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Archives of The Medicine and Case Reports
Published by HM Publisher
ISSN : -     EISSN : 27472051     DOI : https://doi.org/10.37275/amcr
Core Subject : Health,
Health Professions Medicine & Pharmacology Nursing Public Health
Archives of The Medicine and Case Reports (AMCR) is a broad scope journal aims to publish the most exciting Case studies/reports in Clinical and Medical Sciences. AMCR aims to provide an excellent platform for Clinical Practitioners, medical/ health practitioners, students, professionals, researchers in medicine. AMCR accept any original case report that expands the field of general medical knowledge, and original research relating to case reports including report of the symptoms, diagnosis, treatment, and follow-up of an individual patient. The journal covers all medical specialties including : • Oncology • Paediatrics • Respiratory disorders • Allergy • Radiology • Nephrology • Neurology • Haematology • Immunology • Radiology • Nuclear medicine • Medical imaging • Audiovestibular medicine • Cardiology and cardiovascular systems • Critical care medicine • Dermatology • Emergency medicine • Endocrinology and metabolism • Gastroenterology and hepatology • Geriatrics and gerontology • Infectious diseases and treatment • Medical disorders in pregnancy • Medical ophthalmology • Sports Medicine • Substance abuse • Palliative medicine • Psychiatry • Rheumatology • Sexual and reproductive health
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 231 Documents
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Maintenance Immunosuppressive Prescribing Patterns in Kidney Transplant Recipients at an Indonesian Tertiary Referral Hospital: A Retrospective Cross-Sectional Study Dimo Pratama; Aqmarina Tamimi; Yulia Wardhani
Archives of The Medicine and Case Reports Vol. 7 No. 3 (2026): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v7i3.925

Abstract

Kidney transplantation is the optimal kidney replacement therapy for end-stage kidney disease, but graft survival depends on lifelong maintenance immunosuppression. Indonesian data on how these medicines are actually prescribed remain scarce. Retrospective cross-sectional drug-utilisation study of 53 maintenance immunosuppressant prescriptions dispensed to kidney transplant recipients at a tertiary referral hospital in Yogyakarta, Indonesia, between 2017 and 2024. Proportions were estimated with Wilson 95% confidence intervals (CI); within-class preference with exact binomial tests; associations with Fisher exact tests; prescribing concentration with diversity indices and bootstrap CIs; and frequencies were benchmarked against published French, Korean and Indonesian reference proportions using Holm-adjusted exact binomial tests, reported as absolute differences and prevalence ratios. Reporting followed STROBE. Recipients were mostly aged 18–49 years (73.6%) and male (64.2%). Tacrolimus was the only calcineurin inhibitor prescribed (100.0%; 95% CI 93.2–100.0), and mycophenolic acid the only antiproliferative agent. Methylprednisolone was the preferred corticosteroid (69.8%; 56.5–80.5; p = 0.002) and enteric-coated mycophenolate sodium the preferred formulation (77.4%; 64.5–86.5; p < 0.001). The modal regimen was tacrolimus plus methylprednisolone plus mycophenolate sodium (56.6%; 43.3–69.0). Tacrolimus and mycophenolic acid use exceeded a French national cohort (+8.7 and +9.5 percentage points; Holm-adjusted p = 0.040 and 0.034), whereas corticosteroid maintenance did not differ significantly (96.2% versus 88.1%; p = 0.086). Prescribing was highly concentrated (Herfindahl–Hirschman Index 3,799). In conclusion, maintenance prescribing was exceptionlessly tacrolimus- and mycophenolate-based, exceeding even high-volume European practice, and reproduced an independent Indonesian series almost exactly. Corticosteroid maintenance was near-universal, identifying corticosteroid minimisation and therapeutic drug monitoring capacity as priority targets.

Page 24 of 24 | Total Record : 231

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