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All Journal Jurnal Respirasi (JR) Jurnal Sosial dan Sains Jurnal Kedokteran Meditek
Wijaya, Rike Andy
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Astronomy Biochemistry, Genetics & Molecular Biology Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Library & Information Science Medicine & Pharmacology Neuroscience Physics Public Health

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Evaluasi Terapi Antibiotik pada Pasien yang Didiagnosis Sepsis di ICU RSUD dr. Mohamad Soewandhie berdasarkan Metode Gyssens Ristanti, Safira; Adiwinoto, Ronald Pratama; Wijaya, Rike Andy; Putro, Saptono
Jurnal Kedokteran Meditek Vol 31 No 3 (2025): MEI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i3.3536

Abstract

ABSTRACT In the high-stakes world of Intensive Care Units (ICUs), the judicious application of empirical antibiotic therapy is crucial for managing sepsis in critically ill patients, as its misuse is often linked with unfavorable patient outcomes. Thus, timely and precise treatment strategies are indispensable. This study was designed to evaluate the rationality of such treatments among sepsis patients at RSUD Dr. Mohamad Soewandhie between January 2021 and September 2024. Using an observational and descriptive approach, researchers scrutinized secondary data from 120 patient medical records, with expert reviewers employing the Gyssens method to assess treatment rationality. Findings revealed that 60% of patients received appropriate empirical antibiotic therapy, most commonly intravenous Ceftriaxone. Alarmingly, culture and antibiotic sensitivity tests were conducted on only 18 patients, yielding 11 positive results, and among these were 19 gram-negative and 2 gram-positive bacterial isolates, with a troubling 67.9% being multidrug-resistant organisms (MDRO). Despite the empirical therapy's rationality, the study noted a concerning mortality rate of 81.67%, possibly owing to delays in obtaining culture results and the use of outdated local guidelines for antibiotic therapy in sepsis management, highlighting gaps in existing approaches. Keywords:Empirical Antibiotic Therapy, Intensive Care Unit, Sepsis, Septic Shock, Gyssens Method
A Rare and Fatal Pulmonary Cryptococcosis in HIV/AIDS: Chronological Clinical Decline in a Middle-Aged Male Ediyono, Ediyono; Wijaya, Rike Andy; Al Amin, Yoga Dian Pratama
Jurnal sosial dan sains Vol. 5 No. 10 (2025): Jurnal Sosial dan Sains
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/jurnalsosains.v5i10.32534

Abstract

Cryptococcosis represents a life-threatening opportunistic fungal infection with significant mortality rates among immunocompromised individuals, particularly those with advanced HIV/AIDS. While cryptococcal meningitis dominates the literature, pulmonary involvement remains underrecognized despite its prognostic significance. This case report aims to document the clinical presentation, diagnostic challenges, and fatal outcome of pulmonary cryptococcosis caused by the rare species Cryptococcus laurentii in a severely immunosuppressed HIV-positive patient, and to emphasize the importance of early bronchoscopic investigation and antifungal therapy. We report the case of a 44-year-old Indonesian male with a history of HIV/AIDS who presented with progressive shortness of breath, persistent cough, and intermittent fever over two weeks. He was non-adherent to antiretroviral therapy (ART) and had a CD4 count of fewer than 50 cells/mm³. Chest radiography showed bilateral infiltrates, and sputum culture grew Cryptococcus laurentii. Despite the initiation of broad-spectrum antibiotics and antifungal agents, his respiratory status deteriorated rapidly. Antifungal susceptibility testing confirmed sensitivity to amphotericin B, flucytosine, and fluconazole, yet the patient developed progressive respiratory failure. He ultimately succumbed to refractory hypoxemia on day 23 of hospitalization. This case highlights the diagnostic challenge of pulmonary cryptococcosis in advanced HIV, particularly with rare non-neoformans species. A high index of suspicion and early mycological investigation, including culture and species-level identification, are critical for timely diagnosis. This report contributes to the limited literature on C. laurentii pulmonary infections in Southeast Asia and underscores the importance of adherence to ART, as well as the need for early consideration of fungal infections in severely immunosuppressed patients presenting with atypical pulmonary findings.
Potential Biomarkers and Inflammatory Modulation of Hyperbaric Oxygen Therapy in Long COVID: A Narrative Update Soedarsono, Soedarsono; Wijaya, Rike Andy; Biutifasari, Verna
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.90-96

Abstract

Introduction: Long coronavirus disease (COVID-19), also known as post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), is characterized by persistent, often debilitating symptoms that extend beyond the acute phase of COVID-19. These manifestations are associated with immune dysregulation, chronic inflammation, and oxidative stress. Hyperbaric oxygen therapy (HBOT), which involves inhaling 100% oxygen at elevated atmospheric pressure, has emerged as a potential intervention to mitigate these processes. This narrative review synthesized findings from recent clinical and translational studies evaluating the immunological effects of HBOT in patients with long COVID. Methods: A structured search of PubMed, Scopus, and ScienceDirect was conducted for articles published between January 2020 and April 2025 using predefined keywords related to HBOT, long COVID, inflammation, and biomarkers. Seven primary studies met the inclusion criteria and were analyzed for their clinical outcomes and molecular immunomodulatory effects. Results: Evidence indicates that HBOT contributes to significant reductions in pro-inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor-α (TNF-α), while increasing anti-inflammatory cytokines, such as IL-10. Improvements in systemic biomarkers, including C-reactive protein, ferritin, and reactive oxygen species (ROS), have also been observed. In parallel, HBOT has been linked to enhanced mitochondrial function, immune balance, and tissue oxygenation, all of which support recovery from long COVID-related organ dysfunction. Conclusion: Despite promising results, heterogeneity in study design, small sample sizes, and limited long-term follow-up highlighted the need for further rigorous, standardized clinical trials. Overall, HBOT appears to be a biologically plausible and clinically relevant adjunctive therapy for long COVID, with inflammation-related biomarkers serving as correlates or secondary indicators of therapeutic response.
Co-Authors Al Amin, Yoga Dian Pratama Biutifasari, Verna Ediyono Ediyono, Ediyono Ristanti, Safira Ronald Pratama Adiwinoto Saptono Putro Soedarsono Soedarsono