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Empirical Antibiotic Therapy Assessment of Patients diagnosed with Sepsis in Intermediate Care Ward of Internal Medicine Department of Dr. Soetomo General Hospital according to Gyssens Method Adiwinoto, Ronald Pratama; Sustini, Florentina; Hardiono, Hardiono; Widodo, Agung Dwi Wahyu; Hidajat, Boerhan; Hadi, Usman
Oceana Biomedicina Journal Vol 1, No 2 (2018): Oceana Biomedicina Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (546.601 KB) | DOI: 10.30649/obj.v1i2.17

Abstract

Rational empirical antimicrobial therapy is an important component of sepsis patient management. This study aimed to assess the rationality of empirical antimicrobial therapy in patients diagnosed with sepsis admitted in intermediate care ward of internal medicine department (RPI) of Dr. Soetomo General Hospital from January 2016 to July 2017. Medical records of 91 patients diagnosed with sepsis were collected and studied retrospectively in period from July 2017 to November 2017. 91 (85.05%) medical records from 107 sepsis patients were evaluated. Cultures and antimicrobial sensitivity tests were carried out in 21 (23.07%) patients. 14 patients yielded positive culture results, 9 of which were MDRO positive with ESBL as resistant marker. Empirical antibiotic therapies for these patients were reviewed according to Gyssens method.73 (80.2%) of 91 patients were deemed receiving appropriate empirical antibiotic therapies. Ceftriaxone IV injection as monotherapy or combination therapy were the most common empirical antibiotic therapies (82 in 91 patients, 90.1%), despite local microbiologic flora and antibiogram show most pathogens were resistant to ceftriaxone. Mortality rate in this study was high, 92.3% (84 patients died) despite rational empirical antibiotic therapies were high. This study concluded that empirical antibiotic therapies in sepsis patients according to guidelines adopted in Soetomo General Hospital, albeit deemed rational, was no longer appropriate according to local antibiogram issued by microbiological department of Soetomo General Hospital. Keywords: Empirical Antibiotics Therapy, Gyssens criteria, Intermediate Care Ward, Sepsis, Septic Shock
COMPARISON OF FOSFOMYCIN TROMETAMOL WITH CIPROFLOXACIN FOR UNCOMPLICATED UTI DUE TO E.COLI IN WOMEN budiono, heri; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Soebadi, Doddy M; Widodo, Agung Dwi Wahyu; Budiono, Budiono
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.96

Abstract

Objective: To compare clinical therapeutic effects (frequency, dysuria, and pyuria), microbiology, pharmacokinetics index Cmax/MIC Fosfomycin Trometamol 3 gr single dose with Ciprofloxacin 2 x 500 mg/12 hours for 5 days in the treatment of uncomplicated UTI in women due to Escherichia coli (E.Coli). Materials & Methods: Experimental observational design from February until July 2013. Twenty two women with uncomplicated UTI due to E.Coli performed clinical and microbiological examination. Pharmacokinetics index (Cmax/MIC) is looked for. Patients are divided 2 group, Ciprofloxacin 500 mg/12 hours 5 days and Fosfomycin Trometamol single dose. Repeat clinical and microbiological evaluation is performed in 7 days after therapy. Statistic analysis use Chi Square test, Paired T test, and Independent T test. Results: In the treatment of uncomplicated UTI in women, Fosfomycin Trometamol single dose therapy provides clinical cure (dysuria 81.2%, p = 0.338, frequency 90.9%, p = 0.004, pyuria 90.9%, p = 0.009) much better than Ciprofloxacin 500 mg/12 hours 5 days. Fosfomycin Trometamol single dose therapy also provides bacteriological eradication (100%) better than Ciprofloxacin 500 mg/12 hours 5 days (p = 0.035). Fosfomycin Trometamol single dose had a higher pharmacokinetics index (Cmax/MIC) compared to Ciprofloxacin 500 mg/12 hours (p = 0.035). Conclusion: Fosfomycin Trometamol single dose therapy is superior to Ciprofloxacin 500 mg/12 hours 5 days in the treatment of uncomplicated UTI in women. Keywords: Therapeutic effect, fosfomycin trometamol, ciprofloxacin, uncomplicated UTI, Escherichia coli.
In Vitro Antibacterial Activity of Waste Palm Cooking Oil Against Staphylococcus Aureus Fiqih Faizara Ustadi; Agung Dwi Wahyu Widodo; Yuani Setiawati
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17499

