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Kualitas Penggunaan Antibiotik pada Pasien Community-Acquired Pneumonia di Salah Satu Rumah Sakit di Bali Meriyani, Herleeyana; Sanjaya, Dwi Arymbhi; Juanita, Rr. Asih; Siada, Nyoman Budiartha
Jurnal Ilmiah Medicamento Vol 10 No 1 (2024): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v10i1.7592

Abstract

Community-acquired pneumonia (CAP) is an infectious disease with high morbidity and mortality rates. Antibiotics are essential therapies for bacterial CAP. The use of antibiotics is a critical point in CAP treatment. Inappropriate use of antibiotics leads to antibiotic resistance. The study aimed to evaluate the proper use of antibiotics in CAP patients and identify the relationship between the appropriate use of antibiotics and the use of single/combined antibiotics with prolonged length of stay. This study was a cross-sectional study with retrospective data collection at a general hospital in Bali. Evaluation of the proper use of antibiotics was done using the Gyssens algorithm. The relationship between the appropriate use of antibiotics and the type of antibiotic (single/combined) with the length of stay was carried out using the Chi-square test with a 95% confidence interval. There were 151 CAP patients as samples in this study consisting of 55.63% men and 44.37% women with a median age of 60 years (18-89). The appropriate use of antibiotics was 17.88%, while 82.18% of the total antibiotic use was inappropriate. The Inappropriate use of antibiotics in category IIA (incorrect dosage) is 3.97%, category IIIB (inappropriate interval) is 4.64%, category IVC (cheaper alternative antibiotics were available) is 41.72%, and category V (no indication) is 37.79%. There is no significant relationship between the appropriate use of antibiotics and prolonged LOS [p>0.05; OR: 1.132 (CI: 0.466-2.746)] however the use of antibiotics (single or in combination) significantly affects the prolonged LOS [p<0.05; OR: 0.027 (CI: 0.004-0.204)].
Studi Retrospektif Penggunaan Antibiotik pada Pasien Covid-19 dengan Pneumonia di Rumah Sakit “X” Provinsi Bali, Indonesia Siada, Nyoman Budiartha; Juanita, Rr Asih; Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana
Jurnal Ilmiah Medicamento Vol 10 No 1 (2024): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v10i1.7637

Abstract

COVID-19 with bacterial pneumonia co-infection is a condition with bacteria present in COVID-19 patients. The prevalence of bacterial co-infection in COVID-19 patients ranges from 12.4%–50%. This study aims to determine the relationship between the appropriate use of antibiotics and the severity of inpatients with COVID-19 and pneumonia co-infection at Hospital "X" Bali Province, Indonesia. This research is an observational study with a cross-sectional approach. Data collection was carried out retrospectively on medical record data of COVID-19 inpatients with pneumonia co-infection at Hospital "X" Bali Province, Indonesia for the period January - December 2021. The sampling technique used total sampling according to inclusion and exclusion criteria. Appropriate use of antibiotics antibiotic was analyzed using Pharmaceutical Care Network Europe (PCNE) version 9.1. The patient severity index was an assessment based on the Pneumonia Severity Index (PSI) score. The relationship between the appropriate use of antibiotics and the severity of inpatients with COVID-19 and pneumonia co-infection was analyzed using Fisher's test. Of the 80 COVID-19 inpatients with pneumonia co-infection, 90% experienced inappropriate use of antibiotics. Fisher's test results showed that there was no significant relationship between the appropriate use of antibiotics and the severity of inpatients with COVID-19 and pneumonia co-infection at Hospital "X" Bali Province, Indonesia (p > 0.05).
Revitalisasi Kulit dengan Body Scrub Kulit Buah Naga Merah: Dampak Variasi Asam Stearat dan Perbandingan dengan Produk Komersial Suena, Ni Made Dharma Shantini; Juanita, Rr. Asih; Wardani, I Gusti Agung Ayu Kusuma; Antari, Ni Putu Udayana
Jurnal Ilmiah Medicamento Vol 10 No 2 (2024): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v10i2.9883

