* Corresponding Author
Evaluasi Luaran Klinis Terapi Antibiotik pada Pasien Community Acquired Pneumonia Anak Rawat Inap
https://doi.org/10.22146/jmpf.47915 Sabrina Handayani Tambun(1), Ika Puspitasari(2*), Ida Safitri Laksanawati(3)
(1) Graduate Program of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(2) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(3) Divisi Infeksi dan Tropis Departemen IKA Fakultas Kedokteran UGM/ RSUP DR. Sardjito, Yogyakarta
(*) Corresponding Author
Abstract
Community Acquired Pneumonia (CAP) is an infectious disease which is one of the main causes of child mortality in developing countries. The pattern of giving antibiotics at the hospital is usually still empirical. Inappropriate use of antibiotics may cause failure of therapy or bacterial resistance. This study aims to determine the empirical antibiotic rationality and the relationship of rationality to the clinical outcome of CAP-pediatric inpatients at RSUP. Dr. Sardjito Yogyakarta. The study conducted using a descriptive analytic method with a retrospective cohort design. The subjects were CAP-pediatric inpatients at RSUP. Dr. Sardjito Yogyakarta period 1 January-31 December 2018. The rationality of empirical antibiotics is evaluated using the Gyssens algorithm. The clinical outcome was either good or bad outcome according to the clinician stating in the medical record. Patient characteristics, empirical antibiotic therapy and rationality patterns were analyzed descriptively. The relationship between empirical antibiotic rationality and clinical outcome were evaluated using Chi square test. There were 73 patients who met the inclusion and exclusion criteria (132 empirical antibiotic regimens). Rational antibiotic therapy accounted 76.5% (category 0). Types of irrationality of antibiotic found were IIIB (5.3%) and IIA categories (18.2%). Chi-square analysis showed that empirical antibiotic rationality related to good clinical outcome of CAP children (p = 0.011; OR = 2.957; 95% CI = 1,263 - 6,923).
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1. Anand N, Kollef MH. The alphabet soup of pneumonia: CAP, HAP, HCAP, NHAP, and VAP. Semin Respir Crit Care Med. 2009;30(1):3-9.
2. Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia Tahun 2015. Jakarta: Kemenkes RI; 2016.
3. Perhimpunan Dokter Paru Indonesia. Pneumonia Komuniti, Pedoman Diagnosis & Penatalaksanaan Di Indonesia. Jakarta: PDPI; 2003.
4. Burnham JP, Kollef MH. CAP, HCAP, HAP, VAP: The Diachronic Linguistics of Pneumonia. Chest. 2017;152(5):909-910. doi:10.1016/j.chest.2017.05.002
5. Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar 2013. Jakarta: Kemenkes RI; 2013.
6. UNICEF. One Is Too Many: Ending Child Deaths From Pneumonia And Diarrhoea. New York: UNICEF; 2016.
7. Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia Tahun 2016. Jakarta: Kemenkes RI; 2017.
8. Bradley JS, Byington CL, Shah SS, et al. The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53(7):25-76.
9. Rodrigues CMC. Challenges of Empirical Antibiotic Therapy for Community-Acquired Pneumonia in Children. Curr Ther Res Clin Exp. 2017;84:7-11. doi:10.1016/j.curtheres.2017.01.002
10. Batchelor HK, Marriott JF. Paediatric pharmacokinetics: Key considerations. Br J Clin Pharmacol. 2015;79(3):395-404.
11. Mi X, Li W, Zhang L, et al. The drug use to treat community-acquired pneumonia in children: A cross-sectional study in China. Medicine (Baltimore). 2018;97(46):13224. doi:10.1097/MD.0000000000013224
12. Rosdiana D, Anggraini D, Balmas M, Effendi D, Bet A. Peningkatan Rasionalitas Penggunaan Antibiotik Pasca Implementasi Kebijakan Penggunaan Antimikroba di RSUD Arifin Achmad Pekanbaru. J Kedokt Brawijaya. 2018;30(1):36-40. doi:10.21776/ub.jkb.2018.030.01.7
13. Ventola CL. The Antibiotic Resistance Crisis. Pharm Ther. 2015;40(4):277-283.
14. Llor C, Bjerrum L. Antimicrobial resistance: Risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf. 2014;5(6):229-241. doi:10.1177/2042098614554919
15. Corbett A, Golembiewski J, Gonzales J, Johnson S. Lexicomp -Drug Information Handbook 26th Edition. New York: Wolters Kluwer; 2017.
16. Fuseini H, Newcomb DC. Mechanisms driving gender differences in asthma. Curr Allergy Asthma Rep. 2017;17(3):19. doi:10.1007/s11882-017-0686-1
17. Yung JA, Fuseini H, Newcomb DC. Hormones, sex, and asthma. Ann Allergy Asthma Immunol. 2018;120(5):488-494. doi:10.1016/j.anai.2018.01.016
18. Hartati S. Analisis faktor risiko yang berhubungan dengan kejadian pneumonia pada anak balita di RSUD Pasar Rebo Jakarta,. 2011.
