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All Journal Media Kesehatan Masyarakat Indonesia Pharmaciana: Jurnal Kefarmasian Jurnal Farmasi Klinik Indonesia Journal of Health Science and Prevention JSFK (Jurnal Sains Farmasi & Klinis) Jurnal Ilmu Kefarmasian Indonesia

Setiawan, Eko

Center For Medicine Information And Pharmaceutical Care (CMIPC), Faculty Of Pharmacy, Universitas Surabaya

Author-ID : 2476703

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

Published : 8 Documents Claim Missing Document

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Articles

Analysis of the utilization and cost of antibiotics at an intensive care unit in Surabaya Setiawan, Eko; Felix, Hidayat; Setiadi, Adji Prayitno
Pharmaciana Vol 7, No 2 (2017): Pharmaciana
Publisher : Universitas Ahmad Dahlan

The appropriateness of antibiotic utilization including the compatibility when it was mixed with other pharmaceutical products are important factors determining the effectiveness and cost of antibiotics treatment among patients admitted to the intensive care unit (ICU). The aim of this research was to figure out the antibiotics utilization, appropriateness, cost, and compatibility profile given to the inpatients of the intensive care unit in one hospital in Surabaya during November-December 2015. This research was prospective observational study using medical records as source of information. All patientsâ data receiving antibiotics that met the inclusion and exclusion criteria was collected and analyzed descriptively. There were 42 patients participated in this research. Analysis of antibiotic utilization profile revealed 46 usage (65.71%) of single antibiotics and 24 usage (34.29%) of combination antibiotics. The most frequently used of antibiotic in single usage was ceftriaxone (43.48%) while in combination were ceftazidime and levofloxacin (12.50%). There were 30 antibiotics treatment changes that 43.34% was classified as escalation process and there was no (0%) any switching from intravenous to oral therapy. Only 4 out of 15 patients with infection related diagnosis (26.67%) got appropriate antibiotic treatment. Moreover, result from compatibility analysis found that 13.96% admixtures between antibiotics and other intravenous pharmaceutical products did not have clear compatibility status. The average of antibiotic cost per-patient was Rp. 459.492 (min-max: Rp 15.852,- to Rp 8.314.914,-).

Analisis Perilaku dan Faktor Penyebab Perilaku Penggunaan Antibiotik Tanpa Resep di Surabaya Dewi Paskalia Andi Djawaria; Adji Prayitno Setiadi; Eko Setiawan
Media Kesehatan Masyarakat Indonesia Vol. 14 No. 4: DESEMBER 2018
Publisher : Faculty of Public Health, Hasanuddin University, Makassar

There is limited information regarding the behavior and determinant factors of non-prescribed use of antibioticsinSurabaya. The purpose of this study was to identify the behavior and the most influential factors in usingantibiotics without prescription. This was a cross sectional studyconducted insubjects who bought antibiotics withoutprescription in 90 pharmacies in Surabaya during December 2014-April 2015. Eight complex questions wereused to identify the behavior. The contributing factors of non-prescription behavior were identified by using twostatistical methods, including: descriptive analysis by comparing the mean of the questions in each factor theme,and factor analysis using orthogonal rotation (varimax). There were 267 respondents involved in this study. Themajority of respondents who bought antibiotics without prescription ranged from age 21-30 years old (36.33%),frequency buying antibiotics 1/month (45.70%), intended for themselves (56.55%), buying antibiotics soon afterthe symptoms appeared (33.70%), and intended for runny nose/flu indication (21.30%). Based on the descriptivestatistic, the theme “aspects that encourage” was found as the factor contributed to the use of antibiotics withoutprescription. The value of cumulative percent total variance found in the factor analysis method explained was48.03%, with the biggest value on the first factor that was 23.91%. The most influential factor was the ease of accessto get the antibiotics and the saving of money. The results of this study can be used to determine the appropriateintervention to deal with the use of antibiotics without prescription in the pharmacies.Considering the complexcauses of such behavior, pharmacist should not be blamed as the only cause of non-prescribed use of antibiotics.

