scholarly journals Analysis of Antibiotics on Patients Surgery, before and after Used Guidelines for Antibiotics (PPAB)

2020 ◽  
Vol 7 (1) ◽  
pp. 51
Author(s):  
Lisa Narulita ◽  
Riefkah Bilal ◽  
Mohammad Akram ◽  
Suharjono Suharjono

ABSTRAK Sejak    tahun    2011    World   Health    Organisasi   (WHO)   dan    Komite Pengedalian Resisten Antimikroba  (KPRA) sejak 2015, untuk  menetapkan kebijakan penggunaan antibiotik  dengan menyusun formularium dan  Pedoman Penggunaan Antibiotik (PPAB). Penggunaan antibiotik  berlebihan berkontribusi pada resistensi maka  penelitian ini bertujuan, menganalisis besarnya perbedaan penggunaan antibiotik  pada pasien rawat  inap bedah sebelum digunakan PPAB (Periode  Mei 2018)  dan  setelah  digunakan  PPAB (Periode  Mei 2019)  dengan ATC  / DDD (Defined   Daily  Dose).  Jenis  dan   rancangan  penelitian  adalah deskriptif cross-sectional dengan data retrospektif. Data  yang  diambil  meliputi peresepan antibiotik  di ruang  bedah. Data dianalisis dengan uji tanda (sign test) dan  uji wilcoxon  dengan hasil sign test yang  bertanda negatif sebanyak 9 dan bertanda positif sebanyak 2 dan  uji wilcoxon  menyatakan Sig.(2-tailed 0,062) (α=0,05) artinya   penggunaan  antibiotik   sebelum  dan setelah digunakan PPAB tidak berbeda atau  sama berdasarkan statistik. Tetapi dari  persentasi  penggunaan  antibiotik   terdapat 9  antibiotik   yang penggunaannya  menurun setelah digunakan PPAB  seperti sefoperason 50%, seftriaxon  52%,  sefuroxime  87%,  sepirom  90%,  siproflosasin  17%,  gentamisin 99%, levofloxasin 60%, metronidazol 79% dan  moxifloksasin 86%. Disimpulkan PPAB  perlu ditingkatkan dalam penggunaan antibiotik  di RSUD dr.H.Slamet Martodirdjo dan  penggunaa seftriakson  dapat meningkatkan  multi drug resistant. Dengan  demikian perlu  adanya evaluasi dan  monitoring dalam menerapkan PPAB. Kata kunci: ATC/DDD; Pasien Bedah; PPAB  ABSTRACT Since  2011  the  World Health  Organization (WHO) and  the  National Antimicrobial  Resistant Control  Committee (KPRA) in indonesia since 2015, to establish antibiotic use policies by developing formularies and  Antibiotic  Use Guidelines (PPAB). Excessive use of antibiotics contributing to resistance, this study aims, analyzing the  magnitude of  differences in antibiotic use patients surgery before PPAB (May 2018  period)  and after  PPAB (May 2019  period)  with ATC / DDD (Defined  Daily Dose). Type and  design  of the  study is  descriptive cross-sectional with retrospective. Data  taken  included prescribing antibiotics. Data  were  analyzed by sign test and  Wilcoxon test with 9 negative sign and  2 positive sign results and  Wilcoxon  test stated Sig. (2-tailed 0.062)>  (α = 0.05), meaning that  use of antibiotics before and  after  PPAB is not different or the same based on statistics. But from the percentage of antibiotic 9   decreased  after    PPAB,   such  as   cefoperazone  50%,   cefriaxone   52%, cefuroxime  87%,  cefpirome  90%,  ciprofloxacin  17%,  gentamicin  99%, levofloxacin 60%, metronidazole 79% and  moxifloxacin 86%.  Concluded that PPAB needs to be improved in the use of antibiotics in RSUD dr.H. Islamet Martodirdjo and the use of ceftriaxone can increase multi drug resistant. Thus the need for evaluation and monitoring in implementing PPAB. Keywords:  ATC/DDD; Surgical Patients; PPAB

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 58
Author(s):  
Gulzira Zhussupova ◽  
Dinara Utepova ◽  
Galiya Orazova ◽  
Saule Zhaldybayeva ◽  
Galina Skvirskaya ◽  
...  

The purpose of this study is to conduct a comparative analysis of the consumption of antibiotics for systemic use reimbursed by the state in Kazakhstan for 2017–2019 with the Access, Watch, and Reserve classification (AWaRe 2019) of the World Health Organization (WHO). The evaluation of the consumption of antibiotics for systemic use in Kazakhstan for 2017–2019 was carried out using the ATC/DDD methodology in accordance with the WHO AWaRe classification. The study used data on all antibiotics that were centrally purchased by a single purchaser during the study period. To understand how often Access group antibiotics are taken in Kazakhstan, the top-10 most consumed antibiotics were additionally studied. The results of a comparative analysis of the antibiotics for systemic use consumption for 2017–2019 by the Access, Watch, and Reserve groups showed a negative trend of a decrease in the consumption of Access group drugs from 1.17 defined daily dose (DDDs) per 1000 inhabitants per day (DID) (39%) in 2017 to 0.59 DID (30%) in 2019. There is an increase in consumption of Watch group antibiotics from 1.84 DID (61%) in 2017 to 1.37 DID (68%) in 2019, as well as an increase in consumption of Reserve antibiotics from 0.001 DID (0.03%) to 0.4 DID (2.11%). In recent years in Kazakhstan, there has been a decrease in the consumption of Access group antibiotics. In addition, the Watch group antibiotics are widely consumed with a certain upward trend. In 2019, one Reserve antibiotic was included in the top-10 most commonly consumed antibiotics. There is a predominant consumption of parenteral forms of antibiotics for systemic use in the country.


Author(s):  
Subash Senthilkumar ◽  
Arun Raaj S. A. ◽  
Padmavathi K. ◽  
Dhanapal C. K. ◽  
Periasamy K.

Background: Geriatric patients are more vulnerable to infections and need special consideration on antibiotic use. Resistance to antibiotics among infectious bacteria has developed within a short span. There is a direct correlation between the consumption of antibiotics and the development of resistance. And surprisingly very few literatures were available on antibiotic consumption in geriatric population using defined daily dose (DDD) concept which paved the idea to conduct this study.Methods: A prospective observational study was carried out from November 2018 to April 2019. A total of 206 prescriptions of elderly patients were included in the study. The antibiotics were categorized by anatomical therapeutic classification (ATC) and DDD indicator/1000 inhabitants/day (DID) was used to figure out antibiotic consumption.Results: About 25.2% of patients were treated with antibiotics for respiratory tract infections. The patients received antibiotics empirically (53.8%) and without bacteriological investigation (58.73%). The overall consumption of antibiotics was 20.47 DID in which oral antibiotics was (8.5 DID) 42% and parenteral antibiotics (11.8 DID) 58%. Cephalosporins was observed to be the most consumed antibiotics (33.2%), specifically cefotaxime (14.6%) and ceftriaxone (12.6%). Moreover, 54.4% of antibiotics consumed from watch category of World Health Organisation (WHO) essential medicines list (EML) which was completely against WHO standard proportion.Conclusions: Higher consumption of cephalosporins, which falls into watch category was analysed in geriatric patients. These broad-spectrum antibiotics have high potential to develop antimicrobial resistance. A strict antibiotic policy is needed to be framed that enhance rational prescribing practices in geriatrics.


2020 ◽  
Vol 8 ◽  
Author(s):  
Claudia Maria dos Santos Pereira Indiani ◽  
Karina Ferreira Rizzardi ◽  
Camila Lopes Crescente ◽  
Carolina Steiner-Oliveira ◽  
Marinês Nobre-dos-Santos ◽  
...  

This brief communication assessed whether there was any relationship between the counts of lactobacilli (LB) and mutans streptococci (MS) in the oral cavity and intestine of obese and eutrophic children with early childhood caries (ECC). Seventy-eight preschoolers were assigned into the following groups: 1. obese children with ECC (OECC), 2. eutrophic children with ECC (EECC), 3. obese caries-free children (OCF), and 4. eutrophic caries-free children (ECF). The diagnosis of obesity and ECC was based on the World Health Organization criteria. Dental plaque and fecal samples were collected to assess the counts of MS and LB using selective media. Data were evaluated by Poisson regression analysis, Wilcoxon test, and Sign test. Microbial indicators of ECC in obese children were MS counts in the intestine [rate ratio (RR): 4.38] and presence of LB in the oral cavity (RR: 2.12). The indicators in eutrophic children were MS levels and the presence of LB, both in the oral cavity (RR: 6.35/1.50) and intestine (RR: 2.35/2.38) (p < 0.05). The comparison between MS levels in the mouth and in the intestine revealed significant differences only in the ECF group (p = 0.04). Regarding LB presence in the mouth vs. in the intestine, except for the OCF group (p = 0.03), no other statistical differences were found. Our preliminary findings highlighted that the levels of MS and the presence of LB in the oral cavity, as well as in the lower gastrointestinal tract were associated with ECC. Moreover, obesity was found to influence this relationship.


2015 ◽  
Vol 9 (01) ◽  
pp. 094-098 ◽  
Author(s):  
Iris Hoxha ◽  
Admir Malaj ◽  
Ledjan Malaj

Introduction: Health institutions in Albania have recently reported an increase in antibiotic misuse and microbial resistance. Until now, there have been no comprehensive studies that analyzed the overall use of antibiotics in Albania. The aim of this study was to analyze the overall antibiotic use in Albania between 2011 and 2012, using standardized methodology of measurement, based on World Health Organization guidelines. Methodology: Data from 2011 and 2012 on antibiotic use from ambulatory and hospital sector were examined. Antibiotics were divided based on anatomic therapeutic chemical classification. Defined daily dose (DDD) for each drug was assigned, and DDD per 1,000 inhabitants per day (DID) was used as a measurement unit. In cases of antibiotic combinations for which DDD were not available, unit doses were assigned. Results: In 2011–2012, total antibiotic use decreased from 24.25 to 20.66 DID. Penicillin’s were the most used antibiotic class, with 10.62 DID (2011) and 10.51 DID (2012). Tetracycline use decreased from 5.45 DID (2011) to 0.98 DID (2012). Macrolides increased from 1.36 to 1.88 DID, quinolones from 1.72 to 2.51 DID. The overall antibiotic use was significantly higher than the reimbursed antibiotic use – 3.17 DID (2011) and 2.79 DID (2012) – based on the official data for the same period. Conclusions: This study enables policymakers to further analyze the quality of antibiotic prescriptions and draw comparisons to other countries. The analyzed data suggest there are different factors influencing out-of-pocket use of antibiotics and wrongly prescribed antibiotics. Further studies are necessary to evaluate these factors.


2020 ◽  
Vol 11 (4) ◽  
pp. 7281-7288
Author(s):  
Assajada Lizikri ◽  
Wawaimuli Arozal ◽  
Hesty Utami Ramadaniati

Pneumonia is the leading cause of morbidity and mortality in children worldwide. Antibiotics are the mainstay treatment for bacterial pneumonia so their use should be clearly mentioned in the pneumonia clinical pathway (CP). This study aimed to evaluate the effectiveness of pneumonia CP in pediatrics. A cross-sectional observational study was conducted in a private hospital in Indonesia. The inclusion criteria were pediatric patients admitted with pneumonia in the period of January-December 2017 (pre-CP period) and January-December 2018 (post-CP) and receiving antibiotics. The effectiveness of CP was evaluated according to four parameters: length of stay, clinical outcomes, quality (Gyssens antibiogram) and quantity of antibiotics. A total of 121 eligible patients’ medical records were analyzed (60 before and 61 after CP implementation). Second and third generation cephalosporins (42.1%) predominated the use of antibiotics pre-CP period, whilst aminoglycosides (59.6%) constituted more than half of antibiotic use in post-CP group. More than half of the patients stayed in the hospital not more than 3 days pre-CP period vs 31.1% post-CP period. Nearly all patients had good clinical outcomes during hospitalization between both periods. The proportion of quality of antibiotics was less than 5% either before or after CP implementation. The quantity of antibiotics post-CP (408.42 defined daily dose/DDD per 100 patient days) was almost two times of pre-CP period (222.42 DDD per 100 patient days). In conclusion, implementation of CP could not achieve the targeted goals to reduce the length of hospitalization and improve the antibiotic use. No discernible difference was observed in clinical outcomes before and after CP implementation.


