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Jurnal Farmasi Klinik Indonesia

ijcp
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Published by Universitas Padjadjaran

ISSN : 23375701 EISSN : 2337 5701 DOI : -

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Indonesian Journal of Clinical Pharmacy (IJCP) is a scientific publication on all aspect of clinical pharmacy. It published 4 times a year by Clinical Pharmacy Master Program Universitas Padjadjaran to provide a forum for clinicians, pharmacists, and other healthcare professionals to share best practice, encouraging networking and a more collaborative approach in patient care. Indonesian Journal of Clinical Pharmacy is intended to feature quality research articles in clinical pharmacy to become scientific guide in fields related to clinical pharmacy. It is a peer-reviewed journal and publishes original research articles, review articles, case reports, commentaries, and brief research communications on all aspects of Clinical Pharmacy. It is also a media for publicizing meetings and news relating to advances in Clinical Pharmacy in the regions.

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Faktor-Faktor yang Berhubungan dengan Pemanfaatan Obat Tradisional pada Pasien Hiperkolesterolemia di Rumah Riset Jamu “Hortus Medicus” Tyas F. Dewi; Ulfatun Nisa
Indonesian Journal of Clinical Pharmacy Vol 8, No 1 (2019)
Publisher : Universitas Padjadjaran

Beberapa tahun terakhir ini, terjadi pergeseran pola penyakit dari penyakit menular menjadi penyakit tidak menular, termasuk hiperkolesterolemia. Peningkatan tersebut didukung dengan meningkatnya jumlah kunjungan pasien khususnya pasien hiperkolesterolemia ke Rumah Riset Jamu (RRJ) Hortus Medicus sebagai fasilitas pelayanan kesehatan tradisional pada tahun 2016 sebesar 65% dibandingkan dengan tahun sebelumnya. Tujuan penelitian ini adalah mengetahui faktor yang memengaruhi pemilihan pengobatan tradisional tersebut. Penelitian ini merupakan studi nonintervensi dengan desain penelitian potong lintang yang dilakukan terhadap 150 responden di RRJ Hortus Medicus pada bulan April–Oktober 2017. Pertanyaan pada kuesioner mengacu kepada teori Ronald Andersen. Responden dikelompokkan berdasarkan frekuensi kunjungan ke RRJ Hortus Medicus yaitu kategori jarang, terkadang, dan sering. Korelasi antara variabel bebas dan variabel terikat (perilaku pemilihan pengobatan) dianalisis menggunakan analisis Chi-Square. Hasil yang diperoleh menunjukkan bahwa usia (p=0,000), pekerjaan (p=0,008), waktu tempuh yang dibutuhkan dari rumah ke tempat pengobatan tradisional (p=0,025), pengetahuan tentang pengobatan tradisional (p=0,004), tarif pengobatan tradisional (p=0,011), dan pandangan subjektif responden (p=0,008) memiliki hubungan yang signifikan secara statistik terhadap perilaku pemilihan pengobatan. Hal ini berarti faktor yang berhubungan pada pemilihan pengobatan tradisional adalah faktor predisposisi pasien (umur, pekerjaan, pengetahuan, waktu tempuh), faktor pendukung (tarif), dan faktor kebutuhan (pandangan subjektif).Kata kunci: Hiperkolesterol, obat tradisional, pemanfaatan pengobatan Factors Related to Traditional Healthcare Utilization at Hypercholesterolemic Patient in Jamu Research Center “Hortus Medicus”AbstractIn recent years, there has been a shift in the pattern of diseases from infectious diseases to non-infectious diseases, including hypercholesterolemia. This shifted was supported by the increasing number of patient visits, especially hypercholesterolemic patients to Jamu Research Center (RRJ) Hortus Medicus as traditional health care facilities in 2016 at 65% compared to the previous year. The purpose of this study was to determine the factors that influence the choice of traditional medicine. This study is a non-intervention study with a cross-sectional design conducted on 150 respondents in the RRJ Hortus Medicus in April-October 2017. The questions on the questionnaire refer to Ronald Andersen’s theory. Respondents were grouped based on the frequency of visits to the RR Hortus Medicus, namely: categories rare, sometimes, and often. The correlation between the independent variables and the dependent variable (treatment selection behavior) was analyzed using Chi-Square analysis. The results obtained showed that age (p=0.000), occupation (p=0.008), travel time needed from home to place of traditional medicine (p=0.025), knowledge of traditional medicine (p=0.004), traditional medicine rates (p=0.011), and the perceived opinion of the respondents (p=0.008) has a statistically significant relationship to the behavior of choosing treatment. This means that factors related to the selection of traditional medicine are predisposing factors for patients (age, occupation, knowledge, travel time), supporting factors (rates), and factors of need (perceived opinion).Keywords: Healthcare, herbal medicine, hypercholesterolemia