Abstract

The red dragon fruit peel (Hylocereus lemairei (Hook.) Britton & Rose) is rich in antioxidants like vitamins C, E, and A, along with alkaloids, terpenoids, flavonoids, saponins, and tannins, which protect against free radical damage. Despite its benefits, the peel is underused. This study compares the formulation and physical quality of a body scrub made from red dragon fruit peel extract to commercial products. Stearic acid was added to enhance consistency and stability, and commercial products served as benchmarks due to their compliance with physical, microbiological, and chemical standards. Formulations with stearic acid at 5% (F1), 10% (F2), and 15% (F3) were tested for physical quality—organoleptic properties, homogeneity, pH, adhesion, and spreadability—over 63 days as an intermediate time points, at controlled room temperature. Data were analyzed using SPSS Statistics 20 with a 95% confidence level (α = 0.05). Results showed that all formulations maintained a consistent pH of 6 and homogeneity. The adhesion properties were consistent across all formulas, showing no significant difference (p = 0.815; p > 0.05). In contrast, the spreadability exhibited a statistically significant difference between formulas (p = 0.001; p < 0.05). Stability tests revealed no significant differences in physical quality over time, indicating that the formulations remained stable. The body scrub formulated with red dragon fruit peel extract demonstrated stability and quality comparable to commercially available product. This ensures that the active ingredients in the body scrub remain potent, enabling them to effectively deliver their antioxidant properties to the skin.
Eribulin Effectiveness and Safety in Metastatic Triple-Negative Breast Cancer: A Narrative Review Meriyani, Herleeyana; Sanjaya, Dwi Arymbhi; Juanita, Rr. Asih; Siada, Nyoman Budiartha; Chusna, Nurul; Ketupapa, Florentina Gabriela
Borneo Journal of Pharmacy Vol. 8 No. 1 (2025): Borneo Journal of Pharmacy
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/bjop.v8i1.7913

Abstract

Triple-negative breast cancer is an aggressive and poor prognosis subtype of breast cancer. Eribulin has shown promise in the treatment of metastatic triple-negative breast cancer (mTNBC). This review aimed to provide a specific description, evidence, and discussion of the efficacy and safety of eribulin both as monotherapy and in combination with another agent in patients with mTNBC. The search was conducted in five databases (PubMed, ScienceDirect, PLoS One, Wiley Online Library, and Cochrane Library) towards published articles during the 2013-2023 period. A total of 237 articles were identified. After removing 69 duplicates, 168 articles underwent the screening process and 10 articles met the research criteria. Eribulin monotherapy effectiveness profile includes: overall survival (10.8-17.6 months), progression-free survival (2.8-3.2 months), partial response (21.0%-58.7%), progressive disease (15.5% -47.0%), and stable disease (28.8%-32%). However, there were no cases of complete response. Combination of eribulin with other agents' effectiveness profiles includes: overall survival (8.3-14.5 months), PFS (2.6-8.1 months), partial response (31.8-76.0%), complete response (2.4-8%), progressive disease (8.0-28%), and stable disease (8.0-52.3%). Eribulin monotherapy's safety profile is similar to that of combination therapy. No grade 5 adverse event was reported during monotherapy or in combination with other agents. The grade 4 adverse events reported are neutropenia, leukopenia, thrombocytopenia, anemia, peripheral neuropathy, fatigue, diarrhea, vomiting, dyspnea, back pain, arthralgia, febrile neutropenia, dyspnea, constipation, general physical health deterioration, alopecia. The all-grade adverse events with a percentage above 50% are neutropenia, leukopenia, thrombocytopenia, asthenia, alopecia, elevated AST, elevated ALT, hand-foot syndrome, fatigue, anemia, peripheral neuropathy, oral mucositis, and nausea.
Cross-resistance to antibiotics of Escherichia coli in the inpatient installation of general regional hospital “X” Bali, Indonesia Mahaputra, I Putu Yudistira; Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana; Juanita, Rr Asih; Siada, Nyoman Budiartha; Kamalia, Made Gek Adisti; Adrianta, Ketut Agus; Noviani, Lusy
Pharmaciana Vol. 15 No. 1 (2025): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v15i1.29209

Abstract

Escherichia coli (E. coli) is a critical-priority group of MDR bacteria and its spread can occur in hospital inpatient settings. Several studies showed that antibiotics consumption for inpatients can cause E. coli resistance to other antibiotics called cross-resistance. The aim of this study to determine the cross-resistance in E. coli to antibiotics in the inpatient installation of the regional general hospital "X" in Bali, Indonesia by analyzing the relationship between the antibiotic consumption and the percentage of antibiotic resistance of E. coli. This research is an ecological study with the independent variable is the antibiotics consumption defined as defined daily doses/100 bed-days and the dependent variable is the percentage of E. coli resistance during 2017-2020. The correlation between the level of antibiotic consumption and the percentage of E. coli resistance to antibiotics was analyzed using the Pearson correlation tests. The results showed that the consumption of tetracycline had a significant correlation with increased resistance of E. coli to meropenem and piperacillin-tazobactam (r=0.8-1.0; p<0.05). This showed that there is cross-resistance in E. coli. This incident is associated with selective pressure, horizontal and vertical gene transfer in E. coli. The consumption of tetracycline, apart from inducing the production of the tet gene which is the cause of resistance to tetracycline, can also induce the production of resistance genes to broad-spectrum beta-lactam antibiotics such as piperacillin-tazobactam and meropenem.
Efektivitas dan Efek Samping pada Terapi Multi-Drug-Resistant Tuberculosis (MDR-TB): Kajian Literatur Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana; Juanita, Rr. Asih; Siada, Nyoman Budiartha; Noviani, Lusy
Jurnal Ilmiah Medicamento Vol 11 No 1 (2025): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v11i1.9685

