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Hafiz Yusaryahya
"Penyakit infeksi masih menjadi sepuluh besar penyebab kematian di Indonesia. Antibiotik merupakan salah satu obat yang paling banyak diresepkan oleh dokter untuk mengatasi penyakit infeksi. Namun, penggunaan antibiotik sering tidak tepat sasaran dan tidak dibutuhkan. Data tentang evaluasi penggunaan antibiotik di Departemen Bedah RSCM masih minim. Metode defined daily dose (DDD) dapat digunakan untuk mengevaluasi penggunaan antibiotik secara kuantitatif pada orang dewasa
Penelitian ini merupakan penelitian deskriptif observasional dengan metode pengambilan data secara cross sectional. Data yang digunakan pada penelitian ini berasal dari rekam medis pasien dewasa yang dirawat di lantai 4 zona B gedung A RSCM dari bulan Januari hingga Maret 2015. Penggunaan antibiotik pasien dihitung menggunakan metode defined daily dose (DDD) dengan DDD/1000 patient-days sebagai unit pengukuran. Sampel penelitian ini berjumlah 307 orang. Diagnosis terbanyak pada sampel penelitian adalah jenis neoplasma (104 kasus), nefrourologi (49 kasus), dan trauma (42 kasus). Antibiotik lebih sering diberikan lewat jalur parenteral (5316.5 vial) dibandingkan oral (1182 vial/tablet). Antibiotik dengan DDD/1000 patient-days tertinggi adalah sulbactam (231.3 DDD/1000 patient-days), seftriakson (166 DDD/1000 patient-days), dan sefiksim (96.5 DDD/1000 patient-days). Untuk penelitian selanjutnya, perlu dihubungkan DDD/1000 patient-days antibiotik dengan diagnosis atau prosedur pembedahan untuk mengetahui ketepatan penggunaan antbiotik.

Infectious disease still becoming top ten cause of death in Indonesia. Antibiotic is one of the most common prescribed drug to treat infectious disease. However, the use of antibiotics often mistargeted and unnecessarily needed. Evaluation of antibiotics usage in Surgical Department of RSCM is still few. Defined daily dose (DDD) method could be used to quantitatively evaluate the usage of antibiotic in adult patient.
This study is an observational descriptive study. Data collected cross-sectionally from medical record of adult inpatient in B zone, 4th floor of building A RSCM for January until March 2015 period. Patient’s antibiotics usage were calculated using defined daily dose method with DDD/1000 patient-days as a unit measurement. The number of patients whose medical record were extracted is 307 person. The most common diagnosis of the patients were neoplasm (104 cases), nephrourology (49 cases), and trauma (42 cases). Antibiotics were more frequently administered parenterally (5316.5 vial) rather than orally (1182 tablet). Antibiotics with the highest DDD/1000 patient day are sulbactam (231.3 DDD/1000 patient-days), ceftriaxone (166 DDD/1000 patient-days), dan cefixime (96.5 DDD/1000 patient-days). For further research, DDD/1000 patient-days need to be correlated with the diagnosis or surgical procedure to know the appropriate use of antibiotics."