Profil Penggunaan Antibiotik Pascapencanangan Penerapan Program Pengendalian Resistensi Antibiotik di Intensive Care Unit Rumah Sakit TNI-AL dr. Ramelan Surabaya Stefanie Setiawan; Widyati Widyati; Pandu Harijono
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Universitas Padjadjaran

Program Pengendalian Resistensi Antibiotik (PPRA) merupakan program wajib rumah sakit Indonesia sesuai Permenkes No. 8 tahun 2015. Rumkital dr. Ramelan Surabaya termasuk salah satu rumah sakit yang telah menerapkan PPRA. Tujuan penelitian ini adalah untuk mengetahui deskripsi kuantitatif-kualitatif pemakaian antibiotik, serta luaran klinis dan mikrobiologis yang teramati pascapencanangan penerapan PPRA di ICU Rumkital dr. Ramelan Surabaya. Desain penelitian adalah studi observasi cross-sectional yang dilakukan selama 3 bulan (Februari–Mei 2016) di ICU Rumkital dr. Ramelan. Deskripsi kuantitatif diamati menggunakan Days of Therapy (DOT/100 hari-pasien), deskripsi kualitatif menggunakan alur Gyssens. Pengamatan luaran klinis dilakukan terhadap infeksi nosokomial, mortalitas terkait infeksi, dan lama tinggal di ICU (Length of Stay/LOS). Pengamatan luaran mikrobiologis dilakukan terhadap pola penyebaran bakteri multiresisten. Hasil perhitungan jumlah konsumsi antibiotik didapatkan 151,63 DOT/100 hari-pasien. Penilaian kualitas antibiotik menunjukkan hasil 52,73% terapi tepat; 8,18% tidak tepat; 7,27% tanpa indikasi; 31,82% tidak tercapai kesepakatan antar penilai (κ=0,59; p<0,05). Infeksi nosokomial terbanyak yaitu Hospital Acquired Pneumonia (HAP)/Ventilator Associated Pneumonia (VAP), mortalitas terkait infeksi 44,68%; dan LOS rata-rata 7,17±1,9 hari (p<0,05). Belum ditemukan adanya insiden Methicillin-resistant Staphylococcus aureus (MRSA) ataupun Extended Spectrum Beta-Lactamase (ESBL), namun ditemukan dua kasus Multi Drug Resistant (MDR) Acinetobacter baumannii.Kata kunci: Alur Gyssens, DOT, ICU, PPRA, resistensi antibiotik Antibiotic Usage Profile after Antibiotic Stewardship Program Implementation in Intensive Care Unit of dr. Ramelan Naval Hospital SurabayaAntibiotic Stewardship Program (ASP) is mandatory to all Indonesian hospitals, in accordance to the 2015 Minister of Health Decree No. 8. Dr. Ramelan Naval Hospital Surabaya is one among the many hospitals in Indonesia that has implemented the ASP. The study objective was to describe quantitative-qualitatively the use of antibiotics, along with clinical and microbiological outcomes observed in an Intensive Care Unit (ICU) after ASP implementation in dr. Ramelan Naval Hospital Surabaya. The design was a 3-month (February–May 2016) cross-sectional observational study. Quantitative description was reported using Days of Therapy (DOT)/100 patient-days, the qualitative description was reviewed using Gyssens’ flowchart. Clinical outcomes observed include nosocomial infection, infection-related mortality, and average length of stay (LOS). Microbiological outcome was observed through the occurences of multi-drug resistant organism. The results showed overall antibiotic use was 151.63 DOT/100 patient-days. Quality of antibiotic use were 52.73% definitely appropriate; 8.18% inappropriate regarding dose, intervals, durations, and timing; 7.27% no indication; and no mutual agreement in 31.82% (κ=0.59; p<0.05). Hospital Acquired Pneumonias (HAPs)/Ventilator Associated Pneumonias (VAPs) were the most observed nosocomial infection, infection-related mortality rate was 44.68%; and average LOS were 7.17±1.9 days (p<0.05). No incidents of Methicillin-resistant Staphylococcus aureus (MRSA) or Extended Spectrum Beta-Lactamase (ESBL) have been found, but there were two cases of Multi Drug Resistant (MDR) Acinetobacter baumannii.Keywords: Antibiotic resistance, ASP, DOT, Gyssens’ flowchart, ICU

