157. Impact of Pharmacist-Generated Oral Antimicrobial Test Prescription on Discharge Medication Access and Outcome

Background Cost barriers to accessing discharge oral antimicrobials (ABX) may delay discharges and result in suboptimal discharge ABX. Use of electronic test prescriptions (eTP) or “price checks” is controversial due to potential for erroneous dispensing. This study evaluated discharge ABX access and outcome after implementation of a standardized, inpatient pharmacist-initiated ABX eTP process in collaboration with discharge pharmacy. Methods IRB approved, retrospective, cross-sectional cohort pilot-study. Inclusion: home bound adults admitted for ≥ 72 hours from 1/1/18-2/28/19 and discharged on oral ABX. Patients with an ABX eTP prior to discharge were compared to those discharged on ABX but no eTP. Data were reported using descriptive statistics and bivariate analysis. Primary endpoint: discharge delay after medical stability. Secondary endpoints: medication access, unplanned encounters, and % of patients discharged on first-line ABX. Results 84 patients included: 43 no-ETP and 41 eTP. 75 ABX eTP evaluated among 41 patients. Patients in the no-eTP group had higher Charlson comorbidity index (P = 0.004) and immunosuppression (24% vs. 12%; P = 0.014). Median length of stay, days: 6 (5 – 9) eTP vs. 8 (5 – 15) no-eTP (P = 0.026). Most common eTP requested by pharmacist: linezolid (17, 23%) and oral vancomycin (12, 16%) (Figure 1). eTP results were documented in the medical record in < 24 hours for 66 (88%) of inquiries. 49 (65%) prescriptions were approved by insurance; 16 (21%) had no out of pocket cost and 8 (11%) required prior authorization (PA) (Table 1). Linezolid (5, 35%) and public insurance (10, 71%) were frequently associated with barriers. 29 (70%) patients were discharged on the same ABX as the eTP. There were no discharge delays or erroneous dispensing. 14 (33%) no-eTP and 15 (37%) eTP patients experienced unplanned healthcare encounters after discharge. 9/84 (11%) patients were discharged on suboptimal ABX. Non-white race 8/9 (89%) P = 0.047 and public insurance 8/9 (89%) P = 0.063 were associated with suboptimal discharge ABX. Figure 1. Oral Antimicrobial Test Prescription Pattern (n=75) Table 1. Oral Antimicrobial Test Prescription Result (n=75) Conclusion A standardized eTP process appears to be a safe way to evaluate out of pocket cost without prolonging length of stay. Future work will focus on inequity in access to first line ABX. Disclosures Susan L. Davis, PharmD, Nothing to disclose Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder)

Pelatihan Kecap Sehat Saccharum Officinarum Desa Rantau Alih Kecamatan Sukakarya

This community service aims to increase the skills of Rantau Alih community’s by using local potentials of Rantau Alih village which is Saccharum Officinarum that processed into soy sauce.The methodologyof this activity consist of sosialiszation, training, and workshop. An evaluation held after the activity by the team to find out the Rantau Alih community’s participation and the understandings level concern of the healthy soy sauce. The result of this research shows that through the organoleptic test,the flavour tester, scents, form, and color of the product. In other ways, through the antimicrobial test, this product was able to be consumed and turned into superior product of Rantau Alih village. Based on the activity that have been carried out, however the follow up activityto keep the field monitoring at least once in a month and packaging assists also the product marketing, so it can be recognized by the large people.

Pharmacognostical and Antimalarial Studies of Tamarindus indica Leaves

The present study was performing to know the Antimalarial activity of Tamarind (Tamarindus indica L.) The plant T. indices were collected further by using methanol the extract residue diluted 10% Dimethyl sulphoxide extract from which were produced. The plate diffusion method was used as an antimicrobial test for Plasmodium falciparum and Plasmodium vivax by a zone of inhibition tested.TLC standardization ensures the presence of tartaric acid in the extracted sample against the standard. leaves possess near to standard Antimalarial activity which was confirmed by its effect on experimental living organisms.

