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"Monitoring efek samping obat perlu dilakukan terutama untuk antibiotik golongan aminoglikosida dengan indeks terapi sempit sehingga dapat meminimalisir masalah terkait obat. Penelitian ini bertujuan untuk melakukan monitoring efek samping obat pada pasien yang mendapatkan antibiotik aminoglikosida di Instalasi Rawat Inap RSUP Fatmawati periode Maret-Mei 2017. Metode penelitian yang digunakan adalah deskriptif analitik dengan pengambilan data secara prospektif menggunakan data primer dari wawancara pasien serta data sekunder dari resep pasien dan rekam medis. Data dikumpulkan secara total sampling. Analisis kasualitas efek samping dilakukan dengan menggunakan algoritma Naranjo. Total pasien yang memenuhi kriteria inklusi sebagai subjek penelitian adalah 33 pasien. Sebanyak 14 pasien 42,4 mengalami efek samping nefrotoksik dan 5 pasien 15,2 mengalami ototoksik. Berdasarkan analisis algoritma Naranjo, 5 kejadian 15,15 dikategorikan mungkin probable . Hasil uji chi square menunjukkan tidak ada hubungan antara usia P = 0,726 dan jenis kelamin P = 0,620 dengan efek samping obat.

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Monitoring of drug side effects needs to be done especially for aminoglycoside antibiotic with narrow therapeutic index to minimize drug related problems. The purpose of this research was to monitor the side effects of patients who received aminoglycoside antibiotics at the Inpatient Installation of Fatmawati Hospital from March to May 2017. The method of this research was analytical descriptive with prospective data were collected from primary data through patient interview and secondary data through patient prescription and medical record. Data were collected by total sampling.

Causality analysis of side effects was done by using Naranjo Algorithm. Total patients who participated for the study were 33 patients. Fourteen patients 42.4 experienced nephrotoxicity and 5 patients 15,2 experienced ototoxicity. Based on Naranjo algorithm analysis, five 15,15 were catagorized as probable. The result of chi square test showed there was no correlation between age P 0.726 and sex P 0.620 with drug side effects."

"This is the first book to provide a complete overview of recent advances in the field and explore their tremendous potential for drug discovery and rational drug design. With chapters written by one or more leading experts in their specialty areas, the book addresses the chemistry, biology, and toxicology of aminoglycosides.Aminoglycoside antibiotics : from chemical biology to drug discovery is a great resource for academic and industrial researchers in drug design and mechanism studies and for researchers studying antibiotic resistance, antibiotic design and synthesis, and the discovery of novel pharmaceuticals."

"Latar Belakang: Antimicrobial Resistance (AMR) merupakan ancaman serius bidang kesehatan diseluruh dunia yang menjadi salah satu penyebab kematian. Patogen E. coli dan K. pneumoniae penyebab Infeksi Intra Abdominal (IAI) terbanyak dikhawatirkan memiliki resistan terhadap antibiotik aminoglikosida. Penggunaan antibiotik aminoglikosida (gentamisin dan amikasin) rutin dipakai sebagai terapi pasien IAI di RSUPN Dr. Cipto Mangunkusumo (RSCM). Pentingnya diketahuai data karakteristik resistan aminoglikosida pada E. coli dan K.pneumonia penyebab IAI di Indonesia sebagai panduan untuk mencegah penyebaran gen resistan antibiotik melalui penggunaan antibiotik yang bijak di komunitas dan lingkungan rumah sakit. Metode: Penelitian ini menggunakan desain potong lintang observasional analitik untuk mengetahui karakteristik fenotip dan genotip resistan aminoglikosida pada bakteri Escherichia coli dan Klebsiella pneumoniae sebagai patogen penyebab terbanyak IAI, dan pengaruhnya terhadap luaran klinis pembedahan digestif di RSCM. Sampel yang memenuhi kriteria inklusi yaitu semua isolat tersimpan di Laboratorium Mikrobiologi Klinik (LMK) FKUI dari pasien IAI yang dilakukan pembedahan di RSCM pada Januari tahun 2019 hingga Desember 2020 yang mendapat peretujuan penelitian dan memiliki berkas rekam medik. Penelitian ini akan dilakukan di LMK dan RSCM Jakarta pada tahun 2022-2023. Hasil Penelitian: Hasil studi dari 63 subjek penelitian didapatkan 79 isolat yang dianalisis. Teridentifikasi 57 isolat E. coli dan 22 isolat K. pneumoniae. Penelitian tersebut didapatkan E. coli resistan gentamisin 45,6% dan resistan amikasin 1,7% sedangkan K. pneumoniae resistan gentamisin 45,4% , resistan amikasin 27,3%. Prevalensi gen armA ditemukan lebih banyak pada isolat E. coli (3,9%) maupun K. pneumoniae (20%) peka amikasin . Luaran klinis pasien terinfeksi E. coli resistan aminoglikosida yang meninggal 14,81% sedangkan pasien terinfeksi K. pneumoniae resistan aminoglikosida yang meninggal 12,5%. Faktor risiko yang bermakna terhadap luaran klinis adalah usia (p = 0,003), dan tidak ada hubungan bermakna E. coli dan K. pneumoniae resistan aminoglikosida penyebab IAI terhadap luaran klinis pasien.

