scholarly journals Kajian Penggunaan Antibiotik pada Pasien Meningitis dan Ensefalitis Bakteri di Bangsal Rawat Inap Rumah Sakit Rujukan Utama

2021 ◽  
Vol 18 (2) ◽  
pp. 164-169
Author(s):  
Diyan Ajeng Rossetyowati ◽  
Ika Puspitasari ◽  
Tri Murti Andayani ◽  
Titik Nuryastuti

Inadequate antibiotic therapy for meningitis and bacterial encephalitis is one of the factors that can jeopardize patient safety and turn into a public health issue in a number of nations, including Indonesia. This phenomena has the potential to raise health-care expenses, which should be avoided in the era of the JKN program's implementation. The goal of this research was to describe the profile of antibiotic use and cost in hospitalized meningitis and bacterial encephalitis patients. This cross-sectional observational study took place from January to December 2019. As study materials, patient medical records and billing data were employed. To enhance the data obtained, confirmation with medical and pharmaceutical personnel is required. Antibiotic use and expenditures were described using descriptive analysis. A total of 71 patients, both children and adults, met the study's inclusion criteria. Antibiotics were given to all of the patients, and the results revealed that third generation cephalosporins (49.375%) were the most commonly recommended antibiotic class, either alone or in combination. Antibiotic use receives 46.94% of total medication funding. According to the length of stay category, the majority of patients (45.99 %) were hospitalized for 8-14 days consecutively with antibiotic medication. Antibiotics, which are typically administered to patients with meningitis and bacterial encephalitis, had no effect on the length of stay in the hospital. Antibiotic prescriptions must be carefully reviewed at top referrel hospital, taking into account the local germ map.

2020 ◽  
Author(s):  
Dan Wu ◽  
Eileen Yang ◽  
Wenting Huang ◽  
Weiming Tang ◽  
Huifang Xu ◽  
...  

Abstract Background Homoprejudiced violence, defined as physical, verbal, psychological and cyber aggression against others because of their actual or perceived sexual orientation, is an important public health issue. Most homoprejudiced violence research has been conducted in high-income countries. This study aimed to examine the experience and perpetration of homoprejudiced violence among men who have sex with men (MSM) in Guangzhou, China. Methods MSM in a large Chinese city, Guangzhou, completed an online survey instrument that was distributed through community-based organizations. Descriptive analysis was conducted to describe the sample characteristics. Multivariable logistic regression analyses, controlling for age, residence, occupation, heterosexual marriage, education and income, were carried out to explore associated factors. Results A total of 777 responses were analyzed and most (64.9%) were under the age of 30. Three-hundred-ninety-nine (51.4%) reported experiencing homoprejudiced violence, while 205 (25.9%) reported initiating homoprejudiced violence against others. Compared to respondents who self-identified as gay, respondents who were heterosexual were 0.6 times (AOR=0.6, 95% CI: 0.4-0.9) as likely to have experienced homoprejudiced violence, whereas those who were unsure about their sexual orientation were 2.6 times (AOR=2.6, 95% CI: 1.2-5.5) more likely to have experienced homoprejudiced violence before. Furthermore, a strong association (AOR=2,4. 95% CI: 1.6-3.5) was identified between experiencing homoprejudiced violence and initiating violence. MSM who had disclosed their sexual orientation to people other than their partners were more likely to have experienced homoprejudiced violence (AOR=1.8, 95% CI:1.3-2.5). Conclusions These findings suggest the importance of research and the implementation of interventions focused on preventing and mitigating the effects of homoprejudiced violence affecting MSM in China.


2018 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
Satish Kumar Deo ◽  
Sita Rijal ◽  
Tulza K.C

Background: Antibiotics are considered to be among the most commonly sold drug classes globally. Antibiotic resistance is a recognized public health issue at the local, national and global levels.Objectives: The aim of this study was to identify awareness of general public regarding the use and resistance of antibiotics.Methodology: A descriptive cross-sectional study was conducted in Kathmandu in November 2016 using a quantitative questionnaire among 120 adult people aged 20–60 years. Convenience sampling method was used and information on use of antibiotics and resistance was obtained using semi-structured questionnaire through interview method. Descriptive statistics was done to describe the respondent’s level of awareness regarding use of antibiotics and resistance.Results: Among the total respondents, majority had incorrect awareness as regards to action, reasons for using antibiotics, possible side effects of the antibiotic. Seventy one percent of the respondents had not heard about antibiotic resistance. The study finding showed that about 66.7% of the participants had inadequate awareness towards use and resistance of antibiotics.Conclusion: The findings demonstrate that the overall awareness on antibiotic use and resistance is poorly understood among our respondents. This information can be utilized in future educational and antibiotic resistance awareness raising campaigns.


Author(s):  
Akshata Mane ◽  
Shweta Kamat ◽  
Harish Thanusubramanian

Introduction: Increasing awareness and practice of Antimicrobial Stewardship (AMS) has gained immense importance in Indian hospitals for preventing the irrational use of antibiotics. India is one of the world’s largest consumers for antibiotics. Assessment of the local Knowledge, Attitude and Practices (KAP) of Antimicrobial Resistance (AMR) and AMS among Healthcare Providers (HCPs) will help in designing effective public health policies and engaging the community in campaigns against increasing microbial resistance. Aim: To understand the status of AMS programs and practices in five private sector multispecialty hospitals situated in the East, West, North and South zones of the country and to assess the KAP of HCPs regarding AMR and AMS. Materials and Methods: The cross-sectional survey was conducted to assess the implementation of AMS in five hospitals among clinicians, nurses and pharmacists across India using a predeveloped AMS checklist between June 2019 and October 2019. The analysis was done between July and August 2020. Responses were collected using a five-point Likert scale, with choices ranging from ‘strongly agree’ to ‘strongly disagree’.Descriptive analysis was done for the KAP survey to determine the percentages of participants under each response category. Results: Total 32 clinicians, 55 nurses and eight pharmacists responded to the KAP survey (100% response rate). The clinicians were aware that AMR is caused by irrational prescribing of antimicrobials (n=31, 96.87%) and improper diagnosis of infective conditions (n=27, 84.37%). However, knowledge of clinicians on infection control practices (n=6, 18.75% disagreed) in controlling AMR and practice of referring local epidemiology before prescribing antimicrobials (n=7, 21.87% did not follow routinely) could be improved. The knowledge and practice of nurses and pharmacists on antibiotic use were spread over a wide range. According to the nurses, AMR was mainly caused by using antimicrobials for non bacterial infections (n=30, 54.54%) and deviations from their standard duration (~63.64%-72.73%). As per pharmacists, the lack of restrictions on antimicrobial usage and widespread use or overuse of antibiotics were major contributors to AMR (n=3, 37.5% strongly agreed). Both nurses and pharmacists could benefit from reinforced training on antibiotic usage. Conclusion: Implementation of AMS was not adequate in private Indian hospitals. Although clinicians have good knowledge on antibiotic use, it was not equally reflected in their practice. The KAP data of nurses and pharmacists suggest that training and education on appropriate antibiotic usage should be emphasised. More efforts are required to improve AMS practices in hospitals.


Author(s):  
Swathi Ratnam Regidi ◽  
Billa S. B. Mallika

Background: Examining the knowledge, attitude and practices (KAP) of the medical students regarding antibiotic resistance (ABR) and use can help us in devising suitable educational interventions for them, tailored according to their earlier held knowledge, beliefs, capabilities and experience.Methods: A cross sectional, questionnaire based survey was conducted among medical students of a teaching hospital, whereby their KAP regarding antibiotic use and resistance was assessed by using a questionnaire, whose responses ranged from ‘agree’ to ‘disagree,’ ‘always to never’ and true / false. The data was analysed by using simple descriptive statistics. Wherever it was relevant, the Chi-square test was used to determine any significant difference.Results: The number of medical students who agreed that ABR was an important and a serious public health issue in this teaching hospital was 76 percent (n = 325). But, only 54.3% (n = 233) of the students were aware that bacteria were not responsible for causing cold and flu, while the remaining 37.2 percent (n = 22) were not knowledgeable about this fact. More than 80% rated the adverse effect profile of the antibiotic and the risk of a super infection as the important factors which deserved consideration. Cost of the antibiotic was considered to be an important factor deserving consideration by only 65.5% (n=277) of the participants.Conclusions: Our survey revealed that most of the students were aware of the antimicrobial resistance and its consequences. The only concern was their casual attitude regarding the antibiotic use. Further educational interventions are necessary to improve their understanding and perceptions on antibiotic resistance, as well as their attitude towards antibiotic use.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S107-S108
Author(s):  
Anita Shallal ◽  
Rachel Kenney ◽  
Geehan Suleyman