Pengaruh Konseling Farmasis terhadap Kepatuhan dan Kontrol Hipertensi Pasien Prolanis di Klinik Mitra Husada Kendal Melani Dewi; Ika P. Sari; Probosuseno Probosuseno
Indonesian Journal of Clinical Pharmacy Vol 4, No 4 (2015)
Publisher : Universitas Padjadjaran

dalam keberhasilan terapi hipertensi. Penelitian ini dilakukan untuk mengetahui pengaruh konseling oleh farmasis terhadap kepatuhan dan hubungan antara kepatuhan dan hasil terapi pasien hipertensi anggota program pengelolaan penyakit kronis (PROLANIS) di Klinik Mitra Husada Kabupaten Kendal. Penelitian dilakukan pada November 2013–Januari 2014 melalui desain eksperimen semu (control group design with pretest posttest). Sebanyak 55 pasien dikelompokkan secara random menjadi kelompok yang memperoleh intervensi konseling (28 pasien) dan kelompok tanpa intervensi atau kontrol (27 pasien). Subjek penelitian diikuti selama dua bulan untuk mengamati tingkat kepatuhan minum obat dengan kuesioner MMAS dan penurunan tekanan darah sebelum dan sesudah konseling. Konseling oleh farmasis menyebabkan tingkat kepatuhan minum obat berubah signifikan pada pasien hipertensi, pasien hipertensi dengan DM, maupun pasien hipertensi dengan penyakit lain (p=0,015; 0,025; 0,009). Tingkat kepatuhan pasien kelompok kontrol sebelum dan setelah penelitian diketahui tidak signifikan (p≥0,05). Pemberian konseling mampu menurunkan tekanan darah sistolik/diastolik sebesar 10,7/8,2 mmHg. Penurunan tekanan darah ini belum menunjukkan perbedaan yang bermakna jika dibandingkan dengan kelompok kontrol.Kata kunci: Hipertensi, kepatuhan minum obat, konseling farmasis, penurunan tekanan darahThe Influence of the Pharmacists Counseling on Patient Adherence and Hypertension Control on Patient of Prolanis at Mitra Husada ClinicsPatient adherence and intensive treatment in controlling blood pressure are important factors for achieving success therapy in hypertension. This study was conducted to determine the effect of pharmacist counseling on patient adherence and to determine the relationship of adherence and clinical outcomes of patients with hypertension who is joining chronic disease management program (PROLANIS) on Mitra Husada Clinics in Kendal.The study was conducted during November 2013–January 2014 using quasiexperimental design (pretest-posttest). Fifty five patients were randomly divided into the intervention group who received pharmacist counseling (28 patients) and control group (27 patients). The patients were followed for two months to observe the level of drug adherence using MMAS questionnaires and therapeutic outcomes (decreased blood pressure) before and after counseling. Pharmacist counseling caused a significant increase in the patient adherence on drug administration in intervention group (p<0.05) compared to control group. The reduction of systolic/diastolic blood pressure of hypertension patient in intervention group is higher than control group (SBP/DBP=10.7/8.2 mmHg). However, this reduction does not achieve a significant blood pressure reduction compared to control group.Keywords: Adherence of drug administration, blood pressure reduction, hypertension, pharmacist

Pengoptimalan Peran Apoteker dalam Pemantauan dan Evaluasi Insiden Keselamatan Pasien Wara Kusharwanti; Sekar C. Dewi; Margarita K. Setiawati
Indonesian Journal of Clinical Pharmacy Vol 3, No 3 (2014)
Publisher : Universitas Padjadjaran