Penggunaan Antibakteri Golongan Carbapenem pada Pasien Dewasa Rawat Inap Sebuah Rumah Sakit Swasta di Surabaya Steven V. Halim; Rika Yulia; Eko Setiawan
Indonesian Journal of Clinical Pharmacy Vol 6, No 4 (2017)
Publisher : Universitas Padjadjaran

Kasus resistensi terhadap carbapenem merupakan salah satu masalah kesehatan global. Penggunaan yang tidak bertanggung jawab secara luas, berulang, dan dalam jangka waktu yang panjang merupakan faktor yang menentukan terjadinya fenomena tersebut. Tujuan penelitian ini adalah memberikan gambaran penggunaan dan kesesuaian penggunaan carbapenem untuk beberapa penyakit infeksi pada sebuah rumah sakit swasta di Surabaya. Penelitian ini merupakan penelitian deskriptif dengan menggunakan data rekam medis pasien dewasa yang mendapatkan carbapenem selama periode Januari 2014–September 2014 sebagai bahan penelitian. Penggunaan carbapenem dinyatakan dalam defined daily dose (DDD). Proses analisis kesesuaian jenis, dosis, dan durasi pemberian antibiotik dilakukan dengan menggunakan pedoman terapi Infectious Disease Society of America (IDSA) terbaru sebagai pustaka utama dan Drug Information Handbook edisi 22 sebagai pustaka pendukung. Kesesuaian jenis antibiotik dibandingkan dengan hasil kultur juga dianalisis dalam penelitian ini. Sebanyak 255 data rekam medis pasien dewasa dianalisis dalam penelitian ini. Total penggunaan carbapenem selama periode pengamatan sebesar 1462,25 DDD. Densitas penggunaan carbapenem dapat diklasifikasikan rendah yaitu hampir 20% dari total pasien rawat inap per hari mendapat carbapenem (19,39 DDD/100 bed-days). Sebagian besar penggunaan carbapenem diberikan secara IV bolus. Terdapat 72,95% dan 59,52% penggunaan carbapenem yang dinyatakan sesuai berdasarkan analisis dengan menggunakan pedoman terapi dan hasil kultur, secara berturut-turut. Dengan mempertimbangkan profil penggunaan tersebut, carbapenem perlu digunakan secara lebih bertanggung jawab. Penelitian terkait profil resistensi patogen terhadap golongan carbapenem perlu dilakukan sebagai bahan evaluasi pengambilan kebijakan terkait penggunaan antibakteri golongan tersebut.Kata kunci: Carbapenem, DDD, defined daily dose, drug utilization review Carbapenem Utilization among Adults Inpatients in One Private Hospital in SurabayaCarbapenem resistance is one of the most frightening health problems globally. What determines the occurrence of carbapenem resistance phenomenon is the widely, repeated, irresponsible utilization of carbapenem over a long period of time. This research was aimed to provide an overview of the carbapenem utilization and its appropriateness compared with the guidelines. This research was a descriptive research that analyzed medical record data of adult patients who used carbapenem from January to September 2014 in one private hospital in Surabaya. The carbapenem utilization was defined in defined daily dose (DDD). Identifying the appropriateness of antibiotics’ type, dosage regimen, and duration of treatment were conducted by using the newest Infectious Disease Society of America (IDSA) guidelines as the main reference and Drug Infomation Handbook 22th edition (2014) as the secondary reference. Moreover, the appropriateness of type of antibiotics used for each patient was also analyzed by comparing the actual dosage used with the microbiology culture results. There were 255 adult patient’s medical records used in the present research. The total amount of carbapenem utilization during the observation period was 1462.25 DDD. The density of carbapenem utilization could be considered as low, i.e. almost 20% of total inpatients per day being prescribed with carbapenem (19.39 DDD/100 bed-days). There were 72.95% and 59.52% carbapenem utilization which were defined appropriate based on the analysis using IDSA guidelines and bacteria culture results respectively. Considering the profile of antibiotics utilization in this hospital, the antibiotics prescribing pattern could be improved to a more responsible pattern. Further researches exploring the relationship between pathogen resistance and carbapenem consumption need to be conducted in relation to the consideration in making local hospital regulation regarding the use of antibiotics in the hospital settings.Keywords: Carbapenem, DDD, defined daily dose, drug utilization review