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Background: Antimicrobial Resistance (AMR) is a serious threat to health worldwide and one of the leading causes of death. The pathogens E. coli and K. pneumoniae that cause most Intra Abdominal Infections (IAI) are feared to be resistant to aminoglycoside antibiotics. The use of aminoglycoside antibiotics (gentamicin and amikacin) is routinely used as therapy for IAI patients at Dr. Cipto Mangunkusumo Hospital (RSCM). It is important to know data on the characteristics of aminoglycoside-resistant E. coli and K. pneumoniae causing IAI in Indonesia as a guide to preventing the spread of antibiotic-resistant genes through the wise use of antibiotics in the community and hospital environment. Methods: This study used an analytic observational cross-sectional design to determine the phenotypic and genotypic characteristics of aminoglycoside resistance in E. coli and K. pneumoniae bacteria as the most causative pathogens of IAI, and its effect on clinical outcomes of digestive surgery in RSCM. Samples are those that meet the inclusion criteria, namely all isolates stored in the FKUI Clinical Microbiology Laboratory (LMK) from IAI patients who underwent surgery at RSCM from January 2019 to December 2020, who received research approval and had medical record files. This study will be conducted at LMK and RSCM Jakarta in 2022-2023. Research Results: The study results from 63 research subjects obtained 79 isolates analyzed identified 57 isolates of E. coli and 22 isolates of K. pneumoniae. The study obtained gentamicin-resistant E. coli at 45.6% and amikacin-resistant at 1.7% while K. pneumoniae at 45,4% gentamicin resistant amikacin-resistant at 27,3%. The prevalence of the armA gene was found to be higher in amikacin sensitive E. coli (3.9%) and K. pneumoniae (20%) isolates. Clinical outcomes of patients infected with aminoglycoside resistant E. coli caused 14.81% of patients to die while those infected with aminoglycoside resistant K. pneumonia caused 12.5% of patients to die. The significant risk factor for clinical outcomes was age (p = 0.003), and there was no significant association between aminoglycoside resistant E. coli and K. pneumoniae causing IAI with the clinical outcomes of patients."