Apoteker dapat berkontribusi dalam perawatan pasien dengan mengoptimalkan penggunaan obat dan meminimalisasi efek obat yang tidak diharapkan dengan cara mengidentifikasi Medication Related Problems (MRPs), memberikan solusi terhadap MRPs, dan mencegah MRPs melalui pelayanan farmasi klinik. Tujuan penelitian ini adalah mengintegrasikan kegiatan farmasi klinik dengan kegiatan keselamatan pasien untuk mengoptimalkan peran apoteker dalam pemantauan dan evaluasi insiden keselamatan pasien (IKP). Penelitian ini merupakan penelitian kuasi eksperimental dengan pengambilan data secara prospektif yang dilakukan pada bulan Mei–Juli 2012 dengan subjek penelitian pasien rawat inap sebanyak 5173 pasien. Hasil penelitian ini menunjukkan terdapat 150 MRPs yang terjadi pada 142 pasien. MRPs dikelompokkan dalam 5 kategori insiden, yaitu Kondisi Potensial Cedera (2,67%), Kondisi Nyaris Cedera (16,67%), Kondisi Tidak Cedera (58,66%), Kejadian Tidak Diharapkan (22%), dan sentinel (0%). Setiap MRPs ditindaklanjuti dengan rekomendasi yang diukur tingkat penerimaannya, yaitu diterima sesuai rekomendasi (81,64%), diterima dengan modifikasi (5,70%), diterima tanpa dilakukan perubahan (12,56%.). Setelah itu dilakukan pemetaan risk grading matrix. Integrasi kegiatan farmasi klinik dengan kegiatan keselamatan pasien diwujudkan melalui sistem pelaporan yang memuat MRPs, kategori insiden, dampak klinik, rekomendasi pemecahan masalah, dan risk grading matrix.Kata kunci: Apoteker farmasi klinik, keselamatan pasien, risk grading matrix Optimization of Pharmacists Roles in Patient Safety Monitoring andEvaluationPharmacists can contribute to patient care by optimizing the use of drugs and minimizing adverse drugs effect. This can be performed by identifying the presence of Medication Related Problems (MRPs) and providing a solution to prevent the MRPs through clinical pharmacy services. The aim of this study was to integrate clinical pharmacy activities with patient safety activities in order to optimize the roles of pharmacists both in monitoring and evaluation of patient safety incidents. This study was a quasi-experimental study with prospective data collection which was conducted in May–July 2012 with 5173 hospitalized patients as subjects. The results showed that there were 150 MRPs occurred in 142patients. The existing MRPs were grouped in 5 categories of incidents; Potential Injury (2.67%), Almost Injury (16.67%), No Injury (58.66%), Unexpected Incidents (22%), and Sentinel (0%). Each MRPs was followed by recommendations which level of acceptance were measured; accepted according to the recommendations (81.64%), accepted with modifications (5.70%), and accepted without changes (12.56%). Furthermore, risk grading matrix mapping was also performed. Based on these results,integration of clinical pharmacy activities to patient safety activities was performed through report system. This report including MRP, incident categories, clinical impacts, recommendation, and risk grading matrix.Key words: Clinical pharmacists, patient safety, risk grading matrix

Human Interferon Alpha2a as Anti Hepatitis B and C Ratih A. Ningrum
Indonesian Journal of Clinical Pharmacy Vol 6, No 4 (2017)
Publisher : Universitas Padjadjaran

Hepatitis is an inflammation of the liver mainly caused by hepatitis viruses. There are 5 different types of hepatitis based on the infecting virus; A, B, C, D and E. Hepatitis B and C are chronic diseases that potentially develop into hepatocarcinoma and cirrhosis on unappropriate treatments. World Health Organization (WHO) stated that currently 350 million people worldwide are living with chronic hepatitis B and 150 million people are living with Hepatitis C. The mortality rate in the world due to hepatitis is about 1.5 million people per year. The human interferon alpha2a (hIFNα2a) is a therapeutic protein used as therapeutic protein for hepatitis B and C. This review discusses the hepatitis B (HBV) and C (HCV) viruses, mechanisms of hIFNα2a as antivirus through signal transduction pathway and improvement of hIFNα2a properties by protein modification. The application of recombinant hIFNα2a (rhIFNα2a) in the treatment of hepatitis B and C that recommended by European Association for The Study of Liver (EASL) and the viral resistance mechanism are also included. The status of hepatitis B and C and the development of rhIFNα2a is also described as well.Keywords: Antiviral, hepatitis, human interferon alpha2a, protein modification, viral resistance Protein Interferon Alfa-2a Manusia sebagai Anti Hepatitis B dan CHepatitis merupakan kondisi inflamasi pada hati yang terutama disebabkan oleh virus hepatitis. Berdasarkan tipe virus yang menginfeksi, terdapat lima jenis penyakit hepatitis yaitu A, B, C, D dan E. Hepatitis B dan C merupakan penyakit kronis yang berpotensi menjadi kanker hati dan sirosis jika tidak ditangani dengan baik. World Health Organization (WHO) menyatakan bahwa saat ini terdapat 350 juta orang yang terinfeksi hepatitis B dan 150 juta orang terinfeksi hepatitis C di seluruh dunia. Angka kematian yang disebabkan hepatitis mencapai 1,5 juta orang per tahun. Protein interferon alfa-2a manusia (hIFNα2a) adalah protein terapeutik yang digunakan sebagai obat hepatitis B dan C. Review ini mendiskusikan mengenai virus hepatitis B (HBV) dan C (HCV), mekanisme hIFNα2a sebagai antivirus melalui sistem transduksi sinyal dan peningkatan sifat hIFNα2a melalui modifikasi protein. Review ini juga membahas aplikasi bentuk rekombinan hIFNα2a (rhIFNα2a) dalam penanganan hepatitis B dan C yang direkomendasikan oleh European Association for The Study of Liver (EASL) dan mekanisme resistensi virus. Status hepatitis B dan C serta perkembangan rhIFNα2a juga didiskusikan lebih lanjut.Kata kunci: Antivirus, hepatitis, interferon alfa-2a manusia, modifikasi protein, resistensi virus

Analisis Risiko Reaksi Obat yang Tidak Dikehendaki pada Pasien Lanjut Usia di Rumah Sakit Umum Surabaya Fauna Herawati; Andri Utomo
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Universitas Padjadjaran

Orang lanjut usia memiliki risiko tujuh kali lebih besar mengalami Reaksi Obat yang Tidak Dikehendaki (ROTD) dibandingkan dengan orang yang lebih muda. Penelitian yang dilakukan di rumah sakit di Irlandia melaporkan bahwa kejadian ROTD pada pasien lanjut usia sebesar 26%. Tujuan penelitian ini adalah untuk melihat tingkat risiko ROTD dan jenis obat yang digunakan pada pasien lanjut usia rawat inap di RSUD Dr. Moh. Soewandhie Surabaya Periode November–Desember 2014 dengan alat Gerontonet Score dan kriteria Screening Tool of Older People’s Prescriptions (STOPP). Penelitian ini merupakan studi potong lintang dengan jumlah responden 42 orang. Gerontonet score dan kriteria STOPP digunakan untuk melihat tingkat risiko dan jenis obat yang dapat meningkatkan ROTD. Gerontonet score terdiri dari 6 variabel (≥4 comorbid, gagal jantung, gangguan liver, jumlah obat, riwayat ROTD, dan gangguan ginjal); skor ≥4 menunjukkan pasien yang berisiko tinggi mengalami ROTD. Hasil penelitian menunjukkan variabel yang paling banyak menentukan skor adalah GFR ≤60 mL/menit/1,73 m2 dan jumlah obat yang diterima pasien; 15 orang memiliki risiko tinggi (skor ≥4) mengalami ROTD; dan 9,7% (6/62) jenis obat yang termasuk dalam kriteria STOPP, yaitu: furosemid, aspirin, digoksin, dan golongan OAINS (diklofenak, ketoprofen, dan meloksikam). Jadi, GFR ≤60 mL/menit/1,73 m2 dan jumlah obat merupakan faktor risiko yang dapat meningkatkan ROTD.Kata kunci: Gerontonet score, kriteria STOPP, lanjut usia, ROTD Analysis of the Risk of Adverse Drug Reaction on Elderly Patients in General Hospital Surabaya Abstract Elderly people have the risk of adverse drug reaction (ADR) seven times as high as the adult ones. A research conducted in one of the hospitals in Ireland reported that the incident of ADR was 26%. The objective of this study was to find out the level of ADR risk and types of drugs used to treat elderly inpatients in Dr. Moh. Soewandhi General Hospital Surabaya for the period of November–Desember 2014 utilizing gerontonet score and Screening Tool of Older People’s Prescriptions (STOPP) criteria. The method of this research is cross sectional with a total of 42 participants. In this study, gerontonet score and STOPP criteria was used to analyze the data in order to determine the level of risk and types of drugs. Gerontonet score consists of 6 variables (>4 comorbid, heart failure, liver disorder, amount of drug, history of ADR, and kidney failure); score of ≥4 at presentation identified that the patient is at high risk of ADR. The result of this study showed the variables that mostly determine score was GFR ≤60 mL/min/1,73 m2; 15 participant at high risk of ADR (≥4); and amount of drugs used for treatments; and 9,7% (6/62) kind of drugs used for treatments was included in STOPP criteria: furosemide, aspirin, digoxin, and NSAID (diclofenac, ketoprofen, and meloxicam). The conclusion of this study showed GFR ≤60 mL/min/1,73 m2 and amount of drugs used for treatments increased the risk of ADR.Key words: ADR, elderly, Gerontonet score, STOPP criteria

Efek Kemoterapi Bleomisin, Vincristin, Mitomisin dan Karboplatin terhadap Massa Tumor dan Infiltrasi Parametrium pada Pasien Kanker Serviks: Studi Kasus di RSUP Sanglah Denpasar Rini Noviyani; I Nyoman G. Budiana; I Ketut Tunas; Ayu Indrayathi; Rasmaya Niruri; Ketut Suwiyoga
Indonesian Journal of Clinical Pharmacy Vol 6, No 3 (2017)
Publisher : Universitas Padjadjaran