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Skripsi Membership  Universitas Indonesia Library
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"[Antibiotik merupakan salah satu obat yang paling banyak digunakan dan diresepkan di rumah sakit, salah satunya di Instalasi Gawat Darurat. Tingginya frekuensi penggunaan antibiotik tidak dapat dipisahkan dari risiko meningkatnya resistensi bakteri terhadap antibiotik, sehingga dapat menimbulkan kegagalan terapi antibiotik. Pemakaian antibiotik di suatu fasilitas kesehatan harus selalu di evaluasi agar dapat menghindari hal tersebut. Metode Defined Daily Dose merupakan salah satu metode evaluasi pemakaian obat secara kuantitatif yang sudah terstandardisasi oleh WHO. Penelitian ini menghitung estimasi jumlah pemakaian antibiotik di Instalasi Gawat Darurat RSCM pada bulan Januari-Maret 2015. Penelitian menggunakan 109 sampel rekam medik pasien IGD RSCM yang mendapatkan terapi antibiotik. Hasil perhitungan menunjukkan kuantitas pemakaian antibiotik di IGD RSCM diperkirakan sangat tinggi dengan tiga antibiotik yang paling sering digunakan yaitu ampisilin-sulbaktam (33,59 DDD/1000 kunjungan pasien), sefiksim (20,02 DDD/1000 kunjungan pasien), dan seftriakson (14,44 DDD/1000 kunjungan pasien, The antibiotic is one of the most frequently drug that prescribed in the hospital, especially in the emergency room. High frequency of antibiotic usage is related to the risk of antibiotic resistance that can impact to therapy failure. Antibiotic usage in health care facility must be evaluated in order to prevent that problem. Defined Daily Dose is a method to evaluate antibiotic usage quantitatively which is standardized by WHO. This study calculates estimation amount of antibiotic usage in Emergency Room RSCM on January-March 2015. This study includes 109 medical records from patients of emergency room RSCM that got antibiotic therapy. The result showed that the quantity of antibiotics usage in Emergency Department of RSCM is estimated to be very high with the three most frequently used are ampicillin-sulbactam (33,59 DDD/1000 patients visit), cefixime (20,02 DDD/1000 patients visit), and ceftriaxone (14,44 DDD/1000 patients visit).]"
[, Fakultas Kedokteran Universitas Indonesia], 2015
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UI - Skripsi Membership  Universitas Indonesia Library
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"[Resistensi antibiotik masih menjadi masalah kesehatan di dunia. Resistensi dipercepat oleh penggunaan antibiotik yang berlebihan. Pada pasien diabetes mellitus (DM) terjadi penurunan sistem pertahanan tubuh karena adanya masalah vaskular, saraf perifer, maupun hiperglikemi sehingga menjadi lebih rentan terkena infeksi. Salah satunya kaki diabetes yang juga sering mendapatkan terapi antibiotik. Penelitian ini bertujuan untuk mengetahui jumlah penggunaan antibiotik pada pasien DM di bangsal IPD RSCM. Penelitian ini dilakukan dengan desain deskriptif. Data identitas, diagnosis, lama rawat, serta riwayat penggunaan obat berasal dari rekam medik pasien yang selanjutnya dihitung menggunakan metode Defined Daily Dose (DDD). Pada penelitian ini didapatkan 60 pasien DM yang mendapatkan terapi antibiotik, dengan 67% diantaranya terdiagnosis infeksi. Antibiotik dengan jumlah penggunaan tertinggi yaitu kombinasi ampisilin dan sulbaktam 65,900 DDD/100 patient-days, meropenem 26,266 DDD/100 patient-days, dan levofloksasin 20,265 DDD/100 patient-days. Jumlah penggunaan antibiotik pada pasien DM cukup tinggi. Oleh karena itu, perlu dilakukan peninjauan penggunaan antibiotik terutama dalam hal durasi pemakaian, Antimicrobial resistance is still a world health problem. The progress is accelerated by misuse and overuse. In diabetes mellitus (DM) patients, vascular problems, neuropathy, or hyperglycemia often leads to suppression of immune system and eventually make the patient more susceptible to infection. One of them is diabetic foot which often treated with antibiotics. The aim of this research is to quantify antibiotic usage in DM patient in internal medicine department Cipto Mangunkusumo hospital. This research conducted with a descriptive study design. We obtained patient’s identity, diagnosis, treatment duration, and history of drug use from medical record and count with DDD method. From this study, we found that 67% from 60 DM patient’s who treated with antibiotics diagnosed with bacterial infection. The highest antibiotic that been used in IPD-RSCM is combinatios of ampicillin and sulbactam with 65,900 DDD/100 patient-days, meropenem with 26,266 DDD/100 patient-days, and levofloxacin with 20,265 DDD/100 patient-days. The number of antibiotic usage in DM patient is still high, thus it needs to be reviewed particularly on usage duration]"