Abstract Background Antibiotic overutilization during the COVID-19 pandemic has been reported, despite relatively infrequent bacterial co-infection. We explored antibiotic utilization before, during and after the COVID-19 surge in Michigan. Methods Cross-sectional study at an 877-bed hospital in Detroit, Michigan from January 2019 through May 2020. Measures: Count of COVID-19 hospital admissions by day. Monthly antibiotic utilization for formulary agents used to treat pneumonia were measured using monthly days of therapy (DOT) per 1000 patient days present and the National Health Care Safety Network Standardized Antimicrobial Administration Ratio (SAAR). Descriptive analysis was utilized. Results The first COVID-19 case was detected March 11, 2020 and peaked in early April (Figure 1). Antibiotic utilization is demonstrated in Figure 2. The COVID-19 peak was associated with increased use of multiple antibiotics; notably, DOT per 1000 days present for ceftriaxone, cefepime and doxycycline were 85.43, 79.42 and 71.56, respectively in April. The institutional all-antibacterial SAAR was significantly reduced in May at 0.96, p=0.0022, after the COVID-19 surge. Figure 1 Figure 2 Conclusion We observed increased utilization of multiple antibiotics during the COVID-19 surge, and reduction in the all-antibacterial SAAR after the surge. More robust information is needed to promote optimal antibiotic use for patients with COVID-19 infections. Disclosures All Authors: No reported disclosures


Geriatrics ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 8 ◽  
Author(s):  
Dorte Melgaard ◽  
Maria Rodrigo-Domingo ◽  
Marianne M. Mørch ◽  
Stephanie M. Byrgesen

The aims of this study are to describe the mobility of acute geriatric patients, the length of stay, and to characterise patients who were readmitted within 30 days based on the De Morton Mobility Index (DEMMI). A cross-sectional observational study with longitudinal follow-up was conducted in the period from 1 March 2016 to 31 August 2016. Inclusion criteria were acute geriatric patients hospitalised for a minimum of 24 h. Of the 418 patients hospitalised during the study period, 246 (59%) participated in this study (44% male, median age 83 years [70; 94]). For patients in an acute geriatric department, the median DEMMI score was 41 and the mean score was 39.95. Patients with a DEMMI score ≤40 show a significantly lower Barthel 100 index, lower 30 s. sit-to-stand scores and were significantly more likely to be bedridden or, amongst those not bedridden, to use a mobility aid. Lower DEMMI scores were associated with longer admissions. DEMMI seems to have the ability to predict discharge within one week. There was no significant association between a lower DEMMI score and higher risk for 30-day readmission. Further research is needed to determine whether the DEMMI is suitable for identifying the patient’s need for further rehabilitation following the discharge.


2020 ◽  
Vol 3 (4) ◽  
pp. 134-138
Author(s):  
Aniza Ismail ◽  
Muhammad Alimin Mat Reffien ◽  
Norlinah Mohamed Ibrahim ◽  
Hanani Nabilah Mohd Sobri ◽  
Noor Dalila Inche Zainal Abidin ◽  
...  

ABSTRACT Introduction Globally, stroke continues to become a significant public health issue contributing to one of the significant causes of morbidity and mortality. The study aimed to describe the characteristics of patients with stroke who were admitted to a teaching hospital in Malaysia and to determine the factors associated with length of stay (LOS). Methods This is a single-center, cross-sectional study using in-patient data maintained by the Case-Mix Unit of a teaching hospital in Malaysia from 2016 to 2017. The study included all patients with International Classification of Disease (ICD) code 164 (stroke, not specified as hemorrhage or infarct). The significance of association was determined using nonparametric tests in the form of the Mann-Whitney U test and the Kruskal-Wallis test. Results A total of 162 stroke patients from 2016 to 2017 from Case-Mix database were included in the study. The age ranged from 31 to 97 years old. The minimum and maximum LOS for patients with stroke ranged from 1 to 17 days. The severity of illness was found to be significantly associated with longer LOS (p < 0.001); however, age, sex, and presence of co-morbidities did not show any significant association. Conclusion Despite its limitations, this study is an essential first step to examine the characteristics of patients with stroke and to determine the factors associated with LOS.


2021 ◽  
Vol 3 (2) ◽  
pp. 114
Author(s):  
Ramadhani A. K. S ◽  
Juniastuti Juniastuti ◽  
Muhammad Ardian C. L

