Analisis Penggunaan Antibiotik Di Ruang Bedah Rumah Sakit Umum Daerah Dr. H. Abdul Moloek Provinsi Lampung Dengan Metode Defined Daily Dose Periode Januari-Maret Tahun 2018

ABSTRACT: ANALYSIS OF THE USE OF ANTIBIOTICS IN THE SURGERY ROOM OF THE REGIONAL GENERAL HOSPITAL H. ABDUL MOLOEK PROVINCE LAMPUNG WITH DEFINED DAILY DOSE METHOD OF JANUARY-MARCHPERIOD 2018Background: Antibiotics are chemicals produced by fungi and bacteria, which have the property of killing or inhibiting the growth of germs. In developed countries, 13-37% of all patients hospitalized receive antibiotics either alone or in combination, while in developing countries 30-80% of patients hospitalized receive antibiotics and irrational use of antibiotics is very common. both in developed and developing countries. Germicidal resistance to antibiotics, especially multi-drug resistance, is a problem that is difficult to overcome in the treatment of patients. This study aims to evaluate the use of antibiotics with the Defined Daily Dose method in patients in the surgical room of Dr. H. Abdul Moloek, Lampung Province. Method: This type of research is descriptive using a cross-sectional approach. The sample in this study was 72 medical records in the operating room, data were obtained from RSUD Dr. H. Abdul Moloek, Lampung Province, and carried out by assessing Defined Daily Dose. Results: The frequency distribution of patients in the male operating room who received antibiotic therapy was 72 patients with the largest age range being 18-30 years. The results of the study in the men's surgery room at the Dr, H. Abdul Moloek Regional Hospital showed that quantitatively the use of antibiotics with the Defined Daily Dose category was 570.5 with the antibiotic ceftriaxone (523) being the highest. And for DDD / 100 days of hospitalization as much as 112.6 with the highest ceftriaxone was 104.6 DDD / 100 days of hospitalization. Conclusion: It shows that quantitatively the use of antibiotics is most often prescribed in the Men's Surgery room at RSUD DR. H. Abdul Moeloek, Lampung Province, was Seftriaxone with 104.6 DDD / 100 days of hospitalization. Keywords: Analysis, Antibiotics, Method Defined Daily Dose. ABSTRAK: ANALISIS PENGGUNAAN ANTIBIOTIK DI RUANG BEDAH RUMAH SAKIT UMUM DAERAH DR. H. ABDUL MOLOEK PROVINSI LAMPUNG DENGAN METODE DEFINED DAILY DOSE PERIODE JANUARI-MARET TAHUN 2018Latar Belakang: Antibiotik adalah zat-zat kimia yang dihasilkan oleh fungi dan bakteri, yang memiliki khasiat mematikan atau menghambat pertumbuhan kuman. Di negara yang sudah maju 13-37% dari seluruh penderita yang dirawat di rumah sakit mendapatkan antibiotik baik secara tunggal atau kombinasi, sedangkan di negara berkembang 30-80% penderita yang dirawat di rumah sakit mendapatkan antibiotik dan penggunaan antibiotik yang tidak rasional sangat banyak dijumpai baik di negara maju maupun berkembang. Resistensi kuman terhadap antibiotik, terlebih lagi multi drug resistance merupakan masalah yang sulit diatasi dalam pengobatan pasien. Penelitian ini bertujuan untuk mengevaluasi penggunaan antibiotik dengan metode Defined Daily Dose pada pasien di Ruang Bedah RSUD Dr. H. Abdul Moloek Provinsi Lampung.Metode: Jenis penelitian ini adalah deskriptif dengan menggunakan pendekatan cross-sectional. Sampel pada penelitian ini sebanyak 72 catatan rekam medik di ruang bedah, data diperoleh dari RSUD Dr. H. Abdul Moloek Provinsi Lampung dan dilakukan dengan penilaian Defined Daily Dose.Hasil: Di dapatkan distribusi frekuensi pasien di ruang bedah laki-laki yang menerima terapi antibiotik adalah sebanyak 72 pasien dengan rentang usia yang terbanyak 18-30 tahun. Hasil penelitian di ruang bedah laki-laki di RSUD Dr, H. Abdul Moloek Provinsi Lampung menunjukkan bahwa secara kuantitatif penggunaan antibiotik dengan kategori Defined Daily Dose sebanyak 570,5 dengan antibiotik seftriakson (523) yang paling tinggi. Dan untuk DDD/100 hari rawat sebanyak 112,6 dengan pemberian seftriakson yang paling tinggi sebesar 104,6 DDD/100 hari rawat.Kesimpulan : Menunjukkan bahwa secara kuantitatif penggunaan antibiotik yang paling banyak di resepkan di ruang Bedah Laki-laki di RSUD DR. H. Abdul Moeloek Provinsi Lampungadalah Seftriakson sebesar 104,6 DDD/100 hari rawat.Kata kunci : Analisis, Antibiotik, Metode Defined Daily Dose.

