Evaluation of potential drug-drug interactions in stage 5 chronic kidney disease patients on routine hemodialysis at Dr. Cipto Mangunkusumo General Hospital, Jakarta

Nusmirna Ulfa — 2025-06-20

Patients with chronic kidney disease (CKD) face heightened susceptibility to adverse drug reactions (ADRs) owing to alterations in the pharmacokinetics and pharmacodynamics of medications. Patients with Stage 5 CKD receiving hemodialysis (HD) have numerous medications that are eliminated during the HD process. This study aims to assess the prescribing patterns in stage 5 CKD patients undergoing routine HD and their association with drug-drug interactions (DDIs) and the potential for adverse drug reactions (ADRs) resulting from DDIs. This cross-sectional study encompassed stage 5 CKD patients undergoing routine HD at Dr. Cipto Mangunkusumo General Hospital from 2020 to 2021. Data were obtained from the medical records of the HD Unit. An evaluation was performed utilizing the Lexicomp software to discover DDIs. The study had 147 individuals, with 101 different medications taken, the most prevalent being epoetin alfa (70.4%). Eighty nine percent of patients who underwent treatment associated with a potential DDIs, with the bulk of these interactions classified as moderate (88%). Fifty percent of patients were suspected of experiencing ADRs due to DDIs. Diabetes mellitus exhibited a statistically significant association with suspected ADRs attributable to DDIs (p = 0.04). Hypertension was the most predicted ADR resulting from DDIs, and diabetes mellitus significantly contributed to the incidence of ADRs owing to DDIs in patients with stage 5 CKD on routine HD. In conclusion, DDI in patients undergoing routine HD is sometimes unavoidable considering the many comorbidities. The DDI that occurred was moderate in severity and could be managed well at the Dr. Cipto Mangukusumo General Hospital.

Antibiotic use at the ear, nose, and throat outpatient clinic in Bangli Regional Hospital, Bali

Ni Putu Eka Sudiadewi — 2025-06-24

Ear, nose, and throat (ENT) diseases are defined as diseases that occur around the ear, nose, and throat organs, which do not recognize seasons and can affect various ages. The prevalence of ENT diseases in Indonesia is quite high, with the most common therapy being antibiotics. Irrational antibiotics use can lead to increased treatment costs, risk of side effects, and toxicity. This study aimed to evaluate the use of antibiotics among ENT outpatient. This was a cross-sectional study using medical records data from the ENT Outpatient Clinic in Bangli Regional Hospital in 2022 that meet the inclusion criteria. Data were analyzed descriptively and presented in tables or diagrams. A total of 80 samples were evaluated, predominantly aged 18-44 yo (60%), female (53.8%), and diagnosed with chronic suppurative otitis media (20%). The pattern of antibiotic prescription consisted of monotherapy antibiotics (62.5%) in solid dosage forms (58.8%), administered orally (60%), and with a duration of administration ≥ 5 d (82.5%). Patients aged 18-44 yr, both male and female, receiving either monotherapy or
polytherapy antibiotics were predominantly cases of infection (>90%). The results of this study are expected to serve as one of the sources of information for the development of practical clinical guidelines for ENT patients receiving antibiotic therapy, particularly at the Bangli Regional Hospital, Bali.

Indonesian Journal of Pharmacology and Therapy

Evaluation of potential drug-drug interactions in stage 5 chronic kidney disease patients on routine hemodialysis at Dr. Cipto Mangunkusumo General Hospital, Jakarta

Antibiotic use at the ear, nose, and throat outpatient clinic in Bangli Regional Hospital, Bali