Abstrak Latar Belakang: Berdasarkan data Dinas Kesehatan Kota Surabaya tercatat 748 bayi lahir dari ibu dengan HBsAg positif diseluruh wilayah puskesmas kota Surabaya. Penelitian ini bertujuan untuk mengetahui pemberian imunisasi hepatitis B (pasif) pada bayi yang dilahirkan dari ibu dengan HBsAg positif di 4 wilayah puskesmas di Kota Surabaya. Metode: Penelitian ini menggunakan deskriptif observasional dan teknik total sampling dengan pendekatan cross-sectional. Sampel yang memenuhi kriteria inklusi sebanyak 56 bayi. Variabel yang diamati meliputi pemberian imunisasi hepatitis B (pasif) pada bayi yang dilahirkan dari ibu dengan HBsAg positif. Analisis data menggunakan univariat atau deskriptif. Hasil: Didapatkan distribusi pemberian imunisasi pasif hepatitis B (HBIG) pada bayi sebanyak 91,1% dan 40 bayi (71,4%) dinyatakan non reaktif saat mereka berusia >9 bulan. Kesimpulan: Hampir seluruh bayi yang lahir dari ibu dengan HBsAg melakukan imunisasi pasif (HBIG) dan imunisasi aktif (HB-0) tepat waktu dan sebagian besar bayi dinyatakan non reaktif terhadap HBsAg saat berusia lebih dari 9 bulan.Abstract Background: Based on data from the Surabaya City Health Office, 748 infants born to HBsAg positive mothers in all of the public city health center of Surabaya. This study aims to describe the giveness hepatitis B immunization (passive) in infants born to HBsAg positive mothers in 4 of the public city health center in Surabaya. Method: This study uses descriptive observational study and total sampling technique with a cross-sectional approach. All samples which is included to inclusion criteria were 56 infants. The variables observed the giveness of hepatitis B immunization (passive) in infants born to HBsAg positive mothers and the HBsAg status of the children after hepatitis B immunization which were performed when they were more than 9 months old. Univariate or descriptive analysis was performed. Results: The study  found the distribution frequency the giveness of passive hepatitis B immunization (HBIG) were 91,1% and the HBsAg status when the children more than 9 months old were 71,4% are declared as non-reactive to HBsAg.. Conclusion: Almost all infants born to HBsAg postive mothers have gone through passive immunization (HBIG) and most of them are found to be non-reactive to HBsAg when they are more than 9 months old.


2019 ◽  
Vol 2 (2) ◽  
pp. 13-28
Author(s):  
Ayu Rahmawati ◽  
Husni Muchtar ◽  
Hansen Nasif

To find out the effectiveness of antibiotics in typhoid fever patients at the SMF of Pediatric and SMF in Internal Medicine Dr. RSUP M. Djamil Padang. This study was a cross-sectional study with a retrospective type of data during 2012 and prospective from June to September 2013, with a descriptive analysis design. The number of patients who met the inclusion criteria were 11 patients. Percentage of antibiotic use in adult patients for ceftriaxone (60%) and chloramphenicol (40%). The percentage of antibiotic use in pediatric patients for ceftriaxone, chloramphenicol, and cefixim are 60%, 27%, and 13%, respectively. Fever free for ceftriaxone and chloramphenicol in pediatric and adult patients, each of which is 2-3 days and 4-6 days; 3-4 days and 4 days. To be free of cefixime fever in pediatric patients is 2 days. The length of treatment required is ceftriaxone and chloramphenicol (children and adults) antibiotics, 6 - 13 days and 9-13, respectively; 11-14 and 7 days. For the duration of cefixime antibiotic treatment for children is 13 days. The results of this study indicate that antibiotics that are used effectively against typhoid fever patients are seen from the time of free of fever and length of stay.


2021 ◽  
Vol 2 (1) ◽  
pp. e00163800
Author(s):  
María-Pilar Sánchez-de-Paz ◽  
Gustavo Da-Prat-de-Magalhaes ◽  
Santiago Isa ◽  
Victoria Aldinio ◽  
Andres Norberto-Latella ◽  
...  

Background: Adverse drug reactions (ADRs) have a high impact on morbidity and mortality of the population, becoming a public health issue. Studying and publishing about these is referred as pharmacovigilance.Objective: To describe and compare the adverse reactions produced by drugs of nervous system action (CNS-D) and neurological ADRs produced by drugs of systemic action (Sys-D). To further develop the need of reporting adverse reactions. Methods: An observational, cross-sectional, retrospective study performed on a database of neurological consultations which took place at the Neurology department. Patients meeting the inclusion criteria were selected and divided into two groups: Sys-D and CNS-D. Demographic and neurological variables were analyzed. Parametric and non-parametric statistics were used according to distribution. The Naranjo Algorithm (NA) was used to define causality.Results: 71 ADRs were described, from which 63.38% (n=45) were produced by CNS-D, especially antiepileptics by 47% (n=21) and psycholeptics by 44%. Of the total, 36.62% (n=26) were caused by Sys-D, such as antineoplastics (n=9) and antibiotics (n=9), being Cefepime the most frequent. The diagnosis of ADRs caused by a Sys-D was delayed prolonging hospitalization (p 0.05) due to a lower NA score (p 0.003) compared to the CNS-D group.Conclusion: Multiple frequently used drugs of systemic action, such as antineoplastics and antibiotics, generate neurological adverse effects. From our analysis, it was presumed that the suspicion of a neurological ADR caused by these drugs was scarce, thus causing a higher morbidity for the patient.


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