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The Impact of Clinical Pathway Application on The Quality and Quantity of Antibiotic Use in Inpatient Patients With Tyfoid Fever at Fmc Bogor Hospital Gandes Winarni; Shirly Kumala; Hesty Utami R
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 4, No 2 (2022): CONTAGION
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v4i2.14921

Abstract

Typhoid fever is a global health problem, especially in developing countries, one of which is Indonesia. The incidence of resistance to the use of antibiotics in the treatment of typhoid fever can occur due to inappropriate use of antibiotics. This study aims to determine the impact of the application of clinical pathways on the quality and quantity of antibiotic use in typhoid therapy at FMC Bogor Hospital. This research is a descriptive analytic study conducted retrospectively which was analyzed using the Gyssens and ATC/DDD methods. The research data was taken from patient medical records for the period January-December 2018 and January-December 2020 which met the inclusion criteria. The results showed that from 115 medical records of typhoid fever patients, ceftriaxone was used as the most widely used antibiotic for typhoid therapy. The quality of antibiotic use as much as 40% was declared rational before the use of clinical pathways and as much as 57.3% after the use of clinical pathways (category 0), while the other 60% were irrational (categories I-VI) and after CP as much as 42.7% were included in category 0, the rest fall into the irrational category (Categories I-VI) which includes the use of antibiotics that are not appropriate for the administration interval, the use of antibiotics that are too long, the use of antibiotics that are too short, there are other antibiotics that are more effective, and there are other antibiotics that are less toxic /safer. The quantity of antibiotic use was stated to exceed WHO standards, namely the use of ceftriaxone by 81 DDD/100 patient days before the clinical pathway and 92.4 DDD/100 patient days after the clinical pathway. Based on the results of statistical tests, it was obtained 1) There were differences in the quality of antibiotic use between before and after the implementation of the clinical pathway in inpatients with typhoid fever at FMC Bogor Hospital; 2) There are differences in the quantity of antibiotic use between before and after the implementation of the clinical pathway in inpatients with typhoid fever at FMC Bogor Hospital. The results of this study are expected to be a consideration for the hospital as material for evaluation and improvement in order to increase the rationality of using antibiotics.
PENGARUH KESESUAIAN POLA PERESEPAN OBAT ANTIDIABETES TERHADAP KADAR HbA1C PADA PASIEN DIABETES MELITUS TIPE 2 DI RUMAH SAKIT COLUMBIA ASIA Hidayatri, Nurul; Maelaningsih, Firdha Senja; Winarni, Gandes; Sirait, Sertiwan
Edu Masda Journal Vol 8, No 2 (2024): EDU MASDA JOURNAL
Publisher : STIKes Kharisma Persada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52118/edumasda.v8i2.233