19. Kartasasmita CB. Pneumonia Pembunuh Balita. Bul Jendela Epidemiol. 2010;3:22-26.
20. Artawan A, Purniti PS, Sidiartha IGL. Hubungan antara Status Nutrisi dengan Derajat Keparahan Pneumonia pada Pasien Anak di RSUP Sanglah. Sari Pediatri. 2016;17(6):418-422. doi:10.14238/sp17.6.2016.418-22
21. Rodríguez L, Cervantes E, Ortiz R. Malnutrition and gastrointestinal and respiratory infections in children: A public health problem. Int J Environ Res Public Health. 2011;8(4):1174-1205. doi:10.3390/ijerph8041174
22. Ikatan Dokter Anak Indonesia. Pedoman Pelayanan Medis. Jakarta: Ikatan Dokter Anak Indonesia; 2009.
23. Lodha R, Randev S, Kabra SK. Oral antibiotics for community–acquired pneumonia with chest-indrawing in children aged below five years: A Systematic Review. Indian Pediatr. 2016;53(6):489-495. doi:10.1007/s13312-016-0878-0
24. Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: A literature review. Thorax. 2013;68(11):1057-1065. doi:10.1136/thoraxjnl-2013-204282
25. Stuckey-Schrock K, Hayes BL, George CM. Community-Acquired Pneumonia in Children. Am Fam Physician. 2012;86(7):661-667.
26. Aryani DE, Hasmono D, Zairina N, Setiawan L. ANALYSIS OF ANTIBIOTICS USE IN PEDIATRIC PNEUMONIA PATIENTS AGED 3 MONTHS - 5 YEARS. Folia Medica Indones. 2017;52(2):108-115. doi:10.20473/fmi.v52i2.5224
27. da Fonseca Lima EJ, Lima DEP, Serra GHC, Abreu e Lima MAZS, de Mello MJG. Prescription of antibiotics in community-acquired pneumonia in children: Are we following the recommendations? Ther Clin Risk Manag. 2016;12:983-988. doi:10.2147/TCRM.S101709
28. Queen MA, Myers AL, Hall M, et al. Comparative effectiveness of empiric antibiotics for community-acquired pneumonia. Pediatrics. 2014;133(1):e23-29. doi:10.1542/peds.2013-1773
29. Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 2406/MENKES/PER/XII/2011 Tentang Pedoman Umum Penggunaan Antibiotik. Jakarta: Kemenkes RI; 2011.
30. Leekha S, Terrell CL, Edson RS. General Principles of Antimicrobial Therapy. Mayo Clin Proc. 2011;86(2):156-167. doi:10.4065/mcp.2010.0639
31. Radji M. Mekanisme Aksi Molekuler Antibiotik Dan Kemoterapi. Jakarta: EGC; 2017.
32. Harris M, Clark J, Coote N, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: Update 2011. Thorax. 2011;66(Suppl 2):1-23. doi:10.1136/thoraxjnl-2011-200598
33. Ambroggio, Test, Metlay. Beta-lactam versus Beta- lactam/macrolide Therapy in Pediatric Outpatient Pneumonia. Pediatr Pulmonol. 2016;51(5):541-8. https://www.ncbi.nlm.nih.gov/pubmed/26367389. Accessed July 1, 2019.
34. World Health Organization. Buku Saku Pelayanan Kesehatan Anak Di Rumah Sakit, Pedoman Bagi Rumah Sakit Rujukan Tingkat Pertama Di Kabupaten/ Kota. WHO; 2009.
35. Badminton MN, Bailey S, Bates GDL, Bedford H. BNF for Children 2017 2018 Edition. London,UK: BMJ Group; 2017.
36. Tim PPRA. Panduan Penggunaan Antibiotik RSUP Dr. Sardjito. Yogyakarta, Indonesia: PPRA RSUP Dr. Sardjito; 2017.
37. Handayani RS, Siahaan S, Herman M. Antimicrobial Resistance and Its Control Policy Implementation in Hospital in Indonesia. J Penelit Dan Pengemb Pelayanan Kesehat. 2017;Vol. 1, No. 2:131-140. doi:10.22435/jpppk.v1i2.537
38. Asín-Prieto E, Rodríguez-Gascón A, Isla A. Applications of the pharmacokinetic/pharmacodynamic (PK/PD) analysis of antimicrobial agents. J Infect Chemother Off J Jpn Soc Chemother. 2015;21(5):319-329. doi:10.1016/j.jiac.2015.02.001
39. Rahayu YD, Wahyono D, Mustofa. Evaluasi Rasionalitas Penggunaan Antibiotik Terhadap Luaran Pada Pasien Anak Penderita Pneumonia. J Manaj Dan Pelayanan Farm. 2014;4(4):264-270.
40. PrabhuDas M, Adkins B, Gans H, et al. Challenges in infant immunity: Implications for responses to infection and vaccines. Nat Immunol. 2011;12:189-194. doi:10.1038/ni0311-189
DOI: https://doi.org/10.22146/jmpf.47915
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