Evaluasi Penggunaan Obat Pada Pasien Demam Tifoid Di Unit Rawat Inap Bagian Anak dan Penyakit Dalam Rumah Sakit Umum Daerah Sleman Periode Januari – Desember 2004

Demam tifoid merupakan salah satu dari lima penyebab kematian diIndonesia. Pemakaian obat yang tidak rasional merupakan salah satu masalah pada pusat pelayanan kesehatan, oleh karena itu dilakukan penelitian untuk mengetahui angka prevalensi demam tifoid dan rasionalitas pengobatan pasien demam tifoid termasuk angka kejadian interaksi obat, serta keadaan farmakoterapi tidak rasional di unit rawat inap bagian anak dan penyakit dalam RSUD Sleman selama periode tahun 2004.Penelitian dilakukan dengan rancangan deskriptif non analitik yangbersifat eksploratif dengan pengumpulan data kualitatif dan kuantitatif secara retrospektif. Bahan yang digunakan adalah rekam medik pasien demam tifoid di RSUD Sleman selama periode Januari-Desember 2004. Analisis dilakukan dengan Epi Info 2002, data dibandingkan dengan standar pengobatan demam tifoid dari WHO.Hasil penelitian adalah sebagai berikut: pasien demam tifoid di RSUDSleman terdiri dari 48,1% laki-laki dan 51,9% perempuan. Pasien anak-anak usia < 15 tahun sebanyak 53,75% dan pasien dewasa usia ³ 15 tahun sebanyak 46,25%. Perincian hasil kriteria pengobatan rasional sebagai berikut: tepat indikasi 100%, tepat obat 81,9%, tepat dosis 35,8%, tepat pasien 93,1%. Analisis pengobatan berdasarkan kriteria peresepan tidak rasional adalah sebagai berikut:peresepan berlebih (over) sebesar 38,7%, