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Abstrak :
Peresepan antibiotik adalah salah satu yang harus dikontrol. Hal ini bertujuan untuk mencegah terjadinya resistensi antibiotik yang berlebihan. Hal ini menjadi signfikan ketika berada di lingkup rumah sakit karena banyak dokter yang meresepkan antibiotik untuk lini pertama pengobatan sehingga menyebabkan banyaknya mikroba resisten. Oleh karena itu diharuskan adanya analisis peresepan dan penggunaan antibiotik. Analaisis ini dapat dilakukan dengan menggunakan analisis ATC/DDD yang sudah ditetapkan oleh WHO untuk menganalisis penggunaan antibiotik. Maka dari itu, dilakukan analisis peresepan dan penggunaan antibiotik di RSUP Fatmawati dengan periode Juli – Desember 2022. Hasil analisis ATC/DDD yang dilakukan menunjukkan penggunaan antibiotik di RSUP Fatmawati yang masih tinggi terutama pada antibiotik untuk mengobati TB seperti rifampicin dan ethambutol, antibiotik lain yang tinggi penggunaannya adalah antibiotik cefixim yang biasanya diresepkan sebagai lini pertama ISPA. Oleh karena itu perlunya diadakan pemantauan lebih terkait penggunaan antibiotik tersebut terutama pengetesan berkala mikroba terkait ISPA dan TB yang berada di RSUP Fatmawati untuk melihat resistensi antimikroba yang bertujuan untuk mencegah untreatable nosocomial invection. ...... Antibiotic prescribing is one that must be controlled. This aims to prevent excessive antibiotic resistance. This becomes significant when in the hospital setting because many doctors prescribe antibiotics as the first line of treatment, causing many resistant microbes. Therefore, it is necessary to analyze the prescribing and use of antibiotics. This analysis can be carried out using the ATC/DDD analysis which has been established by WHO to analyze antibiotic use. Therefore, an analysis of the prescribing and use of antibiotics was carried out at Fatmawati Hospital for the period July – December 2022. The results of the ATC/DDD analysis carried out showed that the use of antibiotics at Fatmawati Hospital was still high, especially antibiotics to treat TB such as rifampicin and ethambutol, other antibiotics that The highest use is the antibiotic cefixim which is usually prescribed as the first line of ARI. Therefore, it is necessary to carry out more monitoring regarding the use of antibiotics, especially periodic testing of microbes related to ARI and TB at Fatmawati General Hospital to see antimicrobial resistance with the aim of preventing untreatable nosocomial infections.

Abstrak :
Penggunaan antibiotik harus dilakukan dan kontrol penggunaan antibiotik sudah direkomendasikan dari WHO. Hal ini bertujuan untuk menekan resistensi mikroba terhadap antibiotik karena ancaman resistensi antibiotik adalah salahsatu yang dikhawatirkan oleh WHO. Dalam perespan dan penggunaan antibiotik dapat dianalisis dengan metode ATC/DDD untuk evaluasi rasionalitas penggunaan antibiotik. Analisis menggunakan metode ATC/DDD ini dilakukan di Puskesmas Kecamatan Duren Sawit pada periode Januari-Desember 2022. Setelah dilakukan analisis didapatkan penggunaan antibiotik di Puskesmas Kecamatan Duren Sawit pada periode Januari – Desember 2022 tergolong sangat tinggi terutama pada golongan antibiotik beta laktam dengan kecenderungan peresepan yang kurang rasional. Dari hasil analisis ini dapat dilakukan pengetesan resistensi mikroba terhadap antibiotik di lingkungan Puskesmas Kecamatan Duren Sawit untuk melihat sebaran mikroba resisten terhadap golongan antibiotik sebagai evaluasi pendekatan pengobatan yang optimal. ...... The use of antibiotics must be carried out and control of antibiotic use has been recommended by WHO. This aims to suppress microbial resistance to antibiotics because the threat of antibiotic resistance is one that WHO is concerned about. The prescription and use of antibiotics can be analyzed using the ATC/DDD method to evaluate the rationality of antibiotic use. Analysis using the ATC/DDD method was carried out at Puskesmas Kecamatan Duren Sawit in the period January-December 2022. After the analysis was carried out, it was found that the use of antibiotics in Puskesmas Kecamatan Duren Sawit in the January-December 2022 period was classified as very high, especially in the beta-lactam antibiotics group with a high prescribing tendency. less rational. From the results of this analysis, testing for microbial resistance to antibiotics can be carried out in Puskesmas Kecamatan Duren Sawit environment to see the distribution of microbes that are resistant to antibiotic groups as an evaluation of optimal treatment approaches.

