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All Journal Jurnal Kedokteran Brawijaya Malang Respiratory Journal
Bet, Anwar
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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Peningkatan Rasionalitas Penggunaan Antibiotik Pasca Implementasi Kebijakan Penggunaan Antimikroba di RSUD Arifin Achmad Pekanbaru Rosdiana, Dani; Anggraini, Dewi; Balmas, Mukhyarjon; Effendi, Dasril; Bet, Anwar
Jurnal Kedokteran Brawijaya Vol 30, No. 1 (2018)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2018.030.01.7

Abstract

Ancaman global permasalahan resistensi antibiotik membutuhkan strategi pencegahan yang mencakup penggunaan antibiotik secara bijak melalui pengawasan penggunaan antimikroba. Penggunaan antibiotik harus memenuhi beberapa kriteria seperti indikasi, dosis, lama pemakaian, jarak pemberian yang tepat, serta aman dan terjangkau bagi masyarakat, dan juga memenuhi pola mikroba dan kultur. Pada penelitian ini dilakukan analisis rasionalitas penggunaan antibiotik di Bangsal Kenanga RSUD Arifin Achmad Pekanbaru setelah implementasi kebijakan penggunaan antimikroba pada periode Maret hingga Agustus 2016. Terdapat 252 penggunaan antibiotik yang terbagi menjadi dua kelompok, yaitu pre-implementasi sebanyak 92 dan pasca-implementasi sebanyak 160 penggunaan antibiotik. Rasionalitas penggunaan antibiotik dinilai dengan metode Gyssens yang dilakukan oleh tim pengkaji. Penggunaan antibiotik rasional meningkat sebanyak 15,1%, penggunaan antibiotik tanpa indikasi menurun sebanyak 10,9% dan terdapat peningkatan pemeriksaan kultur sebanyak 57,7%. Berdasarkan uji statistik, terdapat peningkatan bermakna rasionalitas penggunaan antibiotik setelah implementasi pedoman penggunaan antibiotik (33,7% vs 48,8%, p=0,020), dan penurunan penggunaan antibiotik tanpa indikasi (27,2% vs 16,3%, p=0,038). Penerapan kebijakan penggunaan antimikroba efektif meningkatkan rasionalitas penggunaan antibiotik. Program ini dapat diperluas di bangsal lain sehingga rasionalitas penggunaan antibiotik merata di seluruh rumah sakit.
Overlapping of Intestinal Tuberculosis with Typhoid Fever as Initial Diagnosis: A Case Report Simatupang, Elvando Tunggul Mauliate; Simbolon, Rohani Lasmaria; Bet, Anwar; Makmur, Andreas; Simatupang, Elcia
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.03

Abstract

Background: Extrapulmonary Tuberculosis (ETB) cases have increased to 20-30% of all Pulmonary Tuberculosis (PTB) cases, including Intestinal Tuberculosis (ITB). Overlap between ITB and Typhoid Fever (TF) leads to Diagnostic Delays in ITB. Endoscopic and histopathological examinations are needed as diagnostic support, so comprehensive examination and clinical evaluation are necessary. Accurate diagnosis and management will have significant implications for patient survival. Case: A 23-year-old male patient complained of shortness of breath for three weeks. Previously fever, night shivering, loss of appetite, and weight loss were also experienced. A history of previous hospitalization involving abdominal colic complaints, the patient should be hospitalized twice. Repeated administration of antibiotics with TF diagnosis did not show any clinical improvement. The suspicion of ITB was proven after obtaining positive results from Genexpert (GE) of Faeces and clinical response after Anti Tuberculosis Drugs (ATD) administration. Overall, there were clinical, laboratory and radiological improvements in patients with clinical abdominal colic and fever experienced in the last 2 months. Conclusion: Challenge ATD delivery and GE of Faeces can be used as an indicator of suspects ITB so overlap between ITB and TF can be predicted. A comparative diagnostic study of abdominal colic and recurrent fever should also be extended so that it can be continued with several diagnostic support.
Co-Authors Andreas Makmur, Andreas Dani Rosdiana Dewi Anggraini Effendi, Dasril Mukhyarjon Rohani Lasmaria Simbolon, Rohani Lasmaria Simatupang, Elcia Simatupang, Elvando Tunggul Mauliate