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Gambaran Kuantitatif Antibiotik Menggunakan Metode Defined Daily Dose (DDD) Di Ruang Rawat Inap RSPI Prof. Dr. Sulianti Saroso Pada Januari-Juni 2019 Mariana, Nina; Indriyati, Indriyati; Widiantari, Aninda Dinar; Taufik, Muhammad; Wijaya, Chandra; Hartono, Teguh Sarry; Wijaya, Surya Oto; Firmansyah, Iman
Pharmaceutical Journal of Indonesia Vol. 7 No. 1 (2021)
Publisher : Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.pji.2021.007.01.6

Latar Belakang. Penggunaan antibiotik yang tepat dapat meminimalkan terjadinya resistensi antibiotika. selain penghematan secara ekonomi. Oleh karena itu perlu adanya pemantauan dan evaluasi penggunaan antibiotik di fasilitas kesehatan dan feedback terhadap peresepan antibiotik. Tujuan penelitian ini adalah untuk mengevaluasi secara kuantitatif penggunaan antibiotik baik jenis dan jumlah antibiotik berdasarkan klasifikasi Anatomical Therapeutic Chemical (ATC) Â dengan Â pengukuran Defined Daily Dose (DDD) sebagai metode terstandar pengukuran kuantitas penggunaan antibiotik.Â Metode. Penelitian ini adalah Â observasional deskriptif, Â menggunakan rancangan potong lintang pada periode Januari-Juni 2019 pada RSPI Prof. Dr. Sulianti Saroso. Kriteria inklusi berupa kasus pasien dewasa bukan kasus TB yang dirawat di ruang rawat inap non ICU dan penggunaan antibiotiknya masuk ke dalam klasifikasi Anatomical Therapueutic Chemical (ATC). Berdasarkan data rekam medik Â terkumpul dalam lembar pengumpul data.Hasil. Sebanyak 96 status rekam medik dengan 51 kasus penyakit infeksi non bedah dan 45 kasus infeksi bedah yang menggunakan antibiotik. Difteri merupakan kasus infeksi non bedah terbanyak yaitu 10.5%. Distribusi penggunaan antibiotik golongan beta laktam kombinasi inhibitor betalaktamase sebanyak Â 37.28%, golongan sefalosporinÂ 33.90%, golongan penisilin sebanyak 10,17%. Berdasarkan nilai DDD/patient day antibiotik Penicillin Prokain memiliki nilai tertiggi yaitu sebesar 97.22 dan nilai DDD/patient day terendah yaitu pada antibiotik meropenem yaitu sebesar 0.22. Â Kesimpulan. Pada penelitian ini, kuantitas antibiotik berdasarkan nilai DDD/100 patient day tertinggi adalah Penisilin Prokain, seiring dengan difteri sebagai kasus penyakit infeksi non bedah terbanyak pada periode Januari-Juni 2019. Â Mengingat penelitian dilakukan pada saat kejadian luar biasa difteri, perlu dilakukan penelitian lebih lanjut pada periode berikutnya sebagai data pembanding kuantitas antibiotik di masa depan.

Gambaran Kuantitatif Antibiotik Menggunakan Metode Defined Daily Dose (DDD) Di Ruang Rawat Inap RSPI Prof. Dr. Sulianti Saroso Pada Januari-Juni 2019 Mariana, Nina; Indriyati, Indriyati; Widiantari, Aninda Dinar; Taufik, Muhammad; Wijaya, Chandra; Hartono, Teguh Sarry; Wijaya, Surya Oto; Firmansyah, Iman
Pharmaceutical Journal of Indonesia Vol. 7 No. 1 (2021)
Publisher : Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.pji.2021.007.01.6