Tata Laksana Terapi Pasien dengan COVID-19: Sebuah Kajian Naratif Adji P. Setiadi; Yosi I. Wibowo; Steven V. Halim; Cecilia Brata; Bobby Presley; Eko Setiawan
Indonesian Journal of Clinical Pharmacy Vol 9, No 1 (2020)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2020.9.1.70

Kasus pneumonia yang disebabkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) yang disebut coronavirus diseases 2019 (COVID-19) oleh World Health Organization (WHO) merupakan sebuah tragedi dalam dunia kesehatan secara global. Tata laksana yang tepat dan cepat diharapkan dapat menyelamatkan nyawa pasien. Sampai tulisan ini dibuat, belum terdapat satu jenis obat yang secara resmi diizinkan penggunaannya untuk terapi COVID-19. Kajian literatur ini bertujuan untuk 1) memaparkan tata laksana pengobatan dan 2) mendaftar serta menjelaskan alternatif obat yang dapat digunakan untuk SARS-CoV-2. Proses penelusuran artikel dalam kajian pustaka ini dilakukan pada sebuah database, yakni PubMed dengan kombinasi kata kunci ((“corona virus”) OR (“covid-19”) OR (“SARS-CoV-2”)) AND ((“treatment”) OR (“therapy”)). Hasil kajian ini menunjukkan bahwa tata laksana pasien dengan COVID-19 dapat berbeda antar-setting dan negara dengan mempertimbangkan ketersediaan sumber daya, khususnya obat. Pedoman terapi WHO dan pedoman di Indonesia saat ini merekomendasikan supportive therapy untuk penanganan COVID-19, antara lain: terapi untuk gejala yang terjadi, pemberian oksigen, penggunaan antibiotik, terapi cairan, penggunaan vasopresor, dan tindakan medis (termasuk pemasangan ventilator) untuk menyelamatkan nyawa pasien. Belum terdapat obat khusus yang direkomendasikan untuk menekan replikasi SARS-CoV-2. Beberapa jenis obat yang potensial bermanfaat untuk SARS-CoV-2 antara lain: klorokuin atau hidroksiklorokuin, arbidol, ribavirin, favipiravir, lopinavir/ritonavir, remdesivir, oseltamivir, dan interferon. Namun sampai dengan tulisan ini dibuat, terdapat keterbatasan bukti penelitian dengan desain yang baik yang dapat digunakan untuk menarik kesimpulan terkait superioritas suatu jenis obat tertentu dibandingkan dengan alternatif yang lain. Dalam kondisi menunggu hasil penelitian dengan desain penelitian yang baik, penggunaan obat yang memiliki bukti efektivitas (walaupun belum baik) atau diduga efektif, perlu dioptimalkan untuk menyelamatkan nyawa pasien, khususnya mereka yang dalam kondisi parah.Kata kunci: COVID-19, tata laksana, terapi Therapeutic Management of Patients with COVID-19: A Narrative ReviewAbstractPneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—named coronavirus diseases 2019 (COVID-19) by World Health Organization (WHO)—has been a global public health emergency. Timely and effective therapeutic strategies are of importance in saving patients’ lives. However up to now, there is no specific treatment approved for COVID-19. This review aimed 1) to describe the available therapeutic strategies, and 2) to explore options of medications that can be used to treat COVID-19. A search strategy using keywords ((“corona virus”) OR (“covid-19”) OR (“SARS-CoV-2”)) AND ((“treatment”) OR (“therapy”)) was conducted in PubMed database. The review showed that treatment strategies could be different between settings and/or countries considering the availability of resources, particularly medications. The current WHO as well as the Indonesian guidelines mainly recommended supportive therapy to treat COVID-19, including: symptomatic care, oxygen therapy, antibiotics, fluid therapy, vasopressors, and taking medical interventions (including the use of ventilator). Studies conducted so far indicated the potential benefits of some medications, including chloroquine/hydrochloroquine, arbidol, ribavirin, favipiravir, lopinavir/ritonavir, remdesivir, oseltamivir, and interferon; however, the evidences available have been limited and not strong enough to recommend any specific medication for COVID-19. While waiting for quality evidences, optimising the use of medications—reported to have some levels of effectiveness—could be the current best option to save patients, especially those who are critically ill.Keywords: COVID, medication, therapeutic management

