Kurniyanto, Kurniyanto
Department Of Internal Medicine, Faculty Of Medicine, Christian University Of Indonesia, Jakarta

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The Use of Prophylaxis Antibiotics to Prevent Acute Pancreatitis Complications: Meta-Analysis of Clinical Trials Dwita Nitoya Esterini; Kirsten Putriani Hartman; Joue Abraham Trixie; Yessi Setianegari; Kurniyanto Kurniyanto
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2558.37 KB) | DOI: 10.24871/2232021196-202

Abstract

Background: Acute pancreatitis (AP) is an inflammation of the pancreas, a serious emergency with no definitive treatment. It may progress to infected necrosis, non-pancreatitis infection, also death that may occur within the first 1 to 2 weeks. The use of prophylactic antibiotics in AP to prevent complications remains a controversy. The objective of this meta-analysis is to assess the benefit of prophylaxis antibiotics administration to prevent the complication.Method: Trials were identified by searching the medical database. Literature range is within the year 1975 to 2021.  Review Manager 5.4.1 was used to analyse data extraction and risk of bias of included studies were elaborated. Risk ratio (RR) was calculated with 95% confidence interval (CI). P 0.05 was considered significant.Results: Twenty trials with a total of 1.287 patients of AP were analysed; 646 patients treated with antibiotic prophylaxis and 641 patients treated with placebo. Prophylaxis antibiotics were found to have significant difference between the two groups. The administration of prophylaxis antibiotics lower the risk of non-pancreatic infections (RR = 0.77; 95% CI: 0.62–0.95; p 0.05) and infected pancreatic necrosis (RR = 0.74; 95% CI: 0.58-0.94; p 0.05). Meanwhile, prophylaxis antibiotics were found to be insignificant to lower the risk of mortality (RR = 0.75; 95% CI: 0.54-1.03; p 0.05). Conclusion: Prophylaxis antibiotics lower the risk of non-pancreatic infections and infected pancreatic necrosis, but did not lower the risk of mortality.
Comparison of Absolute Neutrophil Count between Hospital and Community Acquired Methicillin-Resistant Staphylococcus aureus Infection Kurniyanto, Kurniyanto; Santoso, Widayat Djoko; Nainggolan, Leonard; Kurniawan, Juferdy
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
Publisher : UI Scholars Hub

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Abstract

Introduction. The virulence factors from community acquired-methicillin resistant Staphylococcus aureus (CA-MRSA) mainly due to toxins like Panton Valentin Leukocidin (PVL) and Phenol Soluble Modulin (PSM). Both of toxins cause decrease of value through neutrophil lysis. This study aimed to identify different value of absolute neutrophil count between hospital and community acquired MRSA. Methods. A cross sectional was conducted which included subjects who were infected by MRSA and hospitalized during 2012-2017. Classification of MRSA were divided due to its sensitivity and resistance to non-beta lactam antibiotics. Isolate that resistance to ≤ 2 antibiotics were classified as CA-MRSA. The others with resistance to ≥ 3 antibiotics were classified as hospital acquired MRSA. Absolute neutrophils count (ANC) were collected 24 hours from the positive MRSA culture. Data were analyzed by using independent T test and Mann-Whitney test. Results. We collected 62 subjects infected by MRSA which 35 subjects were HA-MRSA and 27 subjects were CA-MRSA. The median of ANC from CA-MRSA was 7,410.7 (1,147.3-26,560.2) and HA-MRSA was 16,198.0 (3,921.6-28,794.1) with p value < 0.001. Conclusion. There was a different value of absolute neutrophil count in infections due to community and hospital acquired MRSA.