Abstract

Background: Staphylococcus aureus is a Gram-positive coccus which acts as a pathogen causing awide range of infectious diseases. In recent years, several strains of S. aureus have been found to showresistance to several antibiotics. Waste cooking oil may be considered as an alternative antibacterialproduct, as it contains long-chain fatty acids whose antibacterial effectiveness against S. aureus hasbeen known for years. In addition, oxidative biocides produced during the frying process have manytargets for antibacterial activity in the cell and affect almost every biomolecule. Nonetheless, there isno literature that is able to prove the antimicrobial effects of the waste palm cooking oil. Objective: Toexamine the in vitro antibacterial effect of waste palm cooking oil against S. aureus. Method: a twofoldserial dilution method to set the minimum level of both inhibitory and bactericidal concentrations.Conclusion: This study showed that waste palm cooking oil did not show antibacterial effects againstS. aureus, indicating that waste palm cooking oil is not possibly to be applied as an antibacterial agentagainst S. aureus.
Analysis of Staphylococcus aureus and Escherichia Coli and its Susceptibility to Antibiotic in Catheter-Associated Urinary Tract Infection Patients at Hospital in Province of West Nusa Tenggara BaiqIsti Hijriani; ManikRetno Wahyunitisari; Agung Dwi Wahyu Widodo
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 2 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i2.17945

Abstract

Objective – This study aimed to analyze the proportion of Staphylococcus aureus and Escherichia colifrom urine samples of catheter-associated urinary tract infections (CA-UTI) patients at the GeneralHospital at Province of West Nusa Tenggara. Also measured the pattern of sensitivity to severalantibiotics.Methods –This study is a descriptive observational with a cross-sectional approach. A total of 60 sampleswere used in this study. Bacterial identification was carried out according to standard bacteriologicalculture techniques. Furthermore, the antibiotic sensitivity test following the Kirby-Bauer disc diffusionmethod using several antibiotics, including amoxycillin (AMP), ciprofloxacin (CIP), ceftriaxone(CRO), and sulphamethoxazole trimethoprim (SXT).Results –The results showed that bacteria causing CA-UTI were Staphylococcus aureus (43.33%),Escherichia coli (21.67%), Staphylococcus epidermidis (10%), Proteus mirabilis (6.67%), Enterobacteraerogenes (6.67%), Serratica marcescens (5%), Klebsiella sp (3.33%), and Pseudomonas sp (3.33%).The antibiotic susceptibility test found that 4.58%, 11.25%, 9.16%, and 3% of bacteria were resistant toamoxycillin, ceftriaxone, ciprofloxacin, and sulphamethoxazole trimethoprim, respectively.Conclusion –Staphylococcus aureus and Escherichia coli were the most gram-positive and gramnegativebacteria causing CA-UTI, respectively. The most resistant antibiotic was ciprofloxacin, andthe most sensitive antibiotic is sulphamethoxazole trimethoprim.
Animal Models with Metabolic Syndrome Markers Induced by High Fat Diet and Fructose Larantika Hidayati; Agung Dwi Wahyu Widodo; Boerhan Hidayat
Medical Laboratory Technology Journal Vol. 6 No. 1 (2020): June
Publisher : Poltekkes Kemenkes Banjarmasin Jurusan Analis Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.048 KB) | DOI: 10.31964/mltj.v6i1.266

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Metabolic syndrome is lipid and non-lipid metabolism disorder due to the association of several factors such as physiological, clinical, biochemical, and interrelated factors. People with metabolic syndrome can be diagnosed by fulfilling 3 of 5 criteria, including obesity and increased waist circumference, increased TG levels, increased blood pressure, hyperglycemia, and increased High-Density Lipoprotein (HDL) serum. The high-fat diet disrupts tissue lipid metabolism, so insulin resistance occurs due to lipotoxicity. Besides, some studies use a combination of mixtures (fructose, sucrose) and fat-rich food components to build metabolic characteristics in mice that affect human characteristics. The purpose of this study was to make an animal model with a metabolic syndrome marker induced by the High Fat Diet (HFD) consisting of pork oil and chicken egg yolk, as well as fructose from simple and economical ingredients. This study was an experimental study using experimental animals of male Rattus norvegicus strain wistar, which were grouped into three random treatment groups, namely the control group, HFD group, and High Fat Diet Fructose (HFDF) group. The number of samples used was 27 rats, with nine rats in each group. The animal was induced for four weeks, then measured levels of FPG, HD, and TG. From the research that has been done, it is found that there are significant differences in levels of Fasting Plasma Glucose (FPG), High-Density Lipoprotein (HDL), and Triglycerides (TG) (p
The Ventilation-to-area Ratio and House Lighting Relate to the Incidence of Pulmonary Tuberculosis Adil Jihad Muhammad; Pudji Lestari; Agung Dwi Wahyu Widodo
Althea Medical Journal Vol 7, No 1 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1285.964 KB) | DOI: 10.15850/amj.v7n1.1821