[, Fakultas Kedokteran Universitas Indonesia], 2015
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UI - Skripsi Membership  Universitas Indonesia Library
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Laksmi Bestari
"Salah satu faktor yang dianggap berperan menyebabkan peningkatan resistensi bakteri terhadap antibiotik adalah penggunaan antibiotik yang berlebihan dan tidak tepat. Indonesia adalah salah satu negara dengan angka infeksi yang masih tinggi sehingga tingkat penggunaan antibiotika pun relatif tinggi. Salah satu infeksi dengan insiden yang tinggi adalah infeksi saluran napas bawah. Penelitian ini dilaksanakan untuk mengetahui kuantitas penggunaan antibiotika pada pasien dengan pneumonia di unit rawat inap penyakit dalam RSUPN Cipto Mangunkusumo dalam periode Januari hingga Maret 2015 dengan parameterDefined Daily Dose (DDD)/100 pasien-hari. Penelitian ini merupakan studi deskriptif potong lintang, menggunakan rekam medik pasien. Jumlah sampel adalah 115 orang, dengan jumlah pasien yang didiagnosis pneumonia komunitas 56 orang dan pneumonia nosokomial 53 orang. Antibiotika dengan penggunaan terbanyak adalah azitromisin (35,71 DDD/100 hari pasien), seftriakson (31,34 DDD/ 100 pasien-hari), meropenem (28,83 DDD/100 pasien-hari), sefepim(27,44 DDD/100 pasien-hari), dan levofloksasin (19,64 DDD/100 pasien-hari).

Inappropriate use of antibiotic could increase the number of resistant bacterias. Indonesia is a country with high incidence of infection, therefore the use of antibiotics is relatively high. Lower respiratory tract infection is one of the infection with highest incidence. This study aimed to assess the quantity of antibiotic utilization in internal medicine inpatients ward in Cipto Mangunkusumo Hospital during January to March 2015. This study is a descriptive cross-sectional study using medical record as the data source. The number of sample is 115 patients, with 56 patients diagnosed with community acquired pneumonia and 53 patients diagnosed with nosocomial pneumonia. The most frequently used antibiotics are azithromycin(35,71 DDD/100 patient-days), ceftriaxone(31,34 DDD/ 100 patient-days), meropenem (28,83 DDD/100 patient-days), cefepime(27,44 DDD/100 patient-days), dan levofloxacine (19,64 DDD/100 patient-days).
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Skripsi Membership  Universitas Indonesia Library
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Siti Sarah Ayunda
"[Tingginya frekuensi penyakit tropik infeksi di Indonesia dan peran antibiotik yang sangat vital dalam terapinya menyebabkan tingginya pula potensi penggunaan antibiotik dalam jumlah yang besar di Indonesia. Kondisi ini dapat berujung pada resistensi antibiotik jika penggunaan antibiotik tidak dipantau. Penelitian ini bertujuan untuk melihat kuantitas antibiotik yang diterima oleh pasien rawat inap dewasa di RSCM dengan penyakit tropik infeksi selama periode Juni 2014-2015. Data terkait terapi setiap sampel penelitian diperoleh melalui penelusuran rekam medik, yang kemudian dihitung dengan rumus defined daily dose (DDD). Hasil menunjukkan bahwa secara umum, antibiotik dengan kuantitas tertinggi adalah seftriakson (60,85 DDD/100 pasien-hari). DDD tersebut tergolong tinggi karena terdapat 18 pasien dari 34 sampel penelitian yang menerima terapi seftriakson. Untuk setiap diagnosis yang ditemukan pada sampel penelitian, seftriakson juga menjadi yang tertinggi pada demam tifoid (33,27 DDD/100 pasien-hari). Ditemukan pula penggunaan seftriakson pada pasien DBD (7,83 DDD/100 pasien-hari) dan malaria (3,20 DDD/100 pasien-hari) yang kemungkinan disebabkan oleh adanya infeksi sekunder pada pasien. Sementara itu, pada pasien leptospirosis, kuantitas penggunaan antibiotik tertinggi adalah meropenem (24,91 DDD/100 pasien-hari).;As the frequency of communicable disease in Indonesia is still high and antibiotic’s role as its therapy is