Penggunaan regimen BOM-cisplatin untuk kemoterapi pasien kanker serviks masih belum memberikan hasil efektivitas yang memuaskan, sehingga dilakukan penggantian agen cisplatin dengan karboplatin. Kemoterapi BOM-karboplatin merupakan salah satu regimen terapi kanker serviks di RSUP Sanglah Denpasar. Informasi tentang efektivitas penggunaan BOM-karboplatin untuk kemoterapi kanker serviks masih sangat minim, maka dari itu penelitian ini dilakukan dengan melihat massa tumor dan infiltrasi parametrium. Penelitian ini merupakan penelitian studi kasus terhadap 9 pasien kanker serviks sel skuamosa stadium IIB–IIIB sebelum dan sesudah kemoterapi BOM-karboplatin di RSUP Sanglah dari bulan Februari hingga Agustus 2015 yang memenuhi kriteria. Pemeriksaan Massa Tumor dan Infiltrasi Parametrium (%CFS) dilakukan sebelum kemoterapi seri I dan sesudah kemoterapi seri III. Pengambilan sampel menggunakan consecutive sampling. Data penelitian dianalisis menggunakan uji normalitas yaitu uji Shapiro-Wilk, selanjutnya dianalisis menggunakan uji t berpasangan dengan taraf kepercayaan 95%, sedangkan data berdistribusi tidak normal ditranformasi ke bentuk fungsi logaritma lalu dianalisis dengan uji Wilcoxon. Berdasarkan analisis statistik diketahui bahwa terdapat penurunan bermakna pada massa tumor dan infiltrasi parametrium kiri sesudah 3 seri kemoterapi dengan nilai p<0,05 yaitu masing-masing p=0,001 dan p=0,025, tetapi tidak terdapat penurunan bermakna pada infiltrasi parametrium kanan dengan nilai p>0.05 yaitu p>0,083.Kata kunci: BOM-cisplatin, cancer free space, kanker serviks, RSUP Sanglah Effect of Chemotherapy Bleomycin, Vincristin, Mitomycin and Carboplatin by Tumor Mass and Infiltration Parametrial for Cervical Cancer Patients: Case Study in Sanglah General Hospital, DenpasarBOM-cisplatin regimen for chemotherapy for cervical cancer patients has not resulted high efficacy, hence a replacement of cisplatin with carboplatin is proposed. BOM-carboplatin chemotherapy is at present a treatment for cervical cancer patients in Sanglah Hospital in Denpasar. Information about the efficacy of using the BOM-carboplatin for cervical cancer chemotherapy is not provided, therefore this research performed by observing tumor mass and parametrial infiltration. This research was carried out using case study method on 9 patients with squamous cell cervical cancer stage IIB–IIIB before and after BOM-carboplatin chemotherapy at Sanglah Hospital from February until August 2015. Examination of tumor mass and parametrial infiltration (%CFS) conducted prior to chemotherapy series I and after chemotherapy series III. Sampling was done consecutively. The research data were analyzed using the normal distribution Shapiro-Wilk test continued by paired t-test with 95% confidence level, while data that is classified otherwise is transformed to logarithmic function and were analyzed using the Wilcoxon test. Based on statistical analysis, there is significant reduction in tumor mass and left parametrial infiltration after the third chemotherapy with (p<0.05) which are p=0.001 and p=0.025, but there is no significant reduction of right parametrial infiltration with p>0.05 that is p>0,083.Keywords: BOM-cisplatin, cancer free space, cervix cancer, Sanglah hospital

Analisis Penggunaan Antimikroba Parenteral pada Pasien Infeksi Saluran Kemih di Bangsal Penyakit Dalam RSUP Dr. M. Djamil Padang Putri Ramadheni; Sanubari R. Tobat; Fatimatu Zahro
Indonesian Journal of Clinical Pharmacy Vol 5, No 3 (2016)
Publisher : Universitas Padjadjaran

Infeksi saluran kemih (ISK) merupakan salah satu penyakit infeksi yang memiliki prevalensi cukup tinggi. Berdasarkan data rekam medis RSUP dr. M. Djamil Padang pada tahun 2013, terdapat pasien ISK sebanyak 273 orang. Tujuan penelitan ini adalah untuk menganalisis rasionalitas terapi antimikroba parenteral serta pengelolaannya di bangsal penyakit dalam RSUP dr. M. Djamil Padang. Penelitian ini merupakan penelitian observasional menggunakan data prospektif pada bulan April sampai Juni 2015 di bangsal penyakit dalam. Kriteria inklusi yaitu pasien ISK dewasa (>18 tahun), dirawat di bangsal penyakit dalam RSUP dr. M. Djamil, serta mendapatkan terapi antimikroba parenteral. Hasil analisis penggunaan antimikroba parenteral menunjukkan bahwa antibiotik sefalosporin generasi III paling banyak digunakan (79,16%) serta dikombinasi dengan quinolon, flukonazol, dan metronidazol. Hasil analisis rasionalitas memperlihatkan bahwa terapi telah tepat indikasi, tepat pasien, tepat obat, dan tepat obat dan penggunaannya (94,7%). Pada proses pengelolaan sediaan antimikroba parenteral ditemukan bahwa penyimpanannya telah tepat, namun proses rekonstitusi belum memenuhi teknik aseptis serta prosedur yang telah ditetapkan oleh Departemen Kesehatan tahun 2009. Penggunaan antimikroba parenteral pada pasien ISK di RSUP dr. M. Djamil Padang telah rasional, namun proses rekonstitusinya belum memenuhi prosedur yang ditetapkan oleh Depkes tahun 2009.Kata kunci: Antimikroba, ISK, parenteral, rasionalitas Analysis of Parenteral Antimicrobial Usage in Patients with Urinary Tract Infection at dr. M. Djamil Padang Hospital Urinary tract infection (UTI) has a high prevalence in dr. M. Djamil Padang hospital in the year of 2013. Based on the Medical Record Data, there were 273 patients with UTI. The purpose of the study was to analyse the rationality of parental antimicrobial preparation use and management. This prospective observasional study used data from April to June 2015 in internal medicine wards. The inclusion criteria include UTI adult patients (>18 years), were treated at the department of internal medicine ward dr. M. Djamil hospital, as well as parenteral antimicrobial therapy. Results of the statistical analysis showed that the use of antimicrobial parenteral used of third generation cephalosporin antibiotik most widely used was (79.16%) and in combination with quinolones, fluconazole, and metronidazole. Results of the analysis showed that the therapy, patient, frequency, dosage and precise method of drug administration was (100%) duration of therapy was (94,7%) appropriate. As for the process management of parenteral antimicrobial preparations was found that the storage was right, but the reconstitution process has not complied with the procedures established by the Ministry of Health in 2009. The use of parenteral antimicrobial in patients with UTIs at dr. M. Djamil Padang hospital has been rational, but the reconstitution process is not appropriate the procedures established by the Ministry of Health in 2009.Keywords: Antimicrobial, parenteral, rationality, UTI

Kualitas Hidup Pasien Kanker Payudara dengan Terapi Kombinasi Fluorouracil, Doxorubicin, dan Cyclofosfamide Dewi D. Agustini; Emma Surahman; Rizky Abdulah
Indonesian Journal of Clinical Pharmacy Vol 4, No 3 (2015)
Publisher : Universitas Padjadjaran

Pengobatan pada kanker payudara dengan kemoterapi kombinasi Fluorouracil, Doxorubicin, dan Cyclofosfamide (FAC) menimbulkan perbedaan kualitas hidup pasien yang penting untuk diketahui karena dapat menunjang keefektifan pengobatan. Tujuan penelitian ini adalah untuk mengukur perbedaan dan mengetahui dimensi yang memengaruhi kualitas hidup pasien kanker payudara dari setiap siklus kemoterapi di RS Hasan Sadikin Bandung. Jenis penelitian ini adalah observasional analitik dengan pedekatan potong lintang. Sebanyak 200 pasien kanker payudara dipilih secara purposive dan dipisahkan berdasarkan siklus terapi. Penilaian kualitas hidup dilakukan secara multidimensional menggunakan instrumen EORTC QLQ (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) C30 dan BR23. Analisis data dihitung menggunakan uji t independen dan regresi linier berganda. Hasil penelitian menunjukkan terdapat perbedaan kualitas hidup yang sangat signifikan antara skala fungsi QLQ-C30 baseline dengan terapi ke-5, skala gejala QLQ-C30 baseline dengan terapi ke-5, skala fungsi QLQ-BR23 baseline dengan terapi ke-1, 2, 3, 4, dan 5, skala gejala QLQ-BR23 baseline dengan terapi ke-4, kemudian perbedaan signifikan antara skala gejala QLQ-BR23 baseline denganterapi ke-1, 3, dan 5. Dimensi yang berpengaruh signifikan terhadap kualitas hidup adalah fungsi sosial, mual dan muntah, gangguan pernapasan, gangguan tidur, dan kesulitan keuangan.Kata kunci: BR23, EORTC QLQ C30, kanker payudara, kualitas hidupQuality of Life Patients with Breast Cancer Therapy Combination Fluorouracil, Doxorubicin, and CyclofosfamideTreatment of breast cancer with combination chemotherapy Florouracil, doxorubicin, and Cyclofosfamide (FAC) lead to differences in the quality of life of patients is important to know because it can support the effectiveness of patient treatment. The aim of the study was to measure the difference and know the dimensions that affect the quality of life of breast cancer patients from each cycle of chemotherapy in Hasan Sadikin Hospital. This research is an observational analytic cross sectional approach. A sample of 200 breast cancer patients who were selected purposively and separated based on cycles of therapy. Assessment of quality of life of patients is done using a multidimensional instrument EORTC QLQ (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) C30 and BR23. Data analysis was calculated using independent t test and linear regression. The results showed that there are differences in quality of life is very significant between QLQ-C30 functioning scale baseline with treatment 5, the QLQ-C30 symptom scale baseline therapy 5th, QLQ-BR23 function scale baseline with therapy 1st, 2nd, 3rd, 4th, and 5th, QLQ-BR23 symptoms scale baseline with therapy 4th, then a significant difference between scale symptoms of QLQ-BR23 baseline therapy with the 1st, 3rd, and 5th. Dimensions have a significant effect on quality of life is a social function, nausea and vomiting, dyspnea, sleep disorders and financial difficulties.Key words: BR23, breast cancer, EORTC QLQ C30, quality of life

Evaluasi Penggunaan Antibiotik dan Profil Kuman pada Seksio Sesarea di Rumah Sakit Umum Daerah Kabupaten Pasuruan Rika Yulia; Fauna Herawati; Abdul K. Jaelani; Wirda Anggraini
Indonesian Journal of Clinical Pharmacy Vol 7, No 2 (2018)
Publisher : Universitas Padjadjaran

Infeksi Luka Operasi (ILO) adalah salah satu komplikasi pembedahan yang paling umum terjadi di dunia, terutama di negara berkembang. Penggunaan antibiotik profilaksis sebelum operasi yang tepat dapat mengurangi ILO. Penelitian ini bertujuan untuk mengetahui profil penggunaan antibiotik dan kesesuaian penggunaan antibiotik pada seksio sesarea dengan peta kuman rumah sakit, Pedoman Penggunaan Antibiotik (PPAB) 2016, Formularium Rumah Sakit (RS), Formularium Nasional (Fornas), serta mengidentifikasi profil kuman penyebab ILO pada luka pasien. Metode penelitian menggunakan metode cohort prospective melalui penelusuran data terhadap rekam medik pasien yang menjalani tindakan operasi seksio sesarea di salah satu rumah sakit di Kabupaten Pasuruan periode Maret–Mei 2017, yaitu data penggunaan antibiotik (jenis antibiotik, dosis, waktu pemberian) dan data peta kuman bulan Januari–Maret 2017 terkait resistensi antibiotik. Analisis data berupa deskripsi profil penggunaan antibiotik, kesesuaian penggunaan antibiotik pada pasien seksio sesarea dengan pedoman, dan profil kuman penyebab ILO. Hasil yang diperoleh dari penelitian ini menunjukkan bahwa penggunaan antibiotik pada pasien seksio sesarea adalah ampisilin/sulbaktam 37%, sefuroksim 34%, seftriakson 24%, sefazolin 5%, metronidazol 1%, dan gentamisin 1%. Kesesuaian berdasarkan jenis antibiotik secara berturut-turut 5% berdasarkan PPAB, 100% berdasarkan Formularium RS dan 63% berdasarkan Fornas. Hal ini disebabkan oleh pola sensitivitas sefazolin berdasarkan peta kuman bulan Januari–Maret 2017 semakin menurun. Kesesuaian berdasarkan dosis antibiotik 100% sesuai berdasarkan PPAB, Formularium RS dan Fornas. Kesesuaian berdasarkan dosis antibiotik dan waktu pemberian 92% sesuai berdasarkan PPAB. Kuman yang ditemukan pada luka pasien adalah bakteri Hafnia alvei.Kata kunci: Antibiotik profilaksis, Infeksi Luka Operasi, seksio sesarea Evaluation of Antibiotics Use and Bacteria Profile of Caesarean Section at Regional General Hospital, PasuruanAbstractSurgical Site Infection (SSI) is one of the most common surgical complications in the world, especially in developing countries. Proper use of prophylaxis antibiotics in appropriate intraoperative procedures may reduce SSI. The aim of this study was to determine the profile of antibiotic used and the adherence of antibiotic in caesarean section to Hospital Guideline 2016, Hospital Formulary, National Formulary, bacteria profile that cause SSI on the patient’s wound. Method used in this study was cohort prospective study design using record data of patients who underwent caesarean section surgery at Regional General Hospital of Pasuruan from March–May 2017, i.e. antibiotics usage data (type, dosage and time of delivery) and microbial pattern data about antibiotic resistance from January–March 2017. Data analysis was description of the profile of antibiotic use, adherence use of antibiotic of caesarean section inpatients to the guidelines, and profile of bacteria that cause SSI. The results showed that the use of antibiotics in caesarean section patients was ampicillin/sulbactam 37%, cefuroxime 34%, ceftriaxone 24%, cefazolin 5%, metronidazole 1%, and gentamycin 1%. Adherence by type of antibiotics was 5% based on Hospital Guideline, 100% based on Hospital Formulary and 63% based on National Formulary. This was due to a decrease of cefazolin sensitivity pattern from 20% to 0% in January–March 2017 period. Adherence of antibiotic dosage was 100% based on Hospital Guideline, Hospital Formulary and National Formulary. Adherence of time of delivery 92% was based on Hospital Guideline. Bacteria found in the wounds of patients was Hafnia alvei.Keywords: Caesarean section, prophylaxis antibiotic, surgical site infection

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