Latar Belakang. Penggunaan antibiotik yang tepat dapat meminimalkan terjadinya resistensi antibiotika. selain penghematan secara ekonomi. Oleh karena itu perlu adanya pemantauan dan evaluasi penggunaan antibiotik di fasilitas kesehatan dan feedback terhadap peresepan antibiotik. Tujuan penelitian ini adalah untuk mengevaluasi secara kuantitatif penggunaan antibiotik baik jenis dan jumlah antibiotik berdasarkan klasifikasi Anatomical Therapeutic Chemical (ATC) Â dengan Â pengukuran Defined Daily Dose (DDD) sebagai metode terstandar pengukuran kuantitas penggunaan antibiotik.Â Metode. Penelitian ini adalah Â observasional deskriptif, Â menggunakan rancangan potong lintang pada periode Januari-Juni 2019 pada RSPI Prof. Dr. Sulianti Saroso. Kriteria inklusi berupa kasus pasien dewasa bukan kasus TB yang dirawat di ruang rawat inap non ICU dan penggunaan antibiotiknya masuk ke dalam klasifikasi Anatomical Therapueutic Chemical (ATC). Berdasarkan data rekam medik Â terkumpul dalam lembar pengumpul data.Hasil. Sebanyak 96 status rekam medik dengan 51 kasus penyakit infeksi non bedah dan 45 kasus infeksi bedah yang menggunakan antibiotik. Difteri merupakan kasus infeksi non bedah terbanyak yaitu 10.5%. Distribusi penggunaan antibiotik golongan beta laktam kombinasi inhibitor betalaktamase sebanyak Â 37.28%, golongan sefalosporinÂ 33.90%, golongan penisilin sebanyak 10,17%. Berdasarkan nilai DDD/patient day antibiotik Penicillin Prokain memiliki nilai tertiggi yaitu sebesar 97.22 dan nilai DDD/patient day terendah yaitu pada antibiotik meropenem yaitu sebesar 0.22. Â Kesimpulan. Pada penelitian ini, kuantitas antibiotik berdasarkan nilai DDD/100 patient day tertinggi adalah Penisilin Prokain, seiring dengan difteri sebagai kasus penyakit infeksi non bedah terbanyak pada periode Januari-Juni 2019. Â Mengingat penelitian dilakukan pada saat kejadian luar biasa difteri, perlu dilakukan penelitian lebih lanjut pada periode berikutnya sebagai data pembanding kuantitas antibiotik di masa depan.

Korelasi Kadar Prokalsitonin (PCT) Dengan Rasio Neutrofil Limfosit (RNL) Pada Pasien COVID-19 Apriliani, Isnawati; Fajrunni’mah, Rizana; Djajaningrat, Husjain; Widiantari, Aninda Dinar; Murtiani, Farida
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.855

BACKGROUND: Covid-19 treatment should be done early before the disease progress. Inflammatory biomarker is needed to ascertain the severity of disease as soon as possible. Neutrophil-to-lymphocyte ratio (NLR) and Procalcitonin (PCT) are two of biomarker that are clinically used around the world. NLR is simpler, can routinely be done and available in peripheral region while PCT is more effective to describe inflammation. PURPOSE: This study aims to determine the correlation of procalcitonin (PCT) levels with neutrophil lymphocyte ratio (NLR) in COVID-19 patients. METHOD: This study is an analytic observational with a cross sectional design. We extracted data from medical record. Samples were 415 COVID-19 patients undergoing inpatient care at the Budhi Asih Hospital, East Jakarta for January - December 2021. RESULTS: Prevalence of male patients more than ≥60 years were 78 patients (18,8%) while female patients were 68 patients (16,4%). Average of PCT level was 1,93 ng/mL (0,02-200 ng/mL). Average of NLR was 5,09 cells/mm3 (0,22-31 cells/mm3). Spearman test proved there was a significant correlation between PCT and NLR levels in COVID-19 patients (p value = 0,0001). CONCLUSION: The higher the PCT level, the higher the NLR value in COVID-19 patients.