Petunia Performance Under Application of Animal-Based Protein Hydrolysates: Effects on Visual Quality, Biomass, Nutrient Content, Root Morphology, and Gas Exchange

Sustainable plant production practices have been implemented to reduce the use of synthetic fertilizers and other agrochemicals. One way to reduce fertilizer use without negatively impacting plant nutrition is to enhance crop uptake of nutrients with biostimulants. As the effectiveness of a biostimulant can depend on the origin, species, dose, and application method, the aim of this research was to evaluate the effect of a commercial animal-based protein hydrolysate (PH) biostimulant on the visual quality, biomass, macronutrient content, root morphology, and leaf gas exchange of a petunia (Petunia × hybrida Hort. “red”) under preharvest conditions. Two treatments were compared: (a) three doses of an animal-based PH biostimulant: 0 (D0 = control), 0.1 (D0.1 = normal), and 0.2 g L–1 (D0.2 = high); (b) two biostimulant application methods: foliar spray and root drenching. The dose × method interaction effect of PH biostimulant on the plants was significant in terms of quality grade and fresh and dry biomass. The high dose applied as foliar spray produced petunias with extra-grade visual quality (number of flowers per plant 161, number of leaves per plant 450, and leaf area per plant 1,487 cm2) and a total aboveground dry weight of 35 g, shoots (+91%), flowers (+230%), and leaf fresh weight (+71%). P and K contents were higher than in untreated petunias, when plants were grown with D0.2 and foliar spray. With foliar spray at the two doses, SPAD showed a linear increase (+21.6 and +41.0%) with respect to untreated plants. The dose × method interaction effect of biostimulant application was significant for root length, projected and total root surface area, and number of root tips, forks, and crossings. Concerning leaf gas exchange parameters, applying the biostimulant at both doses as foliar spray resulted in a significant improvement in net photosynthesis (D0.1: 22.9 μmol CO2 m–2 s–1 and D0.2: 22.4 μmol CO2 m–2 s–1) and stomatal conductance (D0.1: 0.42 mmol H2O m–2 s–1 and D0.2: 0.39 mmol H2O m–2 s–1) compared to control. These results indicate that application of PH biostimulant at 0.2 g L–1 as foliar spray helped to achieve extra-grade plants and that this practice can be exploited in sustainable greenhouse conditions for commercial production of petunia.

RESIDU ANTIBIOTIK PADA SUSU KAMBING PE YANG MENDERITA MASTITIS SUBKLINIS DI DESA AIKMUAL LOMBOK TENGAH

Subclinical mastitis is a disease that often occurs in Etawa (PE) crossbreed goat farms. Farmers in handling this disease usually use antibiotics, giving antibiotics that are not right or according to the procedure can cause residues. The presence of antibiotic residues in goat's milk can have an impact on human health such as poisoning, allergies, and microbiological disorders. This study aims to determine the incidence rate and find the presence of antibiotic residues in the milk of Etawa Peranakan goat who suffer from subclinical mastitis in Aikmual Village, Central Lombok Regency. Test results from 6 samples of etawa-crossed goat milk (PE) suffering from subclinical mastitis using the Bioassay Screening Test method showed negative results containing antibiotic residues. Negative results in the sample are marked by the absence of dead bacteria on paper discs that have been soaked with milk samples from goats that are positive for subclinical mastitis, this is evident from the absence of inhibitory zones formed. The negative effect of this milk sample is due to several possibilities, namely: The stopping period of the drug has been reached and the antibiotics used are in accordance with the dose. The duration of the presence of antibiotics in milk depends on several factors, including: dose, method of administration and type of antibiotic. In general, it is applied that the withdrawal time of narrow spectrum antibiotics is at least 5 days after treatment, for the type of antibiotics that can form a depot (broad spectrum) has a withdrawal time of 1 3 days

The Phytochemical Screning and Assesment of Bioactivity of Pagoda Flower (Clerodendrum paniculatum L.) Using Brine Shrimp (Artemia salina) Lethality Assay

Objectives: The purpose of this study was to determine the bioactive content of the pagoda flower ethanol extract and measure its activity using the brine shrimp lethal dose method Design: The design of this study was qualitative and quantitative experimental, where bioactive compounds of pagoda flower ethanol extract was tested by qualitatitive chemical analisys and brine shrimp lethal dose method was quantitatively calculated the number of deaths. Interventions: The variable that was intervened in this study was the concentration of extract used. Main outcome measurre: The main measurement results in this study were to know the bioactive compounds contained in the extract and the value of Lethality Concentration 50% (LC50). Results: The results of phytochemical screening from the ethanol extract of pagoda flowers showed bioactive compounds such as alkaloids, flavonoids, steroids/triterpenoids, tannins, saponins, and glycosides. The value of LC50 in the toxicity test for artemia salina was 49.415 ppm. Conclusion: The pagoda flower ethanol extract contains alkaloid compounds, flavonoids, steroids/triterpenoids, tannins, saponins, and glycosides. Pagoda flower ethanol extract has strong potential activity.

11 Therapeutic Equivalences in Long-term Antipsychotics

Study ObjectivesThe concept of dose equivalence is very useful when it comes to using drugs. In the case of antipsychotics, the first comparison was established by Davis in 1974, called the classical comparison method. Subsequently, other methods have appeared, such as the minimum effective dose method, the dose response method, the consensus among experts such as consensus method by Gardner, and the Daily Dose method of the World Health Organization. In 2016, Leucht et al performed the meta-analysis comparing the equivalence by the alternative methods of second-generation antipsychotics orally, based on Olanzapine. However, therapeutic equivalences between injectable antipsychotics have not yet been made.The objective of the study is to establish a pattern of therapeutic equivalences between long-acting antipsychotics, based on the method of the Defined Daily Dose (DDD).MethodThe DDD is the dose of the maintenance medium of a drug for its main indication in adults of 70kg. In the case of antipsychotics, psychosis is the most important indication. DDDs are different for each route of administration, especially if the bioavailability of the drug varies between one route and another. To establish the DDD of a drug, 3 measures are taken: firstly, the dose ranges of the drug approved by at least 1 major regulatory authority. Secondly, doses used in clinical trials. Thirdly, post marketing data on dose used in clinical practice when the drug is commercialized. Depot formulations are usually assigned the same DDDs as the ordinary oral dosage form. Based on the DDD according to the WHO classification at http://www.whocc.no/.For comparison, Olanzapine 210mg was used as the main drug and equivalences were established from it. Therapeutic deposit of Aripiprazole (ARI), Flufenazine decanoate (FLU), Haloperidol Decanoate (HAL) Olanzapine pamoate (OLA), Paliperidone palmitate (PAL), Risperidone depot (RIS), and Zuclopenthixol decanoate (ZUC).ResultsThe results will be shown in a 8x8 table.ConclusionsDDD is available for almost all antipsychotics and is an accepted method as well as a clinical level as a researcher. They are based on a wide variety of data from different sources. Several studies have found a strong correlation between this method and other methods of equivalence. This method also has limitations. First, the DDDs were not established for the purpose of therapeutic equivalences. Secondly, the daily dose can be applied mainly to the efficacy of the drug, when the dose could cause some adverse effects.The establishment of therapeutic equivalences may help when a clinician needs to change one long-term antipsychotic. This could reduce psychotic relapses. It may enhance therapeutic adherence avoiding undesirable side effects. On the other hand, long-acting antipsychotics have corroborated the adherence and decrease of relapses, which is why it is increasingly used as a good alternative to oral drugs.