-medication with antibiotics over the last six months. Additionally, there was no significant association between the perceived susceptibility, benefits, barrier, and cues to action with self-medication behavior (p>0.05). Easiness to access antibiotics without prescription was presumed as a factor that contribute to self-medication with antibiotics, therefore strict regulation in antibiotics use is very needed as a basic intervention to decrease self-medication with antibiotic.Key words: Antibiotics, health belief model, self-medication