vital, there is a possibility that the amount of antibiotic used in Indonesia is also high. This condition may lead to antibiotic resistance. This research was conducted to quantify antibiotic usage of patient with tropical infection diseases in Ward A Building of RSCM during June 2014-2015. Data were collected from Medical Record Unit. Then, then data were calculated using defined daily dose (DDD) formula. The result showed that the highest antibiotic used to treat the patients, generally, was ceftriaxone (60,85 DDD/100 patient-days). This number is high as from 34 patients, 22 of them received ceftriaxone as part of their medication. For each diagnosis found in the sample of population, ceftriaxone was also the highest in thyphoid fever (29,78 DDD/100 patient-days). The use of ceftriaxone was also found in dengue hemorrhagic fever (7,48 DDD/100 patient-days) and malaria (2,55 DDD/100 patient-days). There is probability that those patients also had bacterial infection. Meanwhile, in patient with leptospirosis, the highest antibiotic used was levofloxacin (21,98 DDD/100 patient-days).;As the frequency of communicable disease in Indonesia is still high and antibiotic’s role as its therapy is vital, there is a possibility that the amount of antibiotic used in Indonesia is also high. This condition may lead to antibiotic resistance. This research was conducted to quantify antibiotic usage of patient with tropical infection diseases in Ward A Building of RSCM during June 2014-2015. Data were collected from Medical Record Unit. Then, then data were calculated using defined daily dose (DDD) formula. The result showed that the highest antibiotic used to treat the patients, generally, was ceftriaxone (60,85 DDD/100 patient-days). This number is high as from 34 patients, 22 of them received ceftriaxone as part of their medication. For each diagnosis found in the sample of population, ceftriaxone was also the highest in thyphoid fever (29,78 DDD/100 patient-days). The use of ceftriaxone was also found in dengue hemorrhagic fever (7,48 DDD/100 patient-days) and malaria (2,55 DDD/100 patient-days). There is probability that those patients also had bacterial infection. Meanwhile, in patient with leptospirosis, the highest antibiotic used was levofloxacin (21,98 DDD/100 patient-days)., As the frequency of communicable disease in Indonesia is still high and antibiotic’s role as its therapy is vital, there is a possibility that the amount of antibiotic used in Indonesia is also high. This condition may lead to antibiotic resistance. This research was conducted to quantify antibiotic usage of patient with tropical infection diseases in Ward A Building of RSCM during June 2014-2015. Data were collected from Medical Record Unit. Then, then data were calculated using defined daily dose (DDD) formula. The result showed that the highest antibiotic used to treat the patients, generally, was ceftriaxone (60,85 DDD/100 patient-days). This number is high as from 34 patients, 22 of them received ceftriaxone as part of their medication. For each diagnosis found in the sample of population, ceftriaxone was also the highest in thyphoid fever (29,78 DDD/100 patient-days). The use of ceftriaxone was also found in dengue hemorrhagic fever (7,48 DDD/100 patient-days) and malaria (2,55 DDD/100 patient-days). There is probability that those patients also had bacterial infection. Meanwhile, in patient with leptospirosis, the highest antibiotic used was levofloxacin (21,98 DDD/100 patient-days).]"
Jakarta: [Fakultas Kedokteran Universitas Indonesia;Fakultas Kedokteran Universitas Indonesia, Fakultas Kedokteran Universitas Indonesia], 2015
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UI - Skripsi Membership  Universitas Indonesia Library
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Maulana Rosyady
"Latar belakang: Resistensi antibiotik merupakan ancaman kesehatan global. Tingginya tingkat reproduksi mikroorganisme dan kemampuan tekanan selektif yang kuat dari mikroorganisme menghadapi antibiotik pilihan merupakan permasalahan penggunaan antibiotik saat ini. Salah satu cara agar dapat menguatkan pemahaman dan ketaatan staf medis adalah melalui edukasi. Pemanfaatan teknologi seperti e-learning merupakan salah satu cara untuk meningkatkan tingkat pengetahuan dan ketepatan penggunaan antibiotik.