Effect of Fixed‐Dose Combinations Antituberculosis and Separate Formulations on Clinical Symptoms, Weight Gain, Adverse Effect and Plasma Concentration in Tuberculosis and HIV Coinfection Cases Sundari, Titi; Mariana, Nina; Permatasari, Debby Intan; Rusli, Adria; Sitompul, Pompini Agustina; Rosamarlina, Rosamarlina; Widiantari, Aninda Dinar; Maemun, Siti; Lisdawati, Vivi
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.867

BACKGROUND: Fixed Dose Combination (FDC) was aimed to simplify TB therapy and facilitate physician and patient compliance. OBJECTIVE: We aimed to evaluate the effect of FDC antituberculosis and separate formulations (SF) on clinical symptoms, weight gain, adverse effect and plasma concentration in TB/HIV cases during the intensive phase. METHOD: Prospective cohort study was conducted in public hospital, Jakarta. We recruited TB-HIV patients in May 2018-May 2019. Patients (over than 18 years old) diagnosed with TB-HIV who consumed either FDC or SF and had not received antiretroviral. A total of 36 subjects were included in this study, 20 subjects in FDC group and 16 subjects in SF group. RESULT: There was not significant different between FDC and SF groups with an improvement of clinical symptoms (P = 0.70) and weight gain (P = 1.00). Gastrointestinal syndrome was 75% in FDC group; 62.5 % in SF group. Mean (±SD) of rifampicin, isoniazid, pyrazinamide plasma concentration after 2 weeks therapy in FDC group were 5.49 mg/L (±3.40 mg/L), 1.35 mg/L (±1.20 mg/L), 19.87 mg/L (±17.00 mg/L), respectively. Mean (±SD) of rifampicin, isoniazid, pyrazinamide plasma concentration in SF group were 6.42 mg/L (±4.80mg/L), 0.87 mg/L (±0.70 mg/L), 5.03 mg/L (±7.60 mg/L), respectively. CONCLUSION: There was not significant different between FDC and SF groups on improvement of clinical symptoms and weight gain in intensive phase of therapy, the highest of adverse effects was gastrointestinal syndrome, and all subjects had normal reference ranges of rifampicin concentrations, and isoniazid and pyrazinamide below the normal range.

Screening for Latent Tuberculosis Infection using Interferon-Gamma Release Assay Test among Healthcare Workers Rosamarlina, Rosamarlina; Mariana, Nina; Sundari, Titi; Setianingsih, Tri Yuli; Jahiroh, Jahiroh; Pertiwi, Intan; Widiantari, Aninda Dinar; Setiawaty, Vivi; Murtiani, Farida
Global Medical & Health Communication (GMHC) Vol 11, No 2 (2023)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/gmhc.v11i2.10927

Healthcare workers (HCWs) represent a significant demographic for screening latent tuberculosis infection (LTBI) due to their potential exposure to infectious patients. Tests based on immunology detection, such as the tuberculin skin test (TST) and the interferon-gamma release assay (IGRA), have been pivotal in diagnosing LTBI. The objective of this study was to evaluate the efficacy of the IGRA test in detecting LTBI compared to the TST among HCWs in an infectious disease hospital. In a cross-sectional study conducted in August 2019 at the Sulianti Saroso Infectious Disease Hospital, we examined 84 HCWs selected through consecutive sampling. Participants were assessed using questionnaires, and the IGRA and TST tests were performed. The findings revealed that 42 (50%) HCWs tested positive for LTBI based on the IGRA test. Most were female, aged 36–45 years, had direct exposure to TB patients, and had been in the healthcare profession for over a decade. The concordance between the TST and IGRA test, as indicated by a κ value, was 0.234. Furthermore, a significant correlation was observed between the incidence of LTBI and the duration of the healthcare profession (p=0.016). In conclusion, our research suggests that both TST and IGRA tests can effectively detect LTBI. The IGRA test had a higher positivity rate among HCWs with over ten years of service.

