Evaluasi Penggunaan Antibiotik Empirik Terhadap Outcome Klinik dan Gambaran Antibiogram Pada Pasien ISPA di Puskesmas Jetis Yogyakarta

https://doi.org/10.22146/farmaseutik.v1i1.51259

Kris Kurniawan(1), Ika Puspitasari(2*), Titik Nuryastuti(3)

(1) Magister Farmasi Klinik, Farmasi UGM
(2) Faculty of Pharmacy, Universitas Gadjah Mada
(3) Departemen Mikrobiologi, FKKMK UGM
(*) Corresponding Author

Abstract


Infeksi saluran pernafasan akut merupakan salah satu penyebab utama kunjungan pasien di sarana kesehatan baik di Puskesmas maupun di rumah sakit. Telah banyak penelitian mengenai kejadian resistensi antibiotik terhadap mikroba di rumah sakit beserta gambaran antibiogramnya, namun resistensi dalam pengobatan antibiotik di komunitas tepatnya di puskesmas belum pernah dipetakan. Tujuan penelitian ini adalah untuk mengetahui gambaran antibiogram bakteri penyebab ISPA di Puskesmas Jetis Yogyakarta, mengetahui kesesuaian penggunaan antibiotik empiris dengan pedoman terapi serta mengetahui hubungan kesesuaian antibiotik empiris terhadap outcome klinik. Penelitian ini merupakan penelitian observasional yang dilakukan dengan rancangan studi deskriptif-analitik dengan desain cohort melalui penelusuran data secara prospektif pada pasien ISPA di Puskesmas Jetis Yogyakarta pada bulan April-Agustus 2019. Sebanyak 44 pasien yang didiagnosa ISPA di puskesmas Jetis Yogyakarta selama periode bulan April-Agustus 2019. Gambarkan mengenai profil antibiogram pasien ISPA di puskesmas Jetis Yogyakarta, yaitu pola bakteri Gram negatif yang terbesar (50,8%) dan bakteri Gram positif sebanyak 27,2%. Berdasarkan evaluasi kesesuaian penggunaan antibiotik empirik terhadap pedoman, diperoleh 40 pasien (93%) yang sesuai terapinya dengan pedoman dan sebanyak 3 pasien (7%) yang tidak sesuai dengan pedoman. Berdasarkan uji Likelihood ratio menunjukkan tidak terdapat hubungan yang signifikan antara kesesuaian penggunaan antibiotik empirik dengan outcome klinik pada pasien ISPA dengan nilai p=0,152.


Keywords


Antibiogram; Antibiotik Empiris; ISPA; Outcome Klinik

Full Text:

PDF


References

Bhuyan, G.S., Hossain, M.A., Sarker, S.K., Rahat, A., Islam, M.T., Haque, T.N., dkk., 2017. Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city. PLoS ONE. Bosch A, Biesbroek G, Trzcinski K, Sanders E, and Bogaert D. 2013. Viral and Bacterial Interactions in the Upper Respiratory Tract. PLoS Pathog, 9: e1003057. Chen Y, Williams E, Kirk M. 2014. Risk Factors for Acute Respiratory Infection in the Australian Community. PLOS ONE; Volume 9, Issue 7, e101440. CLSI. 2014. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data; Approved Guideline—Fourth Edition. CLSI document M39-A4. Wayne, PA: Clinical and Laboratory Standards Institute. Esposito EP, Cervoni M, Bernardo M, Crivaro V, Cuccurullo S, Imperi F, Zarrilli R. 2018. Molecular Epidemiology and Virulence Profiles of Colistin-Resistant Klebsiella pneumoniae Blood Isolates from the Hospital Agency "Ospedale dei Colli," Naples, Italy. Front Microbiol; 9: 1463. Falagas ME, Mourtzoukoua EG, dan Vardakas KZ. 2007. Sex differences in the incidence and severity of respiratory tract infections. Respiratory Medicine; 101, 1845–1863. Farida H, Severin JA, Gasem MH, Keuter M, Broek P, Hermans PW, Wahyono H, Verbrugh HA. 2013. Nasopharyngeal Carriage of Klebsiella pneumoniae and Other GramNegative Bacilli in Pneumonia-Prone Age Groups in Semarang, Indonesia. Journal of Clinical Microbiology p. 1614–1616. Volume 51 Number 5. Fleming-Dutra, K.E., Hersh, A.L., Shapiro, D.J., Bartoces, M., Enns, E.A., File, T.M., dkk., 2016. Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011. JAMA, 315: 1864–1873. Haryani Y, Noorzaleha AS, Fatimah AB, Noorjahan BA, Patrick GB, Shamsinar AT, Laila RAS, Son R. 2007. Incidence of Klebsiella pneumonia in street foods sold in Malaysia and their characterization by antibiotic resistance, plasmid profiling, and RAPD–PCR analysis. Food Control 18: 847–853. Hicks LA, Chien YW, Taylor TH Jr, Haber M, Klugman KP. 2011. Active Bacterial Core Surveillance (ABCs) Team. Outpatient antibiotic prescribing and nonsusceptible Streptococcus ρneumoniae in the United States, 1996–2003. Clin Infect Dis;53:631-9. Ikatan Dokter Indonesia. 2017. Panduan Praktik Klinis Bagi Dokter di Fasailitas Pelayanan Kesehatan Tingkat Pertama. Edisi 1; Cetakan kedua. Joshi, S., 2010. Hospital antibiogram: a necessity. Indian Journal of Medical Microbiology, 28: 277–280. Kang CI, Kim SH, Bang JW, Kim HB, Kim NJ, Kim EC, Oh MD, Choe KW. 2006. Community-acquired versus nosocomial Klebsiella ρneumoniae bacteremia: clinical features, treatment outcomes, and clinical implication of antimicrobial resistance. J Korean Med Sci, 21(5):816-822. Kemenkes. 2015. Program Pengendalian Resistensi Antimikroba Di Rumah Sakit. PERATURAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR 8. Klein SL. 2000. The effects of hormones on sex differences in infection: from genes to behavior. Neurosci Biobehav Rev, 24(6):627–38. Kousalya K, Thirumurugu S, Arumainayagam DC, Manavalan R,Vasantha J,dan Reddy CU. 2010. Antimicrobial Resistance of Bacterial Agents of The Upper Respiratory Tract in South Indian Population. J Adv Pharm Technol Res; 1(2): 207–215. MacGowan, A. dan Macnaughton, E., 2017. Antibiotic Resistance. Medicine, 45: 622–628. McCullough, A.R., Pollack, A.J., Plejdrup Hansen, M., Glasziou, P.P., Looke, D.F., Britt, H.C., dkk., 2017. Antibiotics for acute respiratory infections in general practice: comparison of prescribing rates with guideline recommendations. The Medical Journal of Australia, 207: 65–69. Parm U, Metsvaht T, Sepp E, Ilmoja M-L, Pisarev H, Pauskar M, Lutsar I. 2011. Risk factors associated with gut and nasopharyngeal colonization by common Gram-negative species and yeasts in neonatal intensive care units patients. Early Hum Dev. 87:391–399. Pettigrew MM, Gent JF, Revai K, Patel JA, dan Chonmaitree T. 2008. Microbial Interactions during Upper Respiratory Tract Infections. Emerging Infectious Diseases; Vol. 14, No. 10. Reichert VC, Seltzer V, Efferen LS, Kohn N. 2004. Women and tobacco dependence. Med Clin North Am, 88:1467–81. Riskesdas. 2013. Prevalensi ISPA, Pneumonia, Tb Dan Campak. Jakarta: Departemen Kesehatan RI. Rodrigo‐Troyano A dan Sibila O. 2017. The respiratory threat posed by multidrug resistant Gram‐negative bacteria. Respirology, 22, 1288–1299. Santos HDP, Ulbrich AH, Woloszyn V and Vieira R. 2018. An initial investigation of the Charlson comorbidity index regression based on clinical notes. International Symposium on Computer-Based Medical Systems. Spurling, G.K., Del Mar, C.B., Dooley, L., Foxlee, R., dan Farley, R., 2017. Delayed antibiotic prescriptions for respiratory infections. The Cochrane Database of Systematic Reviews, 9: CD004417. Tamayo E, Montes M, Vicente D, Pérez-Trallero E. 2016. Streptococcus pyogenes Pneumonia in Adults: Clinical Presentation and Molecular Characterization of Isolates 2006-2015. PLOS ONE | DOI:10.1371/journal.pone.0152640. Theobald S, Tolhurst R, Squire SB. 2006. Gender, equity: new approaches for effective management of communicable diseases. Trans R Soc Trop Med Hyg, 100:299–304. Tobat, S.R., Mukhtar, M.H., dan Pakpahan, I.H.D., 2015. Rasionalitas Penggunaan Antibiotika Pada Penyakit Ispa di Puskesmas Kuamang Kuning I Kabupaten Bungo 5: 5. Tomczyk S, John P. McCracken, Contreras CL, Lopez MR, Bernart C, Moir JC, Escobar K, Reyes L, Arvelo W, Lindblade K, Peruski L, Bryan JP dan JR. 2019. Factors associated with fatal cases of acute respiratory infection (ARI) among hospitalized patients in Guatemala. BMC Public Health 19:499. Walter J, Haller S, Quinten C, Kärki T, Zacher B, Eckmanns T, Abu Sin M, Plachouras D, Kinross P, Suetens C, Ecdc Pps. 2018. Study Group Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012. Euro Surveill, 23(32). Zurainaa NM, Sarimah A, Suharni M, Hasana H dan Suraiya S. 2018. High frequency of Haemophilus influenzae associated with respiratory tract infections among Malaysian Hajj pilgrims. Journal of Infection and Public Health. Volume 11, Issue 6 Pages 878-883.



DOI: https://doi.org/10.22146/farmaseutik.v1i1.51259

Article Metrics

Abstract views : 2127 | views : 2896

Refbacks

  • There are currently no refbacks.


Majalah Farmaseutik Indexed by:

   
 
Creative Commons Licence
 
 
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.