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Evaluasi Penggunaan Antibiotik Pada Pasien Luka Bakar Dengan Nosokomial Pneumonia Di RSUD Dr. Soetomo Pada Tahun 2017-2019 Putra, Oki Nugraha
Pharmauho: Jurnal Farmasi, Sains, dan Kesehatan Vol 6, No 1 (2020): Pharmauho
Publisher : Fakultas Farmasi Universitas Halu Oleo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33772/pharmauho.v6i1.11095

Nosokomial pneumonia merupakan salah satu bentuk infeksi yang seringkali ditemukan pada pasien luka bakar dengan tingkat morbiditas dan mortalitas yang tinggi. Modalitas utama pada nosokomial pneumonia adalah pemberian antibiotik. Tujuan penelitian ini ialah untuk mengevaluasi penggunaan antibiotik untuk pneumonia pada pasien luka bakar dengan nosokomial pneumonia secara kualitatif dengan metode Gyssen dan secara kuantitatif dengan defined daily dose (DDD). Pengambilan data dilakukan secara retrospektif melalui data rekam medik pasien luka bakar dengan nosokomial pneumonia yang di rawat di RSUD Dr. Soetomo pada tahun 2017-2019. Diperoleh tujuh pasien luka bakar dengan nosokomial pneumonia yang memenuhi kriteria inklusi. Dari 7 pasien tersebut, enam diantaranya tergolong hospital acquired pneumonia (HAP), dan 1 pasien termasuk ventilator associated pneumonia (VAP). Antibiotik terbanyak untuk terapi nosokomial pneumonia yakni meropenem (34%), levofloxacin dan amikasin masing-masing sebesar 17%. Didapatkan 3 pasien (42,9%) termasuk kategori IVa (altenatif lebih efektif), 1 pasien (14,2%) termasuk kategori IVb (alternatif lebih tidak toksik), 1 pasien (14,2%) termasuk kategori IVd (spektrum lebih sempit), 1 pasien (14,2%) termasuk kategori IIaÂ (dosis tidak tepat) dan 1 pasien (14,2%) tidak termasuk kategori I-IV. Nilai total DDD /100 patients-days didapatkan sebesar 161,09. DDD/100 patients-days antibiotik pada penelitian ini didapatkan levofloxacin (67,50), amikasin (42,59), meropenem (39,82), serta cefoperazon (11,18). Pemberian antibiotik pada pasien luka bakar dengan nosokomial pneumonia termasuk dalam kategori kurang tepat sebesar 85,5% dan 14,5 % masuk dalam kategori tepat. Selain itu, tingkat pemakaian antibiotik masih cukup tinggi.Â Kata Kunci : Luka Bakar, Nosokomial Pneumonia, Antibiotik, Gyssen, Defined Daily DoseÂ

Skrining Fitokimia Metabolit Sekunder Alga Cokelat (Padina australis) dari Kepulauan Poteran Madura Dyah Nurrahman, Nani Wijayanti; Sudjarwo, Giftania Wardani; Putra, Oki Nugraha
Journal of Pharmaceutical Care Anwar Medika (J-PhAM) Vol 2 No 2 (2020): Volume 2, Nomor 2, Juni 2020
Publisher : STIKES Rumah Sakit Anwar Medika

Alga cokelat (Padina australis) merupakan tanaman laut yang sangat melimpah di perairan Indonesia terutama Pulau Madura. Alga cokelat dikenal sebagai penghasil senyawa bioaktif seperti alginate, karagenan, dan agar yang dapat dimanfaatkan dalam dunia kefarmasian. Penelitian ini bertujuan untuk melakukan skrining fitokimia metabolit sekunder yang terdapat dalam Padina australis. Bahan yang digunakan dalam penelitian ini adalah ekstrak etanol 96% Padina asutralis, HCl 2 N, NaCl, Pereaksi Mayer dan Wagner, NH4OH 28%, methanol, air, etil asetat, Pereaksi Dragendorf, asam asetat anhidrat, H2SO4, n-heksan, anisaldehid asam sulfat, HCl (p), potongan magnesium, butanol, asam asetat glacial, NaCl 10%, gelatine, kloroform, dan FeCl3. Metode penetapan metabolit sekunder dilakukan dengan reaksi warna/pengendapan dan kromatografi lapis tipis. di Fakultas Perikanan Universitas Airlangga Surabaya dan diperoleh hasil yang menyatakan bahwa alga coklat yang digunakan yaitu Padina australis. Skrinin fitokimia yang dilakukan pada sampel ekstrak etanol 96% Padina australis menunjukkan bahwa Padina australis mengandung metabolit sekunder alkaloid, flavonoid, steroid, terpenoid, tannin, saponin.

Case Report : Expanded-Spectrum Beta Lactamase-Producing Klebsiella pneumoniae in Burn Injury With Hospital Acquired Pneumonia Putra, Oki Nugraha
Pharmaceutical Journal of Indonesia Vol 5, No 2 (2020)
Publisher : Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.pji.2020.005.02.2

Significantly higher mortality has been demonstrated in patients with severe burn, complicated by Klebsiella pneumonia infection. This case report assesses the efficacy combination of meropenem and levofloxacin to treat Klebsiella pneumonia ESBL on the scald-burn injury with hospital-acquired pneumonia. A 52-year-old male had scald burn on August, 2016 with late onset of Hospital Acquired Pneumonia (HAP). Klebsiella pneumonia ESBL was isolated from tissue burned culture. Initially, the patient was treated with meropenem and levofloxacin injection for a week. Then, Acinetobacter baumanii was isolated from tissue burned infection and ampicilin-sulbactam was the only one antibiotic which still susceptible to this pathogen. But with the clinical judgment, the combination of these antibiotics was still continued. After administration of these antibotics, rapid clinical improvement with signs short of breath, fever, cough was not observed and also the lung infiltrate was improved. The combination of meropenem and levofloxacin, may be a useful treatment option for hospital-acquired pneumonia related to Klebsiella pneumonia ESBL and also Acinetobacter baumanii, even these combination were resistance to Acinetobacter baumanii. Further research is also needed to clarify the effectiveness of meropenem and levofloxacin to treat Klebsiella pneumonia ESBL infection in the burn patient.

Case Report : Expanded-Spectrum Beta Lactamase-Producing Klebsiella pneumoniae in Burn Injury With Hospital Acquired Pneumonia Putra, Oki Nugraha
Pharmaceutical Journal of Indonesia Vol 5, No 2 (2020)
Publisher : Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.pji.2020.005.02.2

Significantly higher mortality has been demonstrated in patients with severe burn, complicated by Klebsiella pneumonia infection. This case report assesses the efficacy combination of meropenem and levofloxacin to treat Klebsiella pneumonia ESBL on the scald-burn injury with hospital-acquired pneumonia. A 52-year-old male had scald burn on August, 2016 with late onset of Hospital Acquired Pneumonia (HAP). Klebsiella pneumonia ESBL was isolated from tissue burned culture. Initially, the patient was treated with meropenem and levofloxacin injection for a week. Then, Acinetobacter baumanii was isolated from tissue burned infection and ampicilin-sulbactam was the only one antibiotic which still susceptible to this pathogen. But with the clinical judgment, the combination of these antibiotics was still continued. After administration of these antibotics, rapid clinical improvement with signs short of breath, fever, cough was not observed and also the lung infiltrate was improved. The combination of meropenem and levofloxacin, may be a useful treatment option for hospital-acquired pneumonia related to Klebsiella pneumonia ESBL and also Acinetobacter baumanii, even these combination were resistance to Acinetobacter baumanii. Further research is also needed to clarify the effectiveness of meropenem and levofloxacin to treat Klebsiella pneumonia ESBL infection in the burn patient.

Evaluation of Category I of Anti-tuberculosis Therapy in Intensive Phase Pulmonary TB by Conversion of Acid-Fast Bacilli Sputum Putra, Oki Nugraha; Damayanti, Amitasari; Nurrahman, Nani Wijayanti Dyah; Devi, Tsania; Aluf, Wildatul
Pharmaceutical Sciences and Research
Publisher : UI Scholars Hub

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Acid fast bacilli (AFB) sputum microscopy is used to diagnose tuberculosis (TB) and to evaluate the effectiveness of anti-tuberculosis drugs in TB eradication program. The AFB sputum microscopy should be performed before treatment, two months after intensive phase and four months after advance phase treatment. The aim of this study was to evaluate the sputum conversion rate of AFB in pulmonary TB patients who received category I of antituberculosis (anti-TB) drugs. Evaluation of sputum conversion was perfomed before initation of anti TB drugs and at the end of the intensive phase. This cohort prospective study was done from February to May, 2018. Nine pulmonary TB patients fulfilled the criteria during the study. This AFB sputum microscopy was evaluated by using Ziehl Neelsen and read by means of International Union Against Tuberculosis and Lung Disease (IUATLD) scale. Nine sputum smear positive were followed for two months. After two months (end of the intensive phase), the smear conversion rate was 100%. All patients received standard dose of anti-TB drugs in fix dose combination (FDC). It can be concluded that the sputum conversion of AFP in pulmonary TB patients who received category I of anti-TB was success at the second month of intensive phase.

A Mini Review : Clinically Significant Potential Drug-Drug Interactions In COVID-19 and Comorbid Therapy Faizah, Ana Khusnul; Nurrahman, Nani Wijayanti Dyah; Putra, Oki Nugraha
Pharmaceutical Sciences and Research
Publisher : UI Scholars Hub

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Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can be aggravated by comorbid diseases. In administering COVID-19 therapy, we need to consider potential drug-drug interactions (pDDIs) with comorbid drugs. Most patients with comorbid diseases get polypharmacy, therefore the risk of pDDIs increases. Potential drug-drug interactions can cause unwanted effects such as toxicity to death. There is no on-label therapy for COVID-19 but FDA has Emergency Use Authorization (EUA) for hydroxychloroquine, chloroquine, azithromycin, remdesivir, ritonavir, and lopinavir. Some COVID-19 treatment potential drug-drug interactions have a level of severity C and D, so there is a high need for close monitoring during drug administration or modification therapy.

Chloroquine: An Old to be Repurposed Drug For COVID-19 Infection (Risk and Benefit) Putra, Oki Nugraha; Faizah, Ana Khusnul; Nurrahman, Nani Wijayanti Dyah; Hardiyono, Hardiyono
Pharmaceutical Sciences and Research
Publisher : UI Scholars Hub

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19) with a high rate of mortality. Chloroquine and hydroxychloroquine have been used for antimalarial and autoimmune diseases for many years. Due to low toxicity and well tolerability as well as immunomodulatory properties, these drugs are proposed to treat viral infection. Some studies, both in vitro and in a clinical setting, have been evaluated for their ability to treat SARS- CoV-2 as promising therapies. Although The National Agency of Drugs and Food Control of The Republic of Indonesia issued emergency authorization for chloroquine and hydroxychloroquine to be used against COVID-19 infection, the efficacy of these drugs is still based on small clinical non- randomized trials with a limited number of patients. However, the use of these drugs without any risks. The safety of these drugs to be used in COVID-19 patients is lacking. Some experts noticed that the drugs cause harmful adverse effects, especially a harmful QT prolongation. In Indonesia, until now, no study evaluates the effectiveness as well as the safety of these drugs to be used in COVID-19 infection. This article will discuss the role of chloroquine or hydroxychloroquine and its safety to be used against COVID-19 infection.

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