Profile of Clinical, Radiological and Laboratory Pattern in TB-HIV Coinfection in National Infection Centre of Indonesia Rosamarlina, Rosamarlina; Hatta, Mochammad; Murtiani, Farida; Widiantari, Aninda Dinar
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 13, No 2 (2024): September 2024
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v13i2.3959

Background: The study aims to map TB (Tuberculosis) – HIV (Human Immunodeficiency Virus) patients based on clinical, radiological, and laboratory patterns. Objective: This study is expected to provide previous research investigating radiologic and laboratory examinations in TB-HIV patients. Method: We conducted a cross-sectional study based on medical records of TB-HIV patients at RSPI Sulianti Saroso from January 2004 - March 2017. Samples were 240 TB-HIV patients from a population of 1014 People Living with HIV/AIDS (PLWHA). Inclusion criteria were PLWHA, aged over 18 years, diagnosed with TB with completed medical record status. Result: Characteristics of the majority of patients were in the productive age group (99.2%) with an average age of 33 years and male sex (78%). The main symptom is cough (91.7%) and cough with phlegm (59.1%). Most patients (83.37%) have not received ART (Anti-Retroviral Therapy). Pulmonary physical examination showed that most patients had Ronchi (95.8%) while others got wheezing (5%). Laboratory tests revealed an initial CD4 cell count of 71.6 cells/ml and a negative Acid-Fast Bacillus (AFB) smear (59.2%). The patient's radiology was mainly with an infiltrate (82.5%); most infiltrate was presented in apex (52.4%). Conclusion: The majority of TB-HIV coinfected patients are young males, presenting with common TB symptoms, low CD4 counts, and negative AFB smears, complicating diagnosis. Radiological findings frequently show infiltrates, particularly in the apex. These findings emphasize the importance of early diagnosis and ART initiation to improve outcomes in TB-HIV coinfected patients

Comparison of c-MYC Expression between Patients with Germinal Center and Non-Germinal Center B-cell-like Diffuse Large B Cell Lymphoma Hanum, Sitti Fatimah; Hardjolukito, Endang Sri Roostini; Kusmardi, Kusmardi; Murtiani, Farida; Widiantari, Aninda Dinar; Setiawaty, Vivi
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1277

Background: c-MYC expression has been used as a prognostic marker to predict prognosis and determine therapeutic strategies in both Diffuse Large B Cell Lymphoma (DLBCL) subtypes. No study on c-MYC expression associated with DLBCL has ever been conducted in Indonesia. Our study aimed to evaluate differences in c-MYC expression in both DLBCL subtypes and assess the immunophenotype profile.Method: We selected 40 DLBCL cases and divided them into Germinal Center B-cell (GCB) and non-GCB subtypes using Hans Criteria. We evaluated c-MYC expression, and a cut-off value of 60.4% was determined using Receiver Operating Characteristic (ROC) curve analysis.Results: We found that c-MYC expression was significantly higher in GCB subtypes compared to non-GCB subtypes (n = 17 (42.5%) vs n = 20 (7.5%), p 0.000 and mostly had an immunophenotype of CD10+/BCL6+/MUM1+.Conclusion: Higher c-MYC expression is found more frequently in GCB subtypes. These findings suggest that c-MYC may play a subtype-specific role in DLBCL pathogenesis, potentially influencing therapeutic decisions for Indonesian patients. Future studies should validate these results in larger, multi-center cohorts and explore the mechanistic link between c-MYC and the GCB subtype and its clinical implications for targeted therapies.

Clinical and Laboratory Characterization of Hemodialysis Patients in Relation to Survival Outcomes at a Tertiary Referral Hospital in Indonesia Sipayung, Elisabeth; Nariata, I Wayan; Yassir; Satyawati, Rumaisah; Wijaya, Surya Oto; Budi, Gesang Setia; Anitha; Rivaldiansyah; Maemun, Siti; Widiantari, Aninda Dinar
Current Internal Medicine Research and Practice Surabaya Journal Vol. 6 No. 2 (2025): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v6i2.70810

