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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Impresi Indonesia Pharmaceutical Sciences and Research (PSR)
Wibowo, Tjipto
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Religion Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences

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Kajian Narrative terhadap Profil Farmakokinetik Antibiotik pada Pasien Kritis: Implikasi terhadap Ketercapaian Target Farmakokinetik-Farmakodinamik Setiawan, Eko; Widyati,; Marpaung, Ferdy Royland; Sukandar, Edy; Susaniwati,; Lukas, Dwi Lily; Wijono, Heru; Warindra, Taufin; Kurniawan, Roni; Wibowo, Tjipto; Hendradi, Wahyu; Costa, Menino Osbert; Aziz, Mohd-Hafiz Abdu; Roberts, Jason
Pharmaceutical Sciences and Research Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

The severity of diseases, the complexity of treatment, and the use of medical devices in the intensive care unit (ICU) may change the pharmacokinetics (PK) profile of antibiotics among critically ill patients.This narrative review aims to explain the PK profile of critically ill patients compared to other group of patients and to describe the pharmacokinetic-pharmacidynamic (PK-PD) target attainment among this group of patients. Only articles published less than 10 years ago were included in this narrative review. Evidences have indicated that critically ill patients have relatively larger volume distribution (Vd) of hydrophilic antibiotics compared to patients with stable conditions. The fluid shifting to interstitial space, hypoalbuminemia, and aggressive fluid treatment may contribute to the increase value of Vd in critically ill patients. The clearance (CL) of hydrophilic antibiotics in critically ill patients is highly determined by dynamic changing of renal function compared to patients in other wards. The phenomenon of augmented renal clearance and the use of high intensity of renal replacement therapy can increase the CL of hydrophilic antibiotics. The different PK profile of antibiotics may lead to the failure of attaining the PK-PD target if the dose of antibiotics is not adjusted according to such differences
Anosmia Sebagai Faktor Prediktor Derajat Keparahan Ringan Pada Penderita COVID-19 Rawat Inap di Rumah Sakit Primasatya Husada Citra Surabaya Hadi, Wiyono; Ernawati, Titiek; Novita, Bernadette; Wibowo, Tjipto; Supit, Vincentius Diamantino; Setiawan, Albert; Samsudin, Kevin; Erwin, Ferdinand
Majalah Kedokteran Indonesia Vol 71 No 2 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.2-2021-379

Abstract

Introduction: Anosmia is one of the clinical characteristics of COVID-19 patients. Anosmia was reported as the first symptom before other symptoms were discovered. Prior studies have shown anosmia implications as a favorable prognostic factor in COVID-19 patients. The research aim is to describe the characteristics of COVID-19 patients with anosmia and its correlation with disease severity.Methods: This study was a descriptive, cross-sectional, retrospective study with a total sample of 149 patients confirmed COVID-19. This research was conducted on hospitalized patients from March 1 to July 31, 2020, at the Primasatya Husada Citra Hospital Surabaya. Our study classified patients into two groups, with and without anosmia. The patient’s clinical characteristics were described in a table and odds ratio was calculated to determine the risk factors incidence of severe degree in COVID-19 patients.Results: The mean age of patients with anosmia was 32 years old, the patient’s gender was dominated with the female (63.2%). Patients with anosmia had lower severity, the odds ratio of having severe degree is 0.479. Patients with anosmia also had other symptoms such as cough, rhinorrhea, sore throat, tightness, headache, and muscle aches (p less than 0.05).Conclusion: COVID-19 patients with anosmia had lower severity than patients without anosmia.
Late-Onset Central Nervous System (CNS) Tuberculosis Presenting as Delirium in a Treated Pulmonary Tuberculosis Patient: A Ceftriaxone and Streptomycin Responsive Case Michael Willianto, Vincentius; Wibowo, Tjipto; Bajamal, Zaky; Dian Novita Dewi, Bernadette
Jurnal Impresi Indonesia Vol. 4 No. 11 (2025): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i11.7113

Abstract

Tuberculosis (TB) remains a major health burden in Indonesia. While pulmonary TB is common, extrapulmonary manifestations like tuberculous meningitis (TBM) are severe and diagnostically challenging. Standard oral anti-TB drugs often have poor central nervous system (CNS) penetration, which may lead to treatment failure in the CNS despite pulmonary cure. This study aims to describe a rare presentation of late-onset CNS tuberculosis presenting as delirium shortly after completed pulmonary TB treatment, and to discuss the therapeutic role of ceftriaxone and streptomycin. This study employed a qualitative, single-case report research design to conduct an in-depth investigation into a rare clinical presentation. The study presents the case of a 49-year-old male who developed acute delirium one week after being declared cured of pulmonary TB. Diagnosis was based on clinical presentation, brain MRI showing leptomeningeal enhancement, and cerebrospinal fluid analysis suggestive of TBM, despite a negative GeneXpert test. The patient showed marked neurological improvement after a regimen of intravenous ceftriaxone (2g twice daily) and intramuscular streptomycin (1g daily), without re-instituting standard oral anti-TB drugs. This suggests that the previous oral regimen may have achieved pulmonary cure but failed to eradicate a subclinical CNS infection due to insufficient drug levels. This case highlights the potential for CNS TB reactivation post-pulmonary treatment and suggests that alternative regimens with better CNS penetration, such as ceftriaxone and streptomycin, should be considered. Further studies are needed to evaluate their role as adjunctive therapy for TBM.
Co-Authors Aziz, Mohd-Hafiz Abdu Bajamal, Zaky Costa, Menino Osbert Dian Novita Dewi, Bernadette Eko Setiawan Ernawati, Titiek Erwin, Ferdinand Hadi, Wiyono Hendradi, Wahyu Lukas, Dwi Lily Marpaung, Ferdy Royland Michael Willianto, Vincentius Novita, Bernadette Roberts, Jason RR. Ella Evrita Hestiandari Samsudin, Kevin Setiawan, Albert Sukandar, Edy Supit, Vincentius Diamantino Susaniwati, Warindra, Taufin Widyati, Wijono, Heru