Abstrak :
Seven antibiotics including norfloxacin (NOR) were tested via disk susceptibility test on E. coli culture isolated from the MLSS of the two types of lab-scale sequencing batch reactors (SBR), a common SBR and an SBR with rnicrofiltration membrane (SB-MBR) for treatment of synthetic municipal wastewater. The same experiment treating the NOR-added wastewater to examine the possible induction of resistance to itself and the other antibiotics. The MLSS from Bangl culture (TISTR780) were spiked daily into both reactors. The reactors were continuously operated under 2hr/2hr of aeration/non-aeration cycle and resistances to antibiotics of E. coli in MLSS were monitored. When NOR was not added, the SB-MBR showed lower percentages of resistant E. coli than the SBR did to amoxicillin/clavulanic acid, amikacin, nalidixic acid, tetracycline and chloramphenicol. Oppositely, the SB-MBR treating the NOR-added wastewater appeared to promote resistances of E. coli to nalidixic acid, sulfamethoxasole and tetracycline probably due to a long SRT and low DO compared to that of SBR. Although its mechanism should be analyzed with molecular techniques in further studies, this NOR-induced expression of resistance resulted in a higher occurrence of multidrug resistant E. coli in the SB-MBR than that in the SBR.

Abstrak :
Resistensi antibiotik terjadi akibat bakteri berevolusi dan rentan terhadap antibiotik sehingga dapat meningkatkan risiko penyebaran penyakit serta kematian. Antibiotik golongan karbapenem merupakan antibiotik kelompok reserve, yang dapat diakses namun penggunaannya harus disesuaikan dengan pasien dan kondisi yang sangat spesifik, ketika antibiotik lainnya telah gagal atau tidak sesuai dalam pengobatan. Penggunaan meropenem di RSUP Fatmawati dibanding antibiotik lini ke 3 lainnya sangat jauh berbeda signifikan, oleh karena itu perlu dikaji terkait karakteristik pasien, regimen, indikasi, ada tidaknya konsultasi KPRA (Komite Pengendalian Resistensi Antimikroba) dan hasil kultur serta sensitivitas antimikroba. Karakteristik pasien yang menggunakan terapi antibiotik reserve meropenem pada April 2023 didominasi oleh laki-laki (52,8%) daripada perempuan (47,2%) dengan rentang usia 51-60 yang terbanyak (23,9%). Kultur dan sensitivitas yang dilakukan (389 kali/April 2023) menyatakan bahwa hasil terbanyak berupa biakan negatif (76,6%), disusul dengan Acinetobacter baumannnii (6,9%) dan Klebsiella pneumonia (6,4%). Hasil biakan yang tidak negatif atau ditemukannya kuman patogen terdapat 91 biakan (23,4%) dari 389 biakan. Sampel yang masih sensitif terhadap antibiotik meropenem sebanyak 38 sampel (41,8%), sampel yang sudah resisten sebanyak 39 sampel (42,9%) dan yang tidak diketahui sebanyak 14 sampel (15,3%). Konsultasi terhadap tim PPRA dilakukan hanya 129 dari 176 pasien. Hasil konsultasi dapat diterima pemberiannya (32 pasien), ditolak pemberiannya (22 pasien), dan tidak direspon oleh tim PPRA (75 pasien) ...... Antibiotic resistance occurs because bacteria evolve and become susceptible to antibiotics, increasing the risk of disease spread and death. Carbapenem class antibiotics are reserve group antibiotics, which can be accessed but their use must be tailored to patients and very specific conditions, when other antibiotics have failed or are not suitable in treatment. The use of meropenem at Fatmawati General Hospital compared to other 3rd line antibiotics is significantly different, therefore it is necessary to study patient characteristics, regimens, indications, the presence or absence of KPRA (Antimicrobial Resistance Control Committee) consultation and culture results and antimicrobial sensitivity. The characteristics of patients who used meropenem reserve antibiotic therapy in April 2023 were dominated by men (52.8%) rather than women (47.2%) with the highest age range of 51-60 (23.9%). The culture and sensitivity performed (389 times/April 2023) stated that the most results were negative cultures (76.6%), followed by Acinetobacter baumannnii (6.9%) and Klebsiella pneumonia (6.4%). There were 91 cultures (23.4%) out of 389 cultures that were not negative or found pathogenic germs. There were 38 samples (41.8%) that were still sensitive to meropenem, 39 samples (42.9%) that were resistant, and 14 samples (15.3%) that were unknown. Consultation with the PPRA team was conducted for only 129 out of 176 patients. The results of the consultation were accepted (32 patients), rejected (22 patients), and not responded to by the PPRA team (75 patients).