"Latar belakang: Gangguan ginjal akut (GnGA) pada anak sakit tidak kritis salah satunya dapat terjadi akibat pajanan agen nefrotoksik. Aminoglikosida (AG) merupakan agen nefrotoksik yang sering digunakan, tetapi GnGA terkait AG (GnGA-AG) seringkali terlambat atau tidak terdeteksi karena sifatnya yang non-oligurik dan pemantauan fungsi ginjal yang tidak adekuat pasca pemberian AG. Saat ini belum ada penelitian yang menyajikan data insidens dan prediktor GnGA-AG di Indonesia.Tujuan: Tujuan penelitian ini adalah untuk mengetahui insidens GnGA-AG dan faktor prediktornya pada pasien anak sakit tidak kritis.Metode: Penelitian ini merupakan studi deskriptif analitik dengan rancangan penelitian kohort retrospektif observasional. Penelitian dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM) menggunakan data rekam medik dari Januari 2023 hingga Desember 2024. Subyek penelitian adalah pasien anak usia 1 bulan hingga 18 tahun dengan sakit tidak kritis yang dirawat di RSCM, mendapatkan terapi AG dan diperiksakan kadar kreatinin darah. Kriteria eksklusi meliputi pasien yang diketahui memiliki kelainan anatomi dan fungsi ginjal sebelumnya, pasien transplantasi organ, jatuh dalam kondisi sakit kritis dan meninggal. Faktor risiko yang diteliti adalah durasi terapi aminoglikosida, pajanan nefrotoksik lain, penyakit dasar hematologi-onkologi, fokus infeksi saluran pernapasan, dan lama rawat sebelum pemberian AG.Hasil: Pemeriksaan kreatinin serum dilakukan pada 52,2% (83/159) subyek yang diinklusi. Gangguan fungsi ginjal ditemukan pada 19,3% (16/83) pasien yang diperiksakan kreatinin serum, dengan setengahnya (8/16) termasuk dalam GnGA derajat 1. Dari 83 subyek, 89% (74/83) mendapat terapi AG dengan durasi 5 hari atau lebih; 47% (39/83) mendapat 3 nefrotoksik atau lebih; 36% (30/83) dengan penyakit dasar terkait hematologi-onkologi; 22,9% (19/83) mendapat terapi AG atas indikasi infeksi saluran pernapasan; 50,6% (42/83) telah dirawat lebih dari 9 hari sebelum inisiasi AG. Tidak terdapat perbedaan proporsi faktor risiko pada kelompok dengan GnGA-AG dan tidak GnGA-AG. Pada subyek dengan GnGA-AG, 10/16 (62,5%) mendapat terapi AG dengan dosis harian ganda. Satu dari 16 pasien yang mengalami GnGA-AG masih mengalami penurunan fungsi ginjal pada evaluasi 3 bulan setelahnya.Simpulan: Insidens GnGA-AG pada anak sakit tidak kritis di RSCM adalah 19,3%. Terdapat tren peningkatan GnGA-AG pada subyek yang mendapat terapi AG dengan durasi 5 hari atau lebih, mendapat nefrotoksik 3 jenis atau lebih, memiliki penyakit dasar hematologi-onkologi, dan fokus infeksi saluran pernapasan.

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Background: One of the leading causes of acute kidney injury (AKI) in non-critically ill pediatric petients is exposure to nephrotoxic agents. Aminoglycosides (AG) are one of the commonly used nephrotoxic agents. However, AKI associated to AG (AG-AKI) is often delayed in detection due to its non-oliguric nature and inadequate monitoring of kidney function after AG administration. Currently, no studies have presented data on the incidence and predictors of AKI-AG in Indonesia.

Objective: This study aims to determine the incidence of AG-AKI and its predictors in non-critically ill pediatric patients.

Method: This study is a descriptive analytic study with retrospective observational cohort design. The study was conducted at Cipto Mangunkusumo Hospital (RSCM), utilizing medical record data from January 2023 to December 2024. Study subjects included pediatric patients aged 1 month to 18 years, non-critically ill, who received AG therapy and underwent serum creatinine evaluation. Exclusion criteria included patients with known pre-existing anatomical or functional kidney abnormalities, organ transplant recipients, critically ill patients, and those who passed away during observation. Risk factors investigated were the duration of AG therapy, exposure to other nephrotoxic agents, underlying hematology-oncology diseases, respiratory tract infection as the infection focus, and length of hospital stay before AG administration.

Results: Post AG serum creatinine was evaluated in 52.2% (83/159) of included subjects. Kidney dysfunction was identified in 19.3% (16/83) of patients, with half (8/16) classified as AKI stage 1. Among the 83 subjects, 89% (74/83) received AG therapy for 5 days or more; 47% (39/83) were exposed to three or more nephrotoxic agents; 36% (30/83) had underlying hematology-oncology conditions; 22.9% (19/83) received AG therapy for respiratory tract infections; and 50.6% (42/83) had been hospitalized for more than 9 days before AG initiation. No significant differences in risk factor proportions were found between the AG-AKI and non-AG-AKI groups. Among AG-AKI subjects, 10/16 (62.5%) received AG therapy with a multiple daily dose. One of the 16 AG-AKI patients exhibited persistent kidney dysfunction upon evaluation 3 months later.

Conclusion: The incidence of AG-AKI among non-critically ill pediatric patients at RSCM was 19.3%. There is a trend of increased AG-AKI in subjects who received AG therapy for 5 days or more, were exposed to 3 or more nephrotoxic agents, had underlying hematology- oncology conditions, and had respiratory tract infections as the primary infection site."