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Background: Indonesia is one of the heavy burden countries with high pulmonary tuberculosis incidence in the world. The physical condition of houses is one of the environmental factors on how the infection spreads. The objective of this study was to provide supporting facts between the physical environment of the houses and the incidence of pulmonary tuberculosis.Methods: This was an observational analytic study with a case-control design, using checklists among pulmonary tuberculosis patients (n 32) and their healthy controls (n 32). Study subjects were chosen by simple random sampling. The study was performed from March to August 2019 at the Public Health Center (Pusat Kesehatan Masyarakat, Puskesmas) in Sawahan district, Surabaya. The incidence of pulmonary tuberculosis was related to various factors, including window existence, window opening habit, ventilation-to-area ratio, humidity, temperature, lighting, and occupancy density. The collected data were analyzed using the chi-square test to assess statistical significance with a p-value <0.05 was considered significantly related.Results: The ventilation-to-area ratio (p<0.05) and house lighting (p<0.00) were related to pulmonary tuberculosis incidence, whereas other factors such as window existence, window opening habit, temperature, and occupancy density were not.Conclusions: The ventilation-to-area ratio and house lighting have been proven to be related to pulmonary tuberculosis incidence. Government regulation on building permit needs to be encouraged to reduce the spreading and the incidence of pulmonary tuberculosis.
Effects of Prebiotics, Probiotics, and Synbiotics on the Bodyweight, Blood Glucose, Triglyceride and TNF-α of Diet-induced Obesity Rats Lenny Octavia; Soebagijo Adi Soelistijo; Agung Dwi Wahyu Widodo
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 2 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v4i2.4206

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Abstract  High-fat diet leads to obesity-associated chronic low-grade inflammation. Prebiotics, probiotics, and synbiotics produced short-chain fatty acids (SCFA), bonded to G protein-coupled receptors (GPR)-41 and GPR-43 decreased triglyceride deposits in adipocytes and liver, decreased fatty acid oxidation, increased glucose regulation and insulin sensitivity thus reduced the risk of obesity and metabolic syndrome. This study conducted in order to evaluate the effects of prebiotics, probiotics, and synbiotics on the body weight, blood glucose, triglyceride, and TNF-α used rats model, which were fed by a high-fat diet. Thirty-eight 6-8 weeks old male rats were fed by high-fat diet for three weeks, then rats were randomly divided into four groups, high-fat diet (HFD), a high fat diet with prebiotics supplementation (HFD+ PRE), a high fat diet with probiotics supplementation (HFD+PRO), and high-fat diet with synbiotics supplementation (HFD+SYN) for three weeks. Blood samples and body weight were measured at the third and sixth week. There was no effect of prebiotics, probiotics, and synbiotics on body weight, triglyceride levels, blood glucose, and TNF-α in rats fed a high-fat diet compared to control. These results suggested that supplementations gave inconsistent results with other studies and needed further researches.Keywords             : high fat diet, prebiotics, probiotics, synbiotics, meta-inflammationCorrespondence   : soebagijo@yahoo.com
Perbedaan Ekspresi Caspase 3 pada Limpa Tikus Model Sepsis yang Diinfeksi Escherichia coli ESBL dan dengan yang Diinfeksi Klebsiella pneumoniae Carbapenemase Lisa Savitri; Willy Sandhika; Agung Dwi Wahyu Widodo
Prosiding Seminar Nasional Multidisiplin Vol 2 No 1 (2019): Volume 2 No 1 Tahun 2019 (On Proses)
Publisher : KH. A. Wahab Hasbullah University