Abstract

                                                       ABSTRACTDiabetes mellitus is a metabolic disease caused by anomalies in insulin secretion, function, or both. Diabetes sufferers who do not use the right medication and are not controlled can experience long-term complications. The aim of this study is to determine the suitability of anti-diabetes drug prescribing patterns  in patients type 2 diabetes mellitus referring to the values of HbA1c levels at Columbia Asia BSD Hospital. The research design was a quantitative descriptive study with a sample of 115 outpatients with a diagnosis of type-2 DM. The inclusion criteria were patients aged 20 - 79 years and routinely undergoing medication control every month, while the exclusion criteria were incomplete medical records. The results of the study showed that patient characteristics based on gender, women were more likely to be diagnosed with type-2 DM (53.04%), while based on age, more elderly patients (46 - 55 years) received treatment (32.17%). For drug administration routes, the oral route (60.68%) is most often prescribed by doctors compared to the parenteral route (8.69%) and the oral-parenteral combination (30.43%). Meanwhile, based on the therapy given, therapy with a combination of 3 drugs (48.69%) is more often used than monotherapy (18.26%), combination of 2 drugs (20.86%), combination of 3 drugs with insulin (10.43%) and single insulin use (1.73%).  Doctors who provide drug therapy according to PERKENI 2021 are 78.26%. Meanwhile, the results of the T-Test show that there is an influence of prescribing patterns that are in accordance with the 2021 Type-2 Diabetes Mellitus Management and Prevention Guidelines with a reduction in HbA1C levels.                                                       ABSTRAKDiabetes melitus merupakan penyakit metabolik yang diakibatkan anomali dalam sekresi, fungsi insulin, ataupun keduanya. Penderita diabetes yang tidak menggunakan obat yang tepat serta tidak terkontrol bisa mengalami komplikasi jangka panjang. Tujuan dari penelitian ini adalah untuk mengetahui kesesuaian pola peresepan obat anti diabetes (berdasarkan rute pemberian dan terapi yang diberikan) pada pasien diabetes melitus tipe 2 merujuk pada nilai kadar gula darah dan HbA1c di RS Columbia Asia BSD periode Juli - Desember 2023 dan dibandingkan dengan Pedoman Pengelolaan dan Pencegahan DM Tipe 2 Tahun 2021 dari PERKENI. Desain penelitian adalah penelitian deskriptif kuantitati dengan sampel sebanyak 115 pasien rawat jalan dengan diagnosa DM tipe 2. Kriteria inklusi pasien usia 20 – 79 tahun dan rutin melakukan kontrol pengobatan setiap bulan, sedangkan kriteria eksklusi adalah rekam medis yang tidak lengkap. Hasil penelitian menunjukkan karakteristik pasien berdasarkan jenis kelamin, perempuan lebih banyak terdiagnosa DM tipe 2 (53,04%), sedangkan berdasarkan usia, pasien lansia awal (46 - 55 Tahun) lebih banyak yang berobat (32,17%). Untuk rute pemberian obat, rute oral (60,68%) paling banyak diresepkan oleh dokter dibandingkan rute parenteral (8,69%) dan kombinasi oral-parenteral (30,43%). Sedangkan berdasarkan terapi yang diberikan, terapi dengan kombinasi 3 obat (48,69%) lebih sering digunakan dibandingkan monoterapi (18,26%), Kombinasi 2 obat (20,86%), Kombinasi 3 obat dengan insulin (10,43%) dan penggunaan insulin tunggal (1,73%).  Dokter yang memberikan terapai obat sesuai PERKENI 2021 sebesar 78,26%. Sedangkan hasil uji T-Test menunjukan adanya pengaruh pola peresepan yang sesuai dengan Pedoman Pengelolaan dan Pencegahan DM Tipe 2 Tahun 2021 dengan penurunan kadar HbA1C
Artikel : Analisis Drug Related Problems Pada Pasien Tuberkulosis Paru Rawat Inap Di Rumah Sakit Umum Kota Tangerang Selatan Winarni, Gandes; Fajrin, Aulia; Maelaningsih, Firdha Senja; Hidayatri, Nurul
PHRASE (Pharmaceutical Science) Journal Vol 4, No 2 (2024): Pharmaceutical Science Journal Vol 4 No 2
Publisher : Sekolah Tinggi Ilmu Kesehatan Widya Dharma Husada Tangerang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52031/phrase.v4i2.899

Abstract

Tuberkulosis merupakan penyakit menular yang disebabkan oleh infeksi basil Mycobacterium tuberculosis. Tuberkulosis merupakan salah satu dari 10 penyebab kematian terbesar di dunia dan penyebab kematian akibat agen infeksi. Pada tahun 2022, diperkirakan 10,6 juta orang terinfeksi penyakit tuberkulosis di seluruh dunia dan jumlah kematian mencapai 1,13 juta orang. Tuberkulosis memerlukan banyak penggunaan obat dalam terapi, semakin banyak penggunaan obat dalam terapi (polifarmasi), semakin tinggi risiko munculnya masalah terkait obat atau Drug Related Problems (DRPs) dalam proses pengobatan. Terjadinya DRPs dapat mengakibatkan terjadinya penurunan kualitas hidup pasien, lamanya tingkat perawatan pasien pada rawat inap di rumah sakit, meningkatnya biaya pengobatan, serta dapat meningkatkan angka kesakitan dan kematian. Tujuan penelitian ini adalah untuk melakukan analisis kejadian DRPs pada pasien tuberkulosis paru di instalasi rawat inap Rumah Sakit Umum Kota Tangerang Selatan tahun 2023. Metode penelitian ini adalah metode deskriptif menggunakan desain penelitian cross sectional dengan jenis penelitian kuantitatif dan data diambil secara retrospektif. Hasil penelitian menunjukkan analisis DRPs dari 81 pasien yang menderita TB Paru ditemukan 67 (85,90%) mengalami DRPs domain C1.3, domain P1.3(10,26%), domain C1.2(1,28%), dan domain C3.1 (2,56%). Kesimpulan dari penelitian ini diketahui karakteristik demografi pasien terbanyak meliputi jenis kelamin laki-laki 53 (65,43%) dan usia 19-29 tahun (30,86%). Adapun DRPs yang dominan terjadi, yaitu domain C1.3 sebanyak 67 kasus (85,90%)
Artikel : Evaluasi Kualitas dan Kuantitas Penggunaan Antibiotika Pada Pasien Rawat Inap Dengan Demam Tifoid di RSUD Tangerang Selatan Winarni, Gandes; Saputri, Laras Tri; Utami, Anissa; Hidayatri, Nurul
Edu Masda Journal Vol 8, No 2 (2024): EDU MASDA JOURNAL
Publisher : STIKes Kharisma Persada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52118/edumasda.v8i2.239

