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"The “always on-hand” pocket guide to the treatment of infectious diseases.- The most important antibiotics and antimycotics :Spectrum – dosage – side-effects- Numerous tables sorted by substances, pathogens, indications- Administration of antibiotics during pregnancy, renal and hepatic insufficiency, dialysis- Including statements on the cost of therapyNumerous tips and troubleshooting guides on topics such as :- Potential mistakes- Therapy failures- Perioperative antibiotic prophylaxisAdjusted to European standards :Up-to-date substances, authorizations, resistances and trade names."

"The first book was on "Theory and practice" of antibiotic stewardship in its broadest sense -the how to do it and the do's and don’ts. The second, on "Controlling resistance" was very much on the relationships between use and resistance and beginning to home in on the hospital as the main generator of resistance, but mainly looking at it from a disease/clinical perspective. The last 3 chapters on MRSA, ended where the 3rd book will take off. "Controlling HAI " will concentrate on specific MDR organisms highlighting their roles in the current pandemic of HAI and emphasizing that the big issue is not so much infection control but antibiotic control, in the same way that antibiotic over-reliance/ over-use has caused the problem in the first place. Up 'till now the emphasis for controlling MRSA, C diff and all the other MDROs has very much been on IC, which clearly isn't working. This book will gather all the evidence for the increasingly popular view that much more must be done in the area of antibiotic policies/ stewardship, especially when we are in danger of a "post antibiotic" era, due to a real shortage of new agents in the pipeline."

"Buku ini diharapkan dapat menyediakan sebuah pendekatan/cara baru bagi terapis untuk menghadapi pasien kronis, tema dan pola yang relatif lama"

"Infeksi Clostridium difficile toksigenik meningkat tajam pada satu dekade terakhir, menyebabkan pseudo membran colitis (PMC) dan Clostridium difficile associated diarrhea (CDAD). Salah satu faktor risikonya adalah penggunaan antibiotik. Tujuan penelitian adalah mengetahui prevalensi dan gambaran karakteristik subyek dengan Clostridium difficile toksigenik serta menilai kemampuan rapid test toksin terhadap real time PCR. Subyek penelitian prospektif ini adalah 90 subyek dewasa dengan terapi antibiotik lebih dari 2 minggu. Hasil pemeriksaan menggunakan rapid test dan real time PCR disajikan dalam tabel 2x2, dilakukan uji statistik dengan chi square. Hasil penelitian menunjukkan 2 spesimen dieksklusi karena hasil invalid, 24 spesimen positif dan 64 negatif dengan rapid test toksin; 33 spesimen positif dan 55 negatif dengan real time PCR. Prevalensi Clostridium difficile toksigenik berdasar rapid test toksin adalah 27,3% dan real time PCR 37,5%. Terdapat perbedaan bermakna antara konsistensi feses dan jumlah antibiotik dengan terdeteksinya Clostridium difficile toksigenik (p<0,05). Terdapat hubungan antara lama terapi antibiotik dengan terdeteksinya Clostridium difficile toksigenik menggunakan real time PCR (p=0,010, RR=2,116). Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, rasio kemungkinan positif dan rasio kemungkinan negatif rapid test toksin terhadap real time PCR berturut-turut adalah 69,7%; 98,2%; 95,8%; 84,4%; 39,2 dan 0,31. Dari hasil penelitian disimpulkan bahwa prevalensi Clostridium difficile di RSCM lebih tinggi dibanding Malaysia, Thailand dan India; subyek dengan terapi antibiotik lebih dari 4 minggu berisiko terdeteksi Clostridium difficile toksigenik 2 kali lebih besar dibanding subyek dengan terapi antibiotik kurang dari 4 minggu; rapid test toksin dapat digunakan sebagai alat deteksi Clostridium difficile toksigenik.