Introduction: Despite advancements in hemodialysis care, disease progression and outcomes in adults with various comorbidities, particularly in Indonesia’s overburdened tertiary hospitals, remain poorly characterized, limiting tailored care strategies. This study analyzed clinical characteristics and laboratory parameters among hemodialysis patients at Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia, with stratification by survival outcomes. Methods: We conducted a retrospective cohort study of adults (>18 years) undergoing hemodialysis at Sulianti Saroso Infectious Disease Hospital between March and July 2024. Using purposive sampling, we analyzed 27 cases with documented laboratory parameters (i.e., blood urea nitrogen (BUN), serum creatinine, and estimated glomerular filtration rate (eGFR)) and clinical outcomes. Associations between outcomes and laboratory/clinical variables were assessed using Fisher’s exact test and logistic regression (p<0.05). Results: Mortality was reported in 25.9% of patients, including one who passed away due to complications related to coronavirus disease 2019 (COVID-19) shortly after being discharged. The leading indication for hemodialysis was hyperuricemia (85.2%), followed by chronic kidney disease. Nearly half of the patients (48.1%) had comorbid diabetes mellitus. Diabetic nephropathy was a key contributor to elevated urea levels. Prevalent complications reported among the patients included sepsis (70.4%) and glomerular disease (40.7%). Conclusion: This study found an association between diabetes mellitus and mortality in chronic kidney disease patients who underwent hemodialysis. Severe uremia, marked by elevated BUN levels, and symptomatic complications such as shortness of breath were observed, indicative of advanced disease progression. Earlier detection and optimized management are necessary to mitigate preventable morbidity in high-risk populations. Highlights: 1. This study examined undercharacterized hemodialysis patients at an Indonesian tertiary hospital, focusing on high comorbidity burdens and outcomes. 2. Severe kidney disease and high mortality were observed, driven by comorbidities such as diabetes mellitus, hypertension, coronavirus disease 2019 (COVID-19), and infectious diseases (drug-resistant tuberculosis and hepatitis B/C). 3. The findings underscore the importance of optimized risk stratification and early intervention for end-stage renal failure in patients with both communicable and non-communicable disease comorbidities.

The Combination Diagnostic Test for Tuberculosis Screening in HIV Patients in Referral Hospitals in Indonesia Murtiani, Farida; Rosamarlina, Rosamarlina; Purnama, Asep; Farhanah, Nur; Utama, Made Susila; Agustin, Heidy; Sarif, Armaji Kamaludi; Widiantari, Aninda Dinar; Hasugian, Armedy Ronny
Public Health of Indonesia Vol. 11 No. 3 (2025): July - September
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v11i3.1094

Background: Screening tests are needed to help screen suspected Tuberculosis (TB) pulmonary with HIV positive. With the limitation of specificity of the screening test and the need for combination with laboratory tools to increase that, a combination with standard examination is still needed, especially for limited healthcare facilities. Objective: This study aimed to determine Pulmonary TB screening tests with Human Immunodeficiency Syndrome (HIV) positive. Method: This observational study with a cross-sectional design was conducted in four government hospitals. Study subjects were inpatients and outpatients who met study inclusion criteria (> 14 years of age, HIV positive based on HIV test results, had clinical symptoms of episodic history of fever, and volunteered to take part in the study). Total subjects were 193 people, with episodic history of fever from <24 hours to 120 hours. Result: This study assessed a subject's clinical manifestation, physical examination and X-ray test. The “Night Sweat”, Infiltrates in the Upper Lobe”, “Enlargement of Lymph Nodes and “Left Rhonchi” and their combination have a sensitivity of>85%. Still, only the complete combination has a specificity of> 70%. The combination of “Night Sweat + Enlargement of Lymph Nodes + Left Rhonchi + Infiltrates in the Upper Lobe” and then “Enlargement of Lymph Nodes + Left Rhonchi + Infiltrates in the Upper Lobe” can be an alternative for screening Pulmonary TB-HIV positive with history of fever. Conclusion: Pulmonary TB screening in HIV patients with a history of fever can be used by completely combining clinical manifestation, physical examination, and X-ray. the variables "Night Sweat, Enlarged Lymph Nodes, left rhonchi breath sounds and pulmonary upper lobe infiltrates" in a gradual manner. Keywords: Diagnostic Combination Test; HIV-Tb Coinfection; Tuberculosis Screening; Clinical Manifestations in TB-HIV; Pulmonary TB in HIV Patients

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