The Effect of Carbapenem Pharmaceutical Cost Reduction by Blood Culture and De-Escalation:

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

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Inefficiency in 6-Set Requests for Blood Culture Analysis of Cancer Patients with the Central Venous Catheter

Laboratory Medicine Online ◽

10.3343/lmo.2013.3.3.155 ◽

2013 ◽

Vol 3 (3) ◽

pp. 155

Author(s):

Dong-Hyun Lee ◽

Eun-ha Koh ◽

Sunjoo Kim ◽

In-Gyu Bae ◽

Hoon-gu Kim ◽

...

Keyword(s):

Blood Culture ◽

Central Venous Catheter ◽

Cancer Patients ◽

Venous Catheter ◽

Central Venous

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Implementasi Analisis Proses Bisnis Sebagai Upaya Pengurangan Biaya

JRAK Jurnal Riset Akuntansi dan Komputerisasi Akuntansi ◽

10.33558/jrak.v10i1.1642 ◽

2019 ◽

Vol 10 (1) ◽

pp. 1-27

Author(s):

Aniek Wijayanti

Keyword(s):

Business Process ◽

Cost Reduction ◽

Process Analysis ◽

Value Added ◽

Added Value ◽

Natural Material ◽

Management Activity ◽

Procurement Process ◽

Material Procurement ◽

The Cost

Business Process Analysis can be used to eliminate or reduce a waste cost caused by non value added activities that exist in a process. This research aims at evaluating activities carried out in the natural material procurement process in the PT XYZ, calculating the effectiveness of the process cycle, finding a way to improve the process management, and calculating the cost reduction that can achieved by activity management. A case study was the approach of this research. The researcher obtained research data throughout deep interviews with the staff who directly involved in the process, observation, and documentation of natural material procurement. The result of this study show that the effectiveness of the process cycle of natural material procurement in the factory reached as much as 87,1% for the sand material and 72% for the crushed stone. This indicates that the process still carry activities with no added value and still contain ineffective costs. Through the Business Process Mechanism, these non value added activities can be managed so that the process cycle becomes more efficient and cost effectiveness is achieved. The result of the effective cycle calculation after the management activities implementation is 100%. This means that the cost of natural material procurement process has become effective. The result of calculation of the estimated cost reduction as a result of management activity is as much as Rp249.026.635,90 per year.

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