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Toxigenic Clostridium difficile infection have increased sharply in the last decade, causing a pseudo membrane colitis (PMC) and Clostridium difficile associated diarrhea (CDAD). One of the biggest risk factor is the use of antibiotics. The purpose of the study was to determine the prevalence and characteristics of subjects with toxigenic Clostridium difficile and assess the ability of the toxin rapid test compared to real-time PCR. Ninety adult subjects with antibiotic therapy more than 2 weeks were enrolled to this prospective study. The results of toxin rapid test and real-time PCR were presented in 2x2 table, statistical tests was calculated with chi square. Two specimens were excluded due to invalid results. The results showed 24 positive and 64 negative specimens by toxin rapid test; 33 positive and 55 negative specimens by real-time PCR. The prevalence of toxigenic Clostridium difficile based on toxin rapid test were 27.3% and 37.5% by real-time PCR. There were significant differences between stool consistency and number of antibiotics that were used with the detection of toxigenic Clostridium difficile. There was a relationship between duration of antibiotic therapy with detection of toxigenic Clostridium difficile using real-time PCR (p = 0.010, RR = 2.116). Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of toxin rapid test against real-time PCR were 69.7%; 98.2%; 95.8%; 84.4%; 39.2 and 0.31, respectively. The study concluded that the prevalence of Clostridium difficile in RSCM was higher than Malaysia, Thailand and India; subjects with antibiotic therapy for more than 4 weeks had double risk to have toxigenic Clostridium difficile than subjects with antibiotic therapy for less than 4 weeks and toxin rapid test could be used as a tool to detect toxigenic Clostridium difficile."

"ABSTRAKPeranan farmasi klinik di era JKN telah berkembang yaitu melakukan evaluasifarmakoekonomi terutama pada penggunaan antibiotik pasien anak di PICU yangberisiko tinggi akan resistensi. Tujuan penelitian adalah untuk mengevaluasi peranserta farmasi klinik pada terapi antibiotik secara ekonomi di PICU RSCM periodeMei-Oktober 2014. Metode yang digunakan adalah analisis efektivitas biaya.terhadap lama rawat pasien pada kelompok pasien yang tidak mendapatkanrekomendasi periode Mei-Juli 2014 (NR) dibandingkan dengan kelompok pasienyang mendapat rekomendasi dari farmasi klinik periode Agustus-Oktober 2014(R). Hasil yang diperoleh dari 42 pasien kelompok NR dan 51 pasien kelompok Radalah total biaya pada kelompok NR sebesar Rp 427.805.134, sedangkankelompok R sebesar Rp 349.302.060. Total lama rawat pasien pada kelompok NRadalah 268 hari, sedangkan kelompok R adalah 228 hari. Rata-rata lama rawat perpasien kelompok NR yaitu 6,4 hari sedangkan kelompok R yaitu 4,5 hari.Persentase efektivitas pada kelompok NR adalah 15,36%, sedangkan kelompok R22,22%. Hasil ACER kelompok NR adalah Rp 1.591.537/hari, sedangkan ACERkelompok NR adalah Rp 1.522.013/hari. Hasil analisa sensitivitasnya adalahdominan karena biaya lebih kecil sedangkan efektivitasnya lebih besar. Olehkarena itu, dapat disimpulkan bahwa peran serta farmasi klinik dalam terapi dapatmenurunkan biaya dan lama rawat pasien di PICU RSCM.

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ABSTRACTThe role of clinical pharmacy in National Health Insurance era to evaluate the useof antibiotics has been evolved, especially for children in PICU which at high riskfor resistance. The research objective was to evaluate the role of clinical pharmacyon antibiotic therapy in the PICU RSCM period from May to October 2014. Themethod used is cost-effectiveness analysis to length of stay between the group ofpatients who did not received recommendation of clinical pharmacy in the periodMay - July 2014 (NR) compared with the group of patients who received therecommendation of clinical pharmacy period from August to October 2014 (R).The results were obtained from 42 patients NR group and 51 patients in the Rgroup. The total direct medical costs in the NR group Rp 427.805.134 , while theR group Rp 349.302.060. Total length of hospital patients in the NR group was268 days, while the R group was 228 days. Average length of stay per patient inthe NR group was 6.4 days, while R group was 4.5 days. Percentage of effectivityfrom the NR group was 15,36%, while the group R was 22,22 %. ACER in NRgroup is Rp 1.591.537 per length of stay, whereas the R group is Rp 1.522.013per length of stay. The results of the sensitivity analysis is dominant because thecosts was less , while its effectiveness is greater. Thus, it can be concluded thatparticipation in the clinical pharm"