Bioactivity of Kemangi Leaves (Ocimum sanctum) and Ruku Leaves (Ocimum tenuiflorum)

Kemangi (Ocimum sanctum) is commonly used as a vegetable (fresh vegetables) and traditional medicine in Indonesia. Kemangi leaves have been empirically used as an alternative medicine for wound healing. Apart from kemangi, a morphologically similar plant to kemangi, namely ruku ruku, is often used by Indonesians as a cooking spice. The leaves of ruku ruku (Ocimum tenuiflorum) have been empirically used in various alternative medicine, namely to treat fever, cough, gout, nerves, mouth sores, tinea versicolor, nausea and vomiting. The research was conducted to determine the antimicrobial activity (antibacterial and antifungal), antioxidants and phytochemical analysis of the ethanol extract of kemangi leaves and ruku ruku leaves. The extraction method used is the maceration method using 96% ethanol as a solvent. The antimicrobial test was carried out using the agar diffusion method. The bacteria used are Salmonella typhi, Staphylococcus aureus, while the fungi used are Candida albicans. Phytochemical analysis used the Harbone method, and the antioxidant test used the 1,1-Diphenyl-2-picryl Hidrazil (DPPH) method. The results showed that the extracts of kemangi and ruku ruku leaves contained flavonoid and steroid compounds. The antimicrobial test results showed that only ruku ruku leaves inhibited the growth of Staphylococcus aureus with an inhibition zone of 9.35 mm, and the two extracts used could not inhibit the growth of the fungus Candida albicans. In contrast, the results of the antioxidant test showed that the ruku ruku and kemangi leaf extracts had an antioxidant activity with inhibition concentration 50 (IC50) values of 225.64 ppm and 455.11 ppm. Keywords: Bioactivity, Kemangi, Phytochemicals, Ruku.

Antimicrobial Activity of Ethanolic Extract of Sempur (Dillenia suffruticosa (Griff.) Martelli) Leaves against Pathogenic Microorganisms

Sempur (Dillenia suffruticosa) leaves are known as a traditional medicine for the people of Bangka-Belitung Island. The local people empirically utilize the boiled water of D. suffruticosa leaves as anti-diarrhea. However, the antimicrobial activity of the ethanol extract of D. suffruticosa leaves has not been reported. This study aims to determine the antimicrobial activity of the ethanol extract of D. suffruticosa leaves against several microorganisms: Staphylococcus aureus as Gram-positive bacteria, Escherichia coli as Gram-negative bacteria, and Candida albicans as fungi. Extraction was carried out by maceration method with 70% ethanol, then screened for phytochemical constituents. The antimicrobial test was carried out by the disc diffusion method using Nutrient Agar (NA) for bacteria, and Sabouraud Dextrose Agar (SDA) for fungi. The results of phytochemical screening showed that the ethanol extract of D. suffruticosa leaves contained alkaloids, flavonoids, tannins, and saponins. The antimicrobial test showed that the extract of D. suffruticosa leaves could inhibit the growth of S. aureus at concentrations of 10%, 20%, and 40% were 8.35±0.05; 9.34±0.32; and 10.52±0.22, respectively. The ethanol extract of D. suffruticosa leaves could inhibit the growth of S. aureus, whereas E. coli and C. albicans did not show any activity.

PERBANDINGAN KADAR FENOLIK DAN AKTIVITAS ANTIMIKROBA RIMPANG JERINGAU (Acorus calamus) SEGAR DAN TERFERMENTASI

ABSTRACTCalamus rhizome contain phenolic as antimicrobial agent. Fermentation can increase thereleasing of phenolic content from plant cells. The aim of this research was to observe thecomparison of phenolic content and antimicrobial activity between fresh and fermentedcalamus rhizome extract. Phenolic content was determined by using Folin-Ciocalteu method,and antimicrobial test by agar well diffusion. Phenolic content of fresh and fermentedcalamus rhizome extract respectively are 97,272±0,525 and 223,553±3,542 mgGAE/gram.Inhibiton zone against Staphylococcus aureus are 4,04±0,05 and 8,24±0,58 mm, whileagainst Candida albicans are 14,90±0,57 and 18,16±1,47 mm. Fermentation increase phenoliccontent and antimicrobial activity of calamus rhizome.Key words: antimicrobial, calamus rhozome, fermentation, phenolicABSTRAKRimpang jeringau memiliki kandungan senyawa fenolik sebagai antimikroba. Fermentasidapat meningkatkan pelepasan senyawa fenolik pada sel tanaman. Penelitian ini bertujuanuntuk mengetahui perbandingan kadar fenolik dan aktivitas antimikoba ekstrak rimpangjeringau segar dan terfermentasi. Penetapan kadar fenolik dilakukan dengan metode Folin-Ciocalteu dan uji antimikroba dengan metode difusi sumuran. Kadar fenolik ekstrak jeringausegar dan fermentasi secara berurutan sebesar 97,272±0,525 dan 223,553±3,542mgGAE/gram. Daya hambat rimpang jeringau segar dan terfermentasi terhadapStaphylococcus aureus sebesar 4,04±0,05 dan 8,24±0,58 mm, sedangkan terhadap Candidaalbicans sebesar 14,90±0,57 dan 18,16±1,47 mm. Fermentasi dapat meningkatkan kadarfenolik dan aktivitas antimikroba rimpang jeringau.Kata kunci: antimikroba, fenolik, fermentasi, rimpang jeringau

Pengembangan E-modul Berbasis Penelitian Uji Antimikroba pada Matakuliah Mikrobiologi

<p><strong>Abstract:</strong> This study aim was to develop an e-module based on antimicrobial test studies in microbiology courses. Type of research used is research and development with ADDIE model development. The study subject was student of State University of Malang who has taken the course of Microbiology. The instrument used is questionnaire validation of material and media experts and questionnaires for students. The percentage of results from material expert validation is 95%, the media expert's validation is 98% and the readability test is 88%. Based on the result, it can be concluded that e-module based on antimicrobial test research is valid and feasible to be used as teaching material in microbiology course.</p><strong>Abstrak:</strong><em> </em>Tujuan penelitian ini untuk mengembangkan e-modul berbasis penelitian uji antimikroba pada matakuliah mikrobiologi. Jenis penelitian yang digunakan adalah penelitian dan pengembangan (<em>Research and Development</em>) dengan model pengembangan ADDIE. Subjek uji coba adalah mahasiswa S1 Universitas Negeri Malang yang telah menempuh matakuliah Mikrobiologi. Instrumen yang digunakan adalah angket validasi ahli materi dan media serta angket keterbacaan untuk mahasiswa. Persentase hasil dari validasi ahli materi adalah 95%, validasi ahli media adalah 98% dan uji keterbacaan adalah 88%. Berdasarkan hasil tersebut dapat disimpulkan bahwa e-modul berbasis penelitian uji antimikroba valid dan layak digunakan sebagai bahan ajar pada matakuliah mikrobiologi.

FORMULATION DOSAGE FORM OF TABLET CONTAINING KEPEL LEAF EXTRACT (Stelechocarpus burahol (Blume) Hook.f & Thomson) AS AN ANTIMICROBIAL AGENTS

Pharmaceutical dosage form that contains herbal materials has been developed in order to make it easy to consume. Tablet is one of pharmaceutical dosage form that generally used. A formulation and antimicrobial test of tablet containing extract of Kepel leaf with different concentration of diluents, binders, and disintegrants has been studied. The evaluation test showed that formulation consist of 25 % of Kepel leaf extract, 64.5 % of avicel PH 102, 2 % of PVP, 7 % of amprotab, 0.5 % of aerosil, and 1 % of talcum are better than the others. The experimental method used in this study was wet granulation. From the result of the mass granulation evaluation, it was obtain that speed flow without vibration was 2.53 second, with vibration was 2.83 second, bulk density was 0.329 g/mL, taped density was 0.376 g/mL and compressibility was 12.65 %. The result of tablet evaluation obtained that the average weight was 498 mg, with the average hardness was 4 kg/cm2 and disintegration time was 2.36 minutes. Antimicrobial test showed that in the concentration of 50 mg/mL, had average inhibitory diameter against S. aureus of 12.96 mm, P. aeruginosa 12.7 mm, and against B. subtilis was 12.53 mm. Whereas, concentration of 62.5 mg/mL had average inhibitory diameter against S. aureus was 13.5 mm, P. aeruginosa was 13.56 mm, and against B. subtilis was 13.43 mm. Both concentrations did not have antimicrobial activity against E.coli.

General Considerations on Antimicrobial Tests and Conditions Applicable in Textile Industry

Due to the globally increasing need for utilizing antimicrobial materials, it is necessary to improve and develop newer methods and techniques for determining the antimicrobial properties of these materials qualitatively and quantitatively, especially in the medical field. Recently there has been a debate among scientists between the difference between antimicrobial test and sterility test. For antimicrobial and microbial resistance, the test is limited to the standard methods to determine the effect of the sample as an antimicrobial without paying attention to the fact that the sample is sterile or not, unless the sample was taken into sterile atmosphere and isolated with a protective suitable sterile package cover after treatment with the antimicrobial agent because the external atmosphere contains a lot of scattered types of bacterial and fungal microorganisms. In case of sterility test, the sample to be examined should be prepared, isolated and coated from the outside atmosphere, where the presence of microbes on the surface of the sample by standard methods is detected and in some sterilization tests it is prohibited to include an antimicrobial substance to the sample to be tested to avoid the interference with the test. In both cases the tests should be implemented in a sterilized room and conditions according to the recognized scientific principles. In conclusions, the antimicrobial test is used to make sure that the specimen is attained antimicrobial properties or not and the sterilization test is done by ensuring that the sample is free of contaminated microorganisms. This review poses on some factor and conditions affecting antimicrobial action and some standard test methods for determination of antimicrobial and sterility potential of materials.