Abstract

Typhoid fever is an acute infectious disease of the digestive system caused by Salmonella Typhi bacteria. This disease is a global problem, particularly in developing countries. The purpose of this study was to determine the sociodemographics of patients, determine the use of antibiotics based on the type of antibiotic and the quality and quantity of antibiotic use in typhoid fever patients in South Tangerang City Hospital. Methods Observational research was retrospectively analyzed using Gyssens and ATC/DDD methods. The research data were obtained from the medical records of patients who met the inclusion criteria from January to December 2023. The results showed that out of a total of 124 antibiotic prescriptions, ceftriaxone was the most commonly used antibiotic for typhoid fever therapy. The quality of antibiotic use was 21 (12.57%) declared rational (category 0) while others were irrational category IIIA (12.57%), category IIIB (36.53%), category IIA (34.73%) and category IIB (3.59%). The quantity of antibiotic use is in the use of cefixime at 76.4 DDD/100 patient-days, ceftriaxone at 54.3 DDD/100 patient-days, thiamphenicol at 11.5 DDD/100 patient-days, amoxicillin at 2.8 DDD/100 patient-days and ciprofloxacin at 1.4 DDD/100 patient-days. Ampicillin was 0.6 DDD/100 patient-days, in line with WHO standards. The results of this study are expected to be a reference and recommendation for the hospital as an evaluation and improvement material to improve the rationality of antibiotic use, recommendations for the preparation of hospital formularies and drug procurement in the next period with consumption patterns
Cost-Effectiveness Analysis of Third-Generation Cephalosporin Antibiotics in the Treatment of Typhoid Fever at Tangerang Selatan General Hospital Widya Pratama, Mochammad; Winarni, Gandes; Ayu Utari, Luthfinawa
Indonesian Journal of Pharmaceutical Education Vol 5, No 1 (2025): January–April 2025
Publisher : Jurusan Farmasi Universitas Negeri Gorontalo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37311/ijpe.v5i1.30254

Abstract

Typhoid fever is an acute systemic infectious disease caused by Salmonella typhi bacteria that infect through contaminated food or drink. In the treatment of typhoid fever, antibiotic therapy is needed. Third-generation cephalosporin antibiotics are antibiotics used as second-line treatment in typhoid fever. Differences in antibiotic use can increase costs incurred by patients, so a cost-effectiveness analysis is needed to determine the most effective and efficient treatment. The purpose of this study was to determine the cost effectiveness of third-generation cephalosporin antibiotics in patients with typhoid fever hospitalized in South Tangerang City Hospital in 2023. The research method in this study is descriptive method with purposive sampling technique. This research design uses a non-experimental design. This study was conducted in April-May 2024 at the South Tangerang City Hospital using secondary data in the form of medical record data and medical cost data as research instruments. The number of samples in this study were 127 samples that met the inclusion criteria. The third-generation cephalosporin antibiotics used were ceftriaxone and cefixime. Cost-effectiveness is expressed in ACER (Average Cost-Effectiveness Ratio) which is obtained from the average total direct medical costs divided by the average clinical outcome. The results showed the ACER value of cefixime Rp.767,866/day for length of hospitalization and Rp.1,122,611/day for fever-free time, ACER value of ceftriaxone Rp.711,349/day for length of hospitalization and Rp.985,726/day for fever-free time, ACER value of ceftriaxone + cefixime antibiotic combination Rp.763,054/day for length of hospitalization and Rp.1,051.146/day for fever-free time. The conclusion of this study is that the most cost-effective third-generation cephalosporin antibiotic is ceftriaxone.