"ABSTRAKLatar belakang: Pneumonia komunitas merupakan penyakit yang sering terjadi dan berhubungan dengan angka kesakitan dan kematian yang tinggi. Perhimpunan Dokter Paru Indonesia (PDPI) mengeluarkan pedoman pemberian antibiotik penanganan pasien pneumonia komunitas di Indonesia untuk mengurangi angka kematian pasien pneumonia komunitas.Tujuan: untuk mengetahui angka kepatuhan penggunaan panduan antibiotik untuk pasien pneumonia komunitas yang di rawat inap berdasarkan panduan PDPI di RSUP Persahabatan serta pengaruhnya terhadap lama perawatan dan angka mortalitas pasien.Metode: Penelitian observasional kohort retrospektif di Rumah Sakit Umum Pusat Persahabatan. Data diambil dari data rekam medis pasien yang didiagnosis pneumonia komunitas, yang dirawat di ruang rawat inap Departemen Pulmonologi dan Ilmu Kedokteran Respirasi RSUP Persahabatan, periode Juli 2014 sampai dengan Juli 2016.Hasil: Sampel penelitian 107 subjek, dengan karateristik pasien laki-laki 70,1% dan perempuan 29,9%. Median usia 56 tahun dengan usia minimum 18 tahun dan usia maksimum 96 tahun. Angka kepatuhan dokter terhadap penggunaan antibiotik berdasarkan pedoman penatalaksanaan pneumonia PDPI pada pasien pneumonia komunitas yang dirawat inap di RSUP Persahabatan sebesar 70,1%. Angka mortalitas pasien pneumonia komunitas berhubungan secara bermakna dengan kesesuaian pemberian antibiotik dengan pedoman PDPI dan derajat risiko PSI dengan nilai OR berturut-turut 2,93 (95%IK1,23-6,94) dan OR 3.02 (95%IK 1.25-7.29). Kesimpulan: Angka kepatuhan penggunaan antibiotik angka kepatuhan penggunaan panduan antibiotik untuk pasien pneumonia komunitas berdasarkan panduan PDPI berhubungan dengan angka mortalitas pasien.

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ABSTRACT<>br>Background: Community acquired pneumonia (CAP) is a common disease and is associated with high morbidity and mortality. Indonesian Society of Respirology has been recommended empiric antibiotic guidelines for patients with community-acquired pneumonia in 2014. These guidelines are designed to reduce the mortality rate of CAP patients. Objective: to determine the compliance rate of antibiotic guidance for inpatient community pneumonia patients based on PDPI antibiotic guidelines in Persahabatan Hospital and its effect on the length of stay and mortality rate CAP patients. Method: This is a retrospective cohort observational study inPersahabatan Hospital. Data were collected from medical records of patients diagnosed with CAP, who were admitted to the Department of Pulmonology and Respiratory Medicine during July 2014 to July 2016. Results: The sample was 107 subjects. Proportion male and female were 70.1% and 29.9%. The median age was 56 years old with a minimum age was 18 years and a maximum age was 96 years. Doctors' compliance rates on PDPI's guidelines for the management CAP patients was 70.1%. The mortality rate of CAP patients was significantly associated with the national guidelines-concordant empiric antibiotic therapy and the class risk of PSI with OR 2.93 (95% IK1,23-6,94) and OR 3.02 (95% IK 1.25-7.29) reversely. "