Abstract

Multi-drug-resistant tuberculosis (MDR-TB) leads to a reduced cure rate for tuberculosis treatment. The global number of MDR-TB cases remained relatively stable between 2015 and 2020 but increased in 2021. In 2020, the World Health Organization (WHO) estimated 437,000 MDR-TB cases worldwide, which rose to 450,000 cases in 2021. Various treatment regimens recommended by the WHO require a review of the literature on the efficacy and side effects of drug use in MDR-TB. This review aims to provide updated information that can be used as a reference for the early identification and management of side effects. The article was a narrative review that collected and analyzed information from various international articles on databases such as PubMed, PlosOne, and ScienceDirect from January 2014 to June 2024. A total of six relevant articles were synthesized from 609 articles. The effectiveness of MDR-TB therapy with WHO-recommended drugs has shown a high cure rate (cured>50%). The incidence of side effects in MDR-TB therapy is smaller compared to the effectiveness of treatment. However, a study conducted at Wuhan Jinyintan Hospital in China from July 2019 to December 2020 showed that all study subjects experienced side effects. This included nausea and vomiting from protionamide, gatifloxacin, and ethambutol; hyperuricemia from pyrazinamide, and hyperpigmentation from clofazimine. It is recommended that a therapy regimen be selected based on culture test results, patient conditions, and drug availability in each country.
Faktor-Faktor yang Mempengaruhi Lama Rawat Inap Pasien Dengue Hemorrhagic Fever di Salah Satu Rumah Sakit Umum Daerah di Bali Siada, Nyoman Budiartha; Juanita, Rr Asih
Jurnal Ilmiah Medicamento Vol 11 No 1 (2025): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v11i1.9852

Abstract

The World Health Organization (WHO) reported one to five million dengue infections from 2020 to 2022. According to Indonesian Health Profile data in 2020, the province of Bali had the highest Dengue Hemorrhagic Fever (DHF) Incidence Rate (IR), 273.1 morbidity, and a Case Fatality Rate (CFR) of 0.2%. The longer the patient's stay, the greater the costs are incurred for hospital treatment. Therefore, this study aims to analyze the factors influencing the length of stay of DHF patients with complications and comorbidities. This study was an observational study. Medical record data of DHF patients with complications and comorbidities were collected using a retrospective technique from January 2020 to December 2020 during hospitalization at a regional public hospital in Bali. The independent variables in this study include age, the severity of DHF, complications and comorbidities, and the amount of fluid therapy patients use during hospitalization. The dependent variable in this study is the patient's length of stay. The relationship between the independent and dependent variables was analyzed using logistic regression with a significance level set at p<0.05. There were 115 hospitalized DHF patients with complications and comorbidities, consisting of 52% males and 48% females. Most patients were in the age range of 6-11 years (43%). Based on the analysis that has been carried out, there is a factor that is significantly related to the length of stay of DHF patients, namely the use of the amount of fluid therapy (p=0.02). The findings of this study support the evaluation of DHF therapy, particularly in selecting the type and volume of fluids.
Penggunaan Antibiotik dan Resistensi Escherichia coli and Klebsiella pneumoniae: Studi Ekologikal Lima Tahun di Sebuah Rumah Sakit Umum Daerah Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana; Juanita, Rr. Asih; Siada, Nyoman Budiartha; Mahaputra, Yudistira; Kamalia, Made Gek Adisti
Jurnal Ilmiah Medicamento Vol 11 No 2 (2025): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v11i2.11156

Abstract

Antibiotic resistance is a growing global health threat, partly driven by high antibiotic consumption. The World Health Organization (WHO) has identified critical-priority bacteria, including Escherichia coli and Klebsiella pneumoniae, due to their increasing resistance to multiple antibiotics. This study aimed to evaluate the correlation between antibiotic consumption and resistance rates in Escherichia coli and Klebsiella pneumoniae. This ecological study was conducted at a Regional Hospital in Indonesia based on retrospective inpatient data from January 2019 to December 2023. The population in this study is all data on systemic antibiotic consumption based on the J01 category of the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) classification system and antibiogram from inpatient databases. Pearson and Spearman’s rank correlation analyses were performed to examine the associations between systemic antibiotic consumption levels and the percentage of Escherichia coli and Klebsiella pneumoniae resistance to other antibiotics. The most frequently used antibiotics were cefixime (305.664 DDD/100 bed-days), levofloxacin (139.552 DDD/100 bed-days), and ceftriaxone (109.805 DDD/100 bed-days). A strong and statistically significant correlation was observed between doxycycline consumption and Escherichia coli resistance to meropenem (r=0.894; p=0.041). Moreover, consumption levels of cefazolin, ceftazidime, cefepime, and ciprofloxacin were correlated with Escherichia coli resistance to ceftriaxone (p<0.05), while cefoperazone use demonstrated a very strong and statistically significant correlation with Escherichia coli resistance to ampicillin-sulbactam (r=0.952; p=0.012). Conversely, no significant correlation was found between antibiotic consumption and resistance in Klebsiella pneumoniae, suggesting that alternative factors such as intrinsic resistance mechanisms, mobile genetic elements, and environmental reservoirs may influence resistance development.
Formulasi Dan Uji Mutu Fisik Sediaan Foot Lotion Ekstrak Etanol Daun Sirih (Piper bettle L.) Dengan Variasi Konsentrasi Asam Stearat Juliadi, Debby; Juanita, Rr Asih; Dewi Agustini, Ni Putu
Usadha Vol 2 No 1 (2023): Usadha: Jurnal Integrasi Obat Tradisional
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/usadha.v2i1.6420

Abstract

Betel leaf extract (Piper bettle L.) is known to contain flavonoid compounds that have antibacterial activity. Betel leaf extract needs to be formulated as a foot preparation lotion to increase the comfort of use as a topical antibacterial. The composition of the emulsifier influences the physical stability of the preparation foot lotion used. This study aims to determine the variation of stearic acid preparations foot lotion, which has good physical quality and is stable in storage. This research is purely experimental laboratory research that aims at development (development), namely developing something in an existing field (development of test methods, drug formulation). The observed responses were the physical quality of the preparations, which included organoleptic tests, homogeneity tests, pH tests, spreadability tests, and adhesion tests. The physical quality of preparations of foot lotion was analyzed descriptively. This research began with a maceration process using 70% ethanol to obtain a thick betel leaf extract (Piper bettle L.). This study made three preparation formulas with foot lotion with stearic acid concentrations of 10%, 12.5%, and 15%. The preparations that have been made are then tested for their physical quality and stability during four weeks of storage. The results of this study indicate that the preparations obtained foot lotion betel leaf ethanol extract (Piper bettle L.) with a variation of stearic acid of 10% to produce preparations of foot lotion with good physical quality seen from organoleptic tests, homogeneity, pH, spreadability, and adhesion and stable in storage for four weeks.
Antibiotic consumption and resistance: a 3-years ecological study for four critical groups of bacteria in a general regional hospital Sanjaya, Dwi Arymbhi; Siada, Nyoman Budiartha; Juanita, Rr Asih; Mahaputra, I Putu Yudistira; Kamalia, Made Gek Adisti; Meriyani, Herleeyana
Pharmaciana Vol. 14 No. 1 (2024): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v14i1.27321

Abstract

Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae are the most critical groups of multi-drug resistant (MDR) bacteria that cause a threat in hospitals. This study identified the trend of antibiotic consumption, antibiotic resistance pattern, and the relationship between antibiotic consumption and antibiotic resistance in a critical group of bacteria in a general regional hospital. This ecological study was based on retrospective data from inpatient databases in a general regional hospital over three years (2017-2019). The trend for annual antibiotic consumption over 2017-2019 was defined as defined daily doses/100 bed-days. The relationship between total antibiotic consumption and the percentage of antibiotic resistance among four isolated critical bacteria was explored in time series analysis and linear regression. The most frequently used antibiotic was ampicillin (220.33 DDD/100 bed-days), ciprofloxacin (126.86 DDD/100 bed-days), and ampicillin-sulbactam (126.34 DDD/100 bed-days). There was a significant relationship between antibiotic consumption (ampicillin, ampicillin-sulbactam, ceftazidime, gentamicin, amikacin, and ciprofloxacin) in DDD/100 bed-days and antibiotic resistance in E. coli, K. pneumoniae, and P. aeruginosa (p<0.05) but not statically significant in A. baumannii (p=0.062). The annual usage fluctuated or remained stable, with no statistically significant trends change. The relationship between antibiotic consumption and antibiotic resistance was significant in three out of four critical groups of bacteria.