Author(s):  
LARASATI ARRUM KUSUMAWARDANI ◽  
ATIKA WAHYU PUSPITASARI ◽  
VANNISA NABILLA WIDYANTARI

Objective: The abnormally high use of antibiotics can indicate irrational prescribing. One of the ways by which to support rationally prescribingantibiotics is by evaluating their frequency of use. This study aimed to evaluate the use of antibiotics in 2018 by outpatients at the Kebayoran BaruPrimary Health Care of Indonesia.Methods: The study was a cross-sectional and descriptive design. Data were collected retrospectively from sampling outpatient records. The data wereon oral antibiotics prescribed in 2018 at Kebayoran Baru Primary Health Care. There were 10,553 prescriptions for oral antibiotics used as the studysamples. Both quantitative and qualitative evaluations were conducted. The quantitative evaluations were conducted using the method recommendedby the World Health Organization, namely, the anatomical therapeutic chemical/defined daily dose (DDD), and the qualitative evaluations wereconducted using the 90% drug utilization (DU 90%) method and the suitability of antibiotic use with the list of drugs in the Indonesian nationalformulary for the first-level health facilities (FKTP).Results: Three of the antibiotics used most often were amoxicillin at 0.9358 DDD/1000 inhabitants/d, ciprofloxacin at 0.4940 DDD/1000inhabitants/d, and cefadroxil at 0.1983 DDD/1000 inhabitants/d. The drugs within the DU 90% segment were amoxicillin, ciprofloxacin, cefadroxil,and thiamphenicol. There was 70% compatibility of antibiotic use with Indonesian national formulary for the FKTP.Conclusion: We suggest that the use of antibiotics at Kebayoran Baru Primary Health Care tended to be on the high side and not in accordance withnational guidelines.


2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Yusuf Efendi ◽  
Errix Kristian Julianto

ABSTRAKDiera perkembangan jaman saat ini, beberapa keluarga dihadapkan dengan permasalahna tentang adanya angggota keluarga yeng mengaami gangguan jiwa, tak jarang keluarga tidak mengetahui bagaimana merawat angota keluarga dengan gangguan jiwa. Self help group pada keluarga dengan gangguan jiwa perlu dilakukan untuk membantu keluarga mengatasi permasalahannya yang diselesaikan bersama dalam kelompok. Manfaat yang didapatkan pada terapi ini adalah terdapatnya peningkatan pengetahuan keluarga tentang Skizofrenia. Peningkatan pengetahuan ini akan berdampak terhadap kemampuan keluarga dalam merawat klien Skizofrenia..Desain penelitian ini menggunakan desain pre eksperimental dengan rancangan one group pre-posttest design. Sampel pada penelitian ini adalah keluarga penderita Skizofrenia di PKU Jiwa Kalitidu yang berjumlah 32. . Data dikumpulkan menggunakan kuesioner kemudian dianalisis dengan menggunakan uji Wolcoxon sign dengan tingkat kemaknaan 0,05. Hasil penelitian menunjukkan bahwa kondisi responden sebelum dan sesudah dilakukan intervensi dengan self help group pada kemampuan merawat dengan  nilai uji wilcoxon sebesar 0,001 yang berarti ada pengaruh dari intervensi self help group dengan merawat keluarga dengan gangguan jiwa. Kata Kunci       : Self Help Group, Kemampuan Merawat, Skizofrenia   ABSTRACT. In the current era of development, some families are faced with problems about family members who suffer from mental disorders, often families do not know how to care for family members with mental disorders. Self help groups for families with mental disorders need to be done to help families overcome the problems that are solved together in a group. The benefit of this therapy is that there is an increase in family knowledge about Schizophrenia. This increase in knowledge will have an impact on the ability of families to care for Schizophrenia clients.The design of this study used a pre-experimental design with one group pre-posttest design. The sample in this study was the families of Schizophrenics in  Kalitidu public helath centre, amounting to 32.. Data were collected using a questionnaire and then analyzed using the Wolcoxon sign test with a significance level of 0.05.The results showed that the condition of the respondents before and after the intervention with self help group on the ability to care for Wilcoxon test value of 0.001, which means there is an influence of self help group intervention by caring for families with mental disorders. Keywords: Self Help Group, Caring Ability, Schizophrenia


2021 ◽  
Vol 6 (2) ◽  
pp. 83
Author(s):  
Juliet Sanyu Namugambe ◽  
Alexandre Delamou ◽  
Francis Moses ◽  
Engy Ali ◽  
Veerle Hermans ◽  
...  

Antimicrobial consumption (AMC) surveillance at global and national levels is necessary to inform relevant interventions and policies. This study analyzed central warehouse antimicrobial supplies to health facilities providing inpatient care in Uganda. We collected data on antimicrobials supplied by National Medical Stores (NMS) and Joint Medical Stores (JMS) to 442 health facilities from 2017 to 2019. Data were analyzed using the World Health Organization methodology for AMC surveillance. Total quantity of antimicrobials in defined daily dose (DDD) were determined, classified into Access, Watch, Reserve (AWaRe) and AMC density was calculated. There was an increase in total DDDs distributed by NMS in 2019 by 4,166,572 DDD. In 2019, Amoxicillin (27%), Cotrimoxazole (20%), and Metronidazole (12%) were the most supplied antimicrobials by NMS while Doxycycline (10%), Amoxicillin (19%), and Metronidazole (10%) were the most supplied by JMS. The majority of antimicrobials supplied by NMS (81%) and JMS (66%) were from the Access category. Increasing antimicrobial consumption density (DDD per 100 patient days) was observed from national referral to lower-level health facilities. Except for NMS in 2019, total antimicrobials supplied by NMS and JMS remained the same from 2017 to 2019. This serves as a baseline for future assessments and monitoring of stewardship interventions.


2021 ◽  
Vol 2 (1) ◽  
pp. 7-14
Author(s):  
Kaima Ishmata ◽  
Indri Seta Septadina ◽  
Bintang Arryotantri

Anxiety is a feeling of discomfort, worry about something unclear and accompanied by autonomic symptoms. Murottal Al-Quran therapy is a complementary therapy with the most widely used Al-Qur'an media. This study aims to analyze the effect of the murottal Al-Qur'an Surah Al-Mulk and Al-Hasyr on the anxiety of medical students of Universitas Sriwijaya. This research is a quasi-experimental study with a cross-sectional approach with one group pre-post test design which was conducted from July to December 2020 at homes through Zoom meeting application. Sampling using simple random sampling technique. Data in the form of primary data using the Beck Anxiety Inventory (BAI) questionnaire.Primary data were collected using the Beck Anxiety Inventory (BAI) questionnaire before and after receiving the Murottal Al-Qur'an Surah Al-Mulk and Al-Hasyr for 7 consecutive days. The Shapiro-Wilk normality test was performed on the data, then analyzed with Paired t-test or Wilcoxon test using SPSS device. The Wilcoxon test results showed significant results of murottal Al-Qur'an Surah Al-Mulk and Al-Hasyr on anxiety (p = 0.000) in medical students. There is an effect of murottal Al-Qur’an surah Al-Mulk and Al-Hasyr on anxiety among medical students of Universitas Sriwijaya.


2020 ◽  
Vol 8 (1) ◽  
pp. 62
Author(s):  
Indah Jayani ◽  
Fatma Sayekti Ruffaida

Approach to PLWHA by providing interpersonal counseling is the right thing to do to overcome psychological problems including social, emotional and spiritual aspects of PLWHA. This study aims to look at the effect of interpersonal counseling on social, emotional and spiritual responses in HIV/ AIDS patients. This research is a type of non-experimental research with a cross-sectional approach. The sample is post-test people and tested positive for HIV in the Kediri region, which is 32 with purpossive sampling technique. Data on social, emotional and spiritual responses were obtained based on the results of data recapitulation from the instrument in the form of a questionnaire. The results of the study with the non-parametric Wilcoxon test showed there were differences between social responses of HIV/AIDS patients before and after given interpersonal counseling with p value = 0,000, there were differences between the emotional responses of HIV/AIDS patients before being given interpersonal counseling and after being given counseling with p value = 0,000, and there is a difference between spiritual responses in HIV/AIDS patients before being given interpersonal counseling and after being given interpersonal counseling with p value = 0,000. It can be concluded that interpersonal counseling influences social, emotional and spiritual responses of HIV/AIDS patients. It is recommended that the mentoring of HIV/AIDS patients through interpersonal counseling can continue so as to enhance physiological responses that will have an impact on disease prognosis, prevention of opportunistic infections and reduce mortality rates for HIV patients/ AIDS.


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