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Sepsis adalah suatu sindroma klinik yang terjadi karena adanya respon tubuh yang berlebihan terhadap rangsangan produk mikroorganisme. Pasien sepsis dengan infeksi bakteri penghasil ESBL 57,4% terinfeksi E. coli, 21,35% terinfeksi Enterobacter sp, dan 21,3% terinfeksi Klebsiella sp. Sepsis dapat diperberat oleh peningkatan kuman yang multiresisten terhadap bermacam antibiotik, seperti E. coli ESBL dan K. pneumoniae carbapenemase (KPC). Selama infeksi bakteri, faktor virulen diproduksi dan disekresikan dari patogen dan memicu sinyal apoptosis. Penelitian mengenai caspase 3 dianggap penting, karena caspase 3 merupakan efektor caspase terpenting yang bertanggungjawab atas morfologi dan perubahan biologis yang terlihat pada sel apoptosis. Jenis penelitian ini adalah true experimental dengan rancangan penelitian post test only control group design. Hasil penelitian menunjukkan bahwa ekspresi caspase 3 pada limpa mencit yang diinfeksi KPC adalah 65,25±12,69%, sedangkan yang diinfeksi E. coli ESBL adalah 33,75±3,862%, hal tersebut diduga karena adanya kapsul polisakarida yang mengelilingi KPC dan melindungi dirinya terhadap aksi fagositosis dan bakterisidal serum yang dapat dianggap sebagai penentu virulensi paling penting dari KPC dan menyebabkan mitokondria melepaskan ROS. Infeksi bakteri tersebut menyebabkan mitokondria memproduksi ROS dan memicu pelepasan sitokrom c. Sitokrom c akan memicu caspase 9 untuk berikatan dengan efektor caspase 3, sehingga terjadi apoptosis Kata kunci: Sepsis, ekspresi caspase 3, limpa tikus, Escherichia coli ESBL, Klebsiella pneumoniae carbapenemase
The Effect of Snakehead Fish (Channa striata) Extract on Inflammation Reaction of Skin Wound Tissue in Rattus novergicus Wistar Strain Nanda Amalia Ramadhanti; Willy Sandhika; Agung Dwi Wahyu Widodo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 1 (2021): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.1.2021.48-54

Abstract

Background: Snakehead fish has been associated with wound healing due to its high albumin content. Albumin can accelerate the inflammatory process so that tissue repair will be faster. Lack of albumin protein causes a person tend to experience prolonged wound healing. Purpose: This study aims to prove the effect of snakehead fish extract on the number of macrophages and blood vessels on the inflammatory reaction of skin wound tissue in rats. Methods: Laboratory experimental design with a total sample size of 27 male rats have undergone incisions, divided into 3 random groups: control group was given aquadest, treatment group 1was given aquadest and 50% extract of snakehead fish, and treatment group 2 was given 100% extract of snakehead fish. The rat’s skin wound tissues were taken on day 5 and observed under the microscope. The average number of macrophages and blood vessels on granulation tissue that formed at the base of the wound were counted and then performed data analysis. Result: In this study, we found a down wards trend in the average number of macrophages and blood vessels in treatment group 1 and treatment group 2. The control group and the treatment group 2 showed a significant difference, however, between the other groups did not show significant difference. Conclusion: There is a significant effect of giving 100% snakehead fish extract on decreased macrophages and blood vessels in the inflammatory reaction of skin wound tissue.
Mortality Comparison of Using Anti Interleukin-6 Therapy and Using Standard Treatment in Severe Covid-19 Jonathan Christianto Sutadji; Agung Dwi Wahyu Widodo; Danti Nur Indiastuti
Folia Medica Indonesiana Vol. 57 No. 2 (2021): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (860.076 KB) | DOI: 10.20473/fmi.v57i2.21929

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Severe Coronavirus Disease 19 (COVID-19) can cause serious lung inflammation and death. COVID-19 is characterized by a high mortality rate. This severity is associated with the overproduction of proinflammatory cytokines called "cytokine storms". One of the cytokines that play a central role is Interleukin-6 (IL-6). High IL-6 levels are associated with mortality. Expectedly, the IL-6 blockade could reduce cytokine storms and thus reduce deaths in severe COVID-19 patients. This systematic review aimed to summarize the comparison between mortality using anti-IL-6 therapy and mortality using standard treatment in severe COVID-19 patients. We systematically searched the PubMed, ScienceDirect, and ProQuest databases until 13 August 2020. After screening, twelve studies matched the inclusion criteria. The mortality of the anti-IL-6 therapy group was lower than the standard treatment group without anti-IL-6 therapy in COVID-19 patients in 10 of the 12 studies obtained. Four of the ten studies statistically found a significant difference in mortality of the anti-IL-6 therapy group and the standard treatment group. Confirmation of anti-IL-6 therapy effectiveness in reducing mortality in severe COVID-19 patients will require randomized controlled trials.