Metode: Penelitian intervensi ini melibatkan seluruh DPJP dan PPDS Sp1 Ilmu Kesehatan Anak yang berstatus aktif di FKUI RSCM. Intervensi e-learning dilakukan terhadap DPJP dan PPDS dengan topik Antimicrobial Stewardship (AMS) via website EMAS UI kemudian dinilai tingkat pengetahuan pra- dan pasca-intervensi. Penggunaan antibiotik satu bulan pra- dan pasca-intervensi dinilai dengan alur Gyssens untuk menilai ketepatan penggunaan antibiotik.
Hasil: Total penggunaan antibiotik pra- dan pasca-intervensi berturut-turut adalah 248 dan 229 antibiotik. Sebanyak 135 (54,4%) penggunaan antibiotik pra-intervensi dan 170 (72,24%) penggunaan antibiotik pasca-intervensi dinilai tepat. Analisis bivariat terhadap ketepatan penggunaan antibiotik menunjukkan terdapat hubungan bermakna pra- dan pasca-intervensi (OR= 0,537, IK 95% 0,363-0,795; p< 0,002). Sebanyak 42 dari total 56 DPJP anak dan 119 dari total 123 PPDS Sp1 Ilmu Kesehatan Anak mengikuti intervensi e-learning. Analisis bivariat menunjukan terdapat hubungan bermakna terhadap tingkat pengetahuan DPJP pra- dan pasca-intervensi (1 vs 32; p<0,001) dan PPDS pra- dan pasca-intervensi (10 vs 66; p<0,001).
Kesimpulan: Terdapat peningkatan signifikan tingkat ketepatan penggunaan antibiotik pada pasien anak di ruang perawatan RSCM dan tingkat pengetahuan ketepatan pemberian antibiotik pada DPJP dan PPDS setelah dilakukan intervensi edukasi melalui metode e-learning.

Backgorund: Antibiotic resistance is a global health threat. The high rate of reproduction of microorganisms and the strong selective pressure ability of microorganisms against antibiotics are the problems of the current use of antibiotics. Education is a way to strengthen the understanding and obedience of medical staff. Utilization of technology such as e-learning can be used to increase the level of knowledge and the effectiveness of using antibiotics.
Method: This intervention study involved all active pediatric staff and pediatric residents from the Department of Child Health in FMUI-CMH. Staff and residents underwent intervention through e-learning on the topic of Antimicrobial Stewardship (AMS) via the EMAS UI website, and then the level of their pre- and post-intervention knowledge was assessed. The use of antibiotics one month pre- and post-intervention was assessed by Gyssen's flowchart to assess the appropriateness of the antibiotics usage.
Result: A total of 135 (54.4%) uses of pre-intervention antibiotics and 170 (72.24%) uses of post-intervention antibiotics were considered appropriate. Bivariate analysis of the appropriate use of antibiotics showed that there was a significant relationship pre- and post-intervention (135 vs. 170, 95% CI 0.363-0.795; p 0.002). Forty two out of 56 staff and 119 out of 123 residents participate in e-learning. Bivariate analysis showed that there was a significant relationship between the level of knowledge of pre- and post-intervention in pediatric staff (1 vs. 32; p 0.001) and pre- and post-intervention pediatric residents (10 vs. 66; p 0.001).
Conclusion: There was a significant increase in the appropriateness level of using antibiotics in pediatric patients at CMH and the level of knowledge about the appropriateness of giving antibiotics to staff and residents after educational interventions were carried out through the e-learning.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Maulana Rosyady
"Resistensi antibiotik merupakan ancaman kesehatan global. Tingginya tingkat reproduksi mikroorganisme dan kemampuan tekanan selektif yang kuat dari mikroorganisme menghadapi antibiotik pilihan merupakan permasalahan penggunaan antibiotik saat ini. Salah satu cara menguatkan pemahaman dan ketaatan staf medis adalah melalui edukasi. E-learning merupakan salah satu cara untuk meningkatkan tingkat pengetahuan dan ketepatan penggunaan antibiotik. Penelitian intervensi ini melibatkan seluruh DPJP dan PPDS Sp1 Ilmu Kesehatan Anak yang berstatus aktif di FKUI RSCM. Intervensi e-learning dilakukan terhadap DPJP dan PPDS dengan topik Antimicrobial Stewardship (AMS) melalui website EMAS UI kemudian dinilai tingkat pengetahuan pra- dan pasca-intervensi. Penggunaan antibiotik satu bulan pra- dan pasca-intervensi dinilai dengan alur Gyssens untuk menilai ketepatan penggunaan antibiotik. Sebanyak 135 (54,4%) penggunaan antibiotik pra-intervensi dan 170 (72,24%) penggunaan antibiotik pasca-intervensi dinilai tepat. Analisis bivariat terhadap ketepatan penggunaan antibiotik menunjukkan terdapat hubungan bermakna pra- dan pasca-intervensi (OR= 0,537, IK 95% 0,363-0,795; p< 0,002). Sebanyak 42 dari total 56 DPJP anak dan 119 dari total 123 PPDS Sp1 Ilmu Kesehatan Anak mengikuti intervensi e-learning. Analisis bivariat menunjukan terdapat hubungan bermakna terhadap tingkat pengetahuan DPJP pra- dan pasca-intervensi (1 vs 32; p<0,001) dan PPDS pra- dan pasca-intervensi (10 vs 66; p<0,001). Terdapat peningkatan signifikan tingkat ketepatan penggunaan antibiotik pada pasien anak di ruang perawatan RSCM setelah dilakukan intervensi edukasi melalui metode e-learning.

Antibiotic resistance is a global health threat. The high rate of reproduction of microorganisms and the strong selective pressure ability of microorganisms against antibiotics are the problems of the current use of antibiotics. Education is a way to strengthen the understanding and obedience of medical staff. E-learning can be used to increase the level of knowledge and the effectiveness of using antibiotics. This intervention study involved all active pediatric staff and pediatric residents from the Department of Child Health in FMUI-CMH. Staff and residents underwent intervention through e-learning on the topic of Antimicrobial Stewardship (AMS) via the EMAS UI website, and then the level of their pre- and post-intervention knowledge was assessed. The use of antibiotics one month pre- and post-intervention was assessed by Gyssen's flowchart to assess the appropriateness of the antibiotics usage. A total of 135 (54.4%) uses of pre-intervention antibiotics and 170 (72.24%) uses of post-intervention antibiotics were considered appropriate. Bivariate analysis of the appropriate use of antibiotics showed that there was a significant relationship pre- and post-intervention (135 vs. 170, 95% CI 0.363-0.795; p 0.002). Forty two out of 56 staff and 119 out of 123 residents participate in e-learning. Bivariate analysis showed that there was a significant relationship between the level of knowledge of pre- and post-intervention in pediatric staff (1 vs. 32; p 0.001) and pre- and post-intervention pediatric residents (10 vs. 66; p 0.001). The total use of pre- and post-intervention antibiotics being, respectively, 248 and 229 antibiotics. There was a significant increase in the appropriateness level of using antibiotics in pediatric patients at CMH after educational interventions were carried out through the e-learning."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Adriel Sebastian Loekito
"Pneumonia merupakan salah satu penyakit menular yang sering terlihat pada pasien penyakit ginjal kronis (PGK). Antibiotik yang digunakan dalam terapi farmakologis pneumonia sering kali memerlukan pengaturan dosis akibat penurunan fungsi ginjal. Studi cross-sectional ini dilakukan untuk mengetahui ketepatan dosis antibiotik dan pengaruhnya pada luaran terapi dan durasi rawat pada pasien pneumonia dengan PGK di RSUP Persahabatan Jakarta. Data pasien diambil secara retrospektif pada periode 2021-2023 menggunakan metode total sampling. Analisis statistik dilakukan dengan metode Chi-squared untuk kesesuaian dosis dan hubungan kesesuaian dosis dengan luaran terapi dan Mann-Whitney untuk kesesuaian dosis dengan durasi rawat. Diperoleh 111 sampel penelitian yang mayoritias merupakan laki-laki dengan median usia 59 tahun dengan penyakit ginjal stadium akhir. Sefoperazon merupakan antibiotik yang paling banyak digunakan, diikuti oleh levofloksasin dan sefotaksim. Mayoritas pasien (51,4%) menerima peresepan antibiotik dengan pengaturan dosis yang tidak tepat. Ditemukan bahwa nilai laju filtrasi glomerulus (LFG) (p < 0,001; RR = 1,048) dan hemodialisis (p = 0,003; RR = 0,571) memengaruhi kesesuaian dosis. Tidak ditemukan hubungan yang signifikan antara kesesuaian dosis dengan luaran terapi; faktor lain yang memengaruhi luaran terapi meliputi nilai Charlson comorbidity index (CCI) (p = 0,007; RR = 1,829), jenis terapi (p = 0,023; RR = 1,183) dan sepsis (p < 0,001; RR = 0,368). Kesesuaian dosis memengaruhi durasi rawat secara signifikan (p < 0,001) dan faktor lain yang memengaruhi durasi rawat adalah hemodialisis (p = 0,019). Temuan ini menunjukkan masih adanya ketidaksesuaian pengaturan dosis yang perlu diperbaiki dengan melibatkan apoteker dan tenaga kesehatan lain dalam pengaturan dosis antibiotik.

Pneumonia is one of the most prevalent infectious diseases in patients with chronic kidney disease (CKD). Antibiotics used in pneumonia often require dose adjustments. A cross-sectional study was conducted to determine antibiotic dose appropriateness and its impact on patients’ outcomes and length of stay (LOS) at the Persahabatan National Respiratory Hospital Jakarta. Patients’ data were retrospectively reviewed between 2021 and 2023 using the total sampling method. Statistical analyses were performed with the Chi-squared analyses for dose appropriateness and outcomes and the Mann-Whitney test for LOS. A total of 111 samples were included in the study, with the majority being males with a median age of 59 and end-stage renal disease. Cefoperazone was prescribed more than any other antibiotics, followed by levofloxacin and cefotaxime. Most patients (51,4%) received antibiotics with inappropriate dose adjustment. Low estimated glomerular filtration rate (eGFR) (p < 0,001; RR = 1,048) and haemodialysis (p = 0,003; RR = 0,571) were independently associated with inappropriate dose adjustment. No statistically significant association was found between dose appropriateness and clinical outcome; other associated factors include a high Charlson comorbidity index (CCI) score (p = 0,007; RR = 1,829), type of therapy (p = 0,023; RR = 1,183), and sepsis (p < 0,001; RR = 0,368). Inappropriate dose adjustments were associated with a longer LOS (p < 0,001). Other associated factors include haemodialysis (p = 0,019). These findings indicate substantial dose adjustment inappropriateness that requires immediate attention and collaboration by pharmacists and other healthcare professionals to ensure appropriate adjustment."
Depok: Fakultas Farmasi Universitas Indonesia, 2024
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UI - Skripsi Membership  Universitas Indonesia Library
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Hadra Khalisya
"Penelitian ini bertujuan untuk mengevaluasi penggunaan antibiotik oral di Puskesmas Pembantu Cipinang Melayu pada tahun 2022 menggunakan metode ATC/DDD (Anatomical Therapeutic Chemical/Defined Daily Dose). Evaluasi ini penting dilakukan untuk mengetahui rasionalitas penggunaan antibiotik dalam upaya mencegah resistensi antibiotik. Data diperoleh secara retrospektif dari Laporan Pemakaian dan Lembar Permintaan Obat (LPLPO), jumlah pasien, serta harga obat. Hasil penelitian menunjukkan bahwa antibiotik yang paling banyak digunakan adalah amoksisilin, dengan nilai DDD tertimbang sebesar 556 DDD/1000 pasien dan persentase penggunaan sebesar 69,67%. Kelas terapi antibiotik yang paling banyak digunakan adalah antibiotik untuk penggunaan sistemik dengan kode ATC J01, yang mencakup 98,92% dari total penggunaan. Berdasarkan expenditure (pengeluaran biaya), amoksisilin juga merupakan antibiotik dengan pengeluaran biaya tertinggi, sebesar 70,07% dari total pengeluaran untuk antibiotik di Puskesmas Pembantu Cipinang Melayu. Penelitian ini menyimpulkan bahwa amoksisilin adalah antibiotik yang paling sering digunakan dan paling besar pengeluaran biayanya. Disarankan agar dilakukan evaluasi lebih lanjut menggunakan data rekam medis pasien untuk menilai ketepatan pemberian antibiotik berdasarkan diagnosis yang lebih akurat.

This study aims to evaluate the use of oral antibiotics at Cipinang Melayu Sub-Health Center in 2022 using the ATC/DDD (Anatomical Therapeutic Chemical/Defined Daily Dose) method. This evaluation is essential to assess the rationality of antibiotic use in efforts to prevent antibiotic resistance. Data were collected retrospectively from the Drug Usage and Request Form (LPLPO), patient numbers, and drug prices. The results show that the most frequently used antibiotic was amoxicillin, with a weighted DDD value of 556 DDD/1000 patients and a usage percentage of 69.67%. The most commonly used therapeutic class of antibiotics was systemic antibiotics with ATC code J01, accounting for 98.92% of total usage. In terms of expenditure, amoxicillin also had the highest cost, comprising 70.07% of the total antibiotic expenditure at Cipinang Melayu Sub-Health Center. This study concludes that amoxicillin is the most frequently used antibiotic and incurs the highest cost. It is recommended that further evaluation be conducted using patient medical records to assess the appropriateness of antibiotic prescription based on more accurate diagnoses. "
Depok: Fakultas Farmasi Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Gunawan Adhiguna
"Kondisi multipatologi pada pasien geriatri dapat mengakibatkan polifarmasi, interaksi obat, dan peresepan yang tidak sesuai. Penghambat pompa proton adalah salah satu obat yang sering diresepkan pada pasien geriatri. Evaluasi penggunaan obat diperlukan untuk meningkatkan ketepatan dan keefektifan peresepan penghambat pompa proton terutama pada pasien geriatri. Penelitian ini merupakan studi retrospektif deskriptif. Sampel yang digunakan adalah data rekam medik pasien geriatri yang dirawat di ruang rawat inap geriatri RSCM dalam periode Januari hingga Juni 2015. Penelitian ini menganalisa besar penggunaan penghambat pompa proton menggunakan sistem Anatomical Therapeutic Chemical Defined Daily Dose (ATC/DDD) dan perbandingannya dengan penelitian lain. Hasil penelitian menunjukkan 60,2% pasien menggunakan penghambat pompa proton yang 96,4% diantaranya adalah omeprazol. Rute pemberian yang paling dominan adalah intra vena (89,3%). Besar penggunaan penghambat pompa proton 33,79 DDD/100 bed-days. Dibandingkan dengan prevalensi GERD sebagai indikasi obat ini, nilai DDD/100 bed-days penghambat pompa proton lebih tinggi. Hal ini memperlihatkan penggunaan penghambat pompa proton yang berlebihan pada pasien geriatri.

Multipathologic conditions in geriatric patients can lead to polypharmacy, drug interactions, and irrational prescribing. Proton pump inhibitors are one of the most prescribed drug in geriatric patients. Evaluation of the use of the drug is needed to improve the provision and effectiveness of proton pump inhibitors prescription, especially in geriatric patients. This study is a retrospective descriptive study. The samples were taken from geriatric patient medical records during the period of January to June 2015 in inpatient geriatric ward RSCM. This study analyzes quantitatively the use of proton pump inhibitors using the Anatomical Therapeutic Chemical/Defined Daily Dose system (ATC / DDD) and compare it with other studies. The results showed that 60.2% of patients used proton pump inhibitors, 96.4% of which was omeprazole. The most dominant route of administration was IV (89.3%). The total use of proton pump inhibitors is 33.79 DDD / 100 bed-days. Compared with the prevalence of GERD as an indication of this drug , the value of proton pump inhibitors DDD / 100 bed ?days is higher. This shows the utilization of a proton pump inhibitor was excessive in geriatric patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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