Profil Kompatibilitas Sediaan Obat Intravena dengan Pelarut pada Pasien Intensive Care Unit Sharly Dwijayanti; Sylvi Irawati; Eko Setiawan
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Kompatibilitas merupakan salah satu faktor penentu kualitas sediaan intravena (IV) yang berdampak pada keberhasilan terapi pasien Intensive Care Unit (ICU). Tujuan penelitian ini adalah mengidentifikasi profil kompatibilitas dan inkompatibilitas sediaan obat IV yang diberikan kepada pasien ICU. Penelitian observasional ini dilakukan secara prospektif pada pasien di ICU sebuah rumah sakit swasta Surabaya selama periode Oktober–Desember 2014. Pada penelitian ini, data pencampuran obat IV dengan pelarutnya dibandingkan dengan menggunakan brosur sediaan dan Handbook on Injectable Drugs Edisi 17 (2013) sebagai acuan untuk menganalisis kompatibilitas sediaan IV. Campuran antara obat IV dan pelarutnya diklasifikasikan sebagai campuran yang kompatibel, inkompatibel, no information (NI), not applicable (NA), dan not clear (NC) dengan menggunakan kriteria tertentu. Hasil penelitian menunjukkan terdapat 1.186 pencampuran antara senyawa obat IV dengan pelarut dari total 39 pasien ICU yang diamati. Tidak ditemukan pencampuran antara senyawa obat dengan pelarut yang inkompatibel, baik pada pasien dewasa maupun anak. Sebagian besar senyawa obat dicampur dengan pelarut yang kompatibel (dewasa: 72,31%; anak: 69,84%). Akan tetapi, berdasarkan 3 pustaka rujukan untuk kasus kompatibilitas sediaan IV yang digunakan dalam penelitian ini, masih terdapat campuran antara senyawa obat dengan pelarut yang belum diketahui informasi kompatibilitasnya sehingga diklasifikasikan sebagai NI (dewasa: 19,68%; anak: 30,16%). Sebagian kecil dari pencampuran senyawa obat IV dengan pelarutnya, diklasifikasikan sebagai NA dan NC, yaitu sebesar 7,48% dan 0,53%, secara berturut-turut. Terbatasnya informasi terkait kompatibilitas dan stabilitas sediaan IV tersebut mendorong dilakukannya pemantauan kondisi pasien dan kadar obat secara berkesinambungan.Kata kunci: Campuran intravena, ICU, kompatibilitas Profile of Intravenous Admixture Compatibility in The Intensive Care Unit (ICU) Patients Compatibility is one of the important factors determining the quality of intravenous (IV) admixtures which may directly impact to the outcome of treatment to the Intensive Care Unit (ICU) patients. The objective of this study was to identify the profile of compatibility and incompatibility among IV admixtures given to the ICU patients. This observational research was conducted prospectively to the patients admitted in the ICU at a private hospital in Surabaya from October–December 2014. In this research, compatibility data of IV drug and its solution was compared with drug brochure and Handbook on Injectable Drugs 17th ed (2013) as references to analyze the compatibility of IV admixtures. The admixture between IV drug and its solvent was classified as compatible, incompatible, no information (NI), not applicable (NA), and not clear (NC), using a specific criteria. There were 1.186 IV drug‑solvent admixtures observed in 39 ICU patients. There were no IV drug-solvent admixtures classified as incompatible in both adult and child patients. Most of IV drugs were admixed with compatible solvents (adults: 72.31%; children: 69.84%). However, according to two of IV drugs compatibility references used in this research, there were some IV drug-solvent admixtures with unknown information about its compatibility that were classified as NI (adults: 19.68%; children: 30.16%). There were a few of IV drug-solvent admixtures classified as NA and NC, of 7.48% and 0.53%, respectively. The lack of information related to compatibility and stability of the IV admixtures emphasize the importance to continually monitor patients’ condition and drug concentration.Key words: Compatibility, ICU, intravenous admixture

PENGEMBANGAN DAN VALIDASI KUESIONER UNTUK MENGIDENTIFIKASI FAKTOR PENYEBAB PERILAKU PENGGUNAAN ANTIBIOTIK TANPA RESEP DOKTER Eko Setiawan; Dewi Paskalia Andi Djawaria; Adji Prayitno
JURNAL ILMU KEFARMASIAN INDONESIA Vol 16 No 1 (2018): JIFI
Publisher : Fakultas Farmasi Universitas Pancasila

Factors attributing to the behavior of non-prescription used of antibiotics in Indonesia setting have not been identified yet. The availability of effective and efficient instrument or method to identify the attributing factors might be the cause of non-optimal identifying process. The objective of present study was to develop instrument, i.e questionnaire, to identify factors contributing to the behavior of non-prescription used of antibiotics. The questionnaire was developed based on factors identified on published scientific literatures. Face and content validity were conducted by having the experts’ judgement, while the construct validity was conducted by using the Spearman Correlation Test. Reliability was tested by using Cronbach’s alpha test. There were 14 rating and 8 multiple answer questions in the questionnaire that could be classified unto 5 domains. After conducting the validity and reliability test, the final questionnaire had a R value 0.276-0.628 and Cronbach’s alpha 0.833. This valid and reliable questionnaire could be used to portray the attributing factors of non-prescription used of antibiotics in larger area, therefore, the most appropriate intervention could be planeed based on the identified factors.

Quantitative Analysis of Medication Management and Use in Bima Regional Public Hospital Sirajudin; Adji Prayitno Setiadi; Yosi Irawati Wibowo; Eko Setiawan
Journal of Health Science and Prevention Vol. 5 No. 1 (2021): JHSP Vol 5 No 1 - 2021
Publisher : State Islamic University of Sunan Ampel

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29080/jhsp.v5i1.390

Banyaknya jumlah obat-obatan di rumah sakit seringkali meningkatkan risiko ketidaktepatan dalam manajemen persediaan farmasi, oleh karena itu, perlu dilakukan studi pengelolaan dan penggunaannya. Penelitian ini dimaksudkan untuk mengkaji efektivitas pengelolaan dan penggunaan obat di Bima, Nusa Tenggara Barat. Adapun metode penelitian ini bersifat observasional retrospektif. Analisa data dilakukan secara deskriptif. Evaluasi pengelolaan dilakukan pada tahap perencanaan, pengadaan, penyimpanan dan pendistribusian, sedangkan evaluasi penggunaan dilakukan dengan menghitung DDD/100 patient-days untuk antibiotika yang paling banyak digunakan. Hasil penelitian pada evaluasi perencanaan, diperoleh tiga jenis obat pada matrik AV yaitu Ringer Lactat, Fentanil dan Tetagam; satu jenis obat vital pada Matrik BV, yaitu anti bisa ular; dan sembilan jenis obat pada matrik CV yaitu Aminophylline inj 24mg, Serum anti tetanus 1.500IU, Fenobarbital inj, Levosol inj, Magnesium sulfat inj 20%, Norepinefrin inj, Otsu D40, Otsu MgSO4 40, Pethidine 50mg/ml. Kesesuaian dana pengadaan obat 107,3% dan rerata ketepatan pengadaan 275%; terdapat 2 jenis obat rusak pada penyimpanan (0,476 %). Analisa DDD/100 patient-days untuk 12 injeksi antibiotika diperoleh total 45,44 DDD/100 patient-days. Kesimpulan: Hasil temuan pada penelitian ini memberikan gambaran informasi awal yang dapat digunakan untuk menyempurnakan praktek pengelolaan obat yang lebih efektif dan efisien di rumah sakit-rumah sakit khususnya di RSUD Bima di masa mendatang.The large number of medications circulating in hospitals may increase the risks of mismanagement of pharmaceutical inventory; hence studies on the management and use of medication are needed. This present study aims to analyse medication management and use in Bima Regional Public Hospital. This is a retrospective observational study, using descriptive data analysis. The analysis of medication management was conducted for the planning, procurement, storage and distribution stages; while the evaluation of medication use was done on antibiotic injections commonly prescribed using DDD/100 patient-days. The results showed that in the planning stage, three medications were in the AV category (i.e. Lactated Ringer’s Infusion, Fentanyl and Tetagam Inj.); one vital medication was in the BV category (i.e. anti-snake venom serum); and nine medications were in the CV category (i.e. Aminophylline Inj. 24mg, Anti-Tetanus Serum 1500 IU, Phenobarbital Inj., Levosol Inj., Magnesium Sulphate Inj. 20%, Norepinephrine Inj., OTSU D40 Infusion, OTSU MgSO4-40 Inj., Pethidine Inj. 50 mg/ml). The conformity of procurement funding was 107.3%, while the accuracy of procurement process (medication purchased/prescribed) was 275%; and there were two damaged products during storage (0.476 %). The evaluation of medication use for 12 antibiotic injections found a total 45.44 DDD/100 patient-days. The findings in this study provides a baseline data in optimising future practices of medication management and use in hospitals, especially in Bima Regional Public Hospital.

Persepsi Dokter tentang Strategi Antimicrobial Stewardship Program di Sebuah Rumah Sakit Umum di Surabaya Dian Kusuma Wardhani; Yosi Irawati Wibowo; Eko Setiawan
Jurnal Sains Farmasi & Klinis Vol 7, No 1 (2020): J Sains Farm Klin 7(1), April 2020
Publisher : Fakultas Farmasi Universitas Andalas

Antimicrobial Stewardship Program (ASP) dikembangkan untuk mengoptimalkan penggunaan antibiotik melalui implementasi kebijakan, strategi maupun pedoman. Penelitian ini bertujuan untuk mengkaji persepsi dokter terhadap ASP dan mengeksplorasi pilihan beserta pertimbangan pemilihan suatu jenis strategi ASP. Pendekatan kualitatif melalui wawancara dengan dokter yang aktif bekerja di sebuah rumah sakit umum di kota Surabaya dilakukan dengan bantuan panduan wawancara semi terstruktrur untuk mengeksplorasi: i) sikap terhadap implementasi ASP, dan ii) strategi ASP yang disarankan. Hasil wawancara diolah secara thematic analysis. Sebanyak 27 dokter bersedia terlibat. Secara umum, partisipan memiliki sikap yang baik terhadap implementasi ASP. Terdapat tiga tema terkait implementasi ASP, yaitu: 1) persetujuan implementasi sebagai konsekuensi dari bagian komunitas profesi di rumah sakit (RS); 2) relevansi implementasi bagi perbaikan kualitas RS, dan 3) tuntutan pemenuhan sumber daya sebelum diimplementasikan. Pembuatan pedoman terapi atau clinical pathway merupakan strategi yang paling banyak dipilih oleh partisipan. Pertimbangan dalam memilih suatu strategi adalah: 1) kesepakatan oleh komunitas RS; 2) practicability dan feasibility; dan 3) penggunaan bukti penelitian sebagai dasar penyusunan strategi. Penelitian ini memberikan gambaran mengenai persepsi dokter terkait dengan implementasi ASP. Diharapkan hasil penelitian ini dapat dijadikan sebagai salah satu acuan dalam merancang strategi ASP yang tepat dalam konteks RS di Indonesia.

Co-Authors Adji P. Setiadi Adji Prayitno Adji Prayitno Setiadi Adji Prayitno Setiadi Adji Prayitno Setiadi Andi Makkulawu Bobby Presley, Bobby Cecilia Brata Dewi Paskalia Andi Djawaria Dewi Paskalia Andi Djawaria Dian Kusuma Wardhani Dwi Lily Lukas Edy Sukandar Felix, Hidayat Ferdy Royland Marpaung Heru Wijono Jason Roberts Menino Osbert Costa Mohd-Hafiz Abdul-Aziz Rika Yulia Roni Kurniawan Setiadi, Adji Prayitno Sharly Dwijayanti Sirajudin Steven V. Halim Steven V. Halim Susaniwati Susaniwati Sylvi Irawati Tjipto Wibowo Tri Budi Wahyuni Rahardjo Wahyu Hendradi Warindra, Taufin Wibowo, Yosi Irawati Widyati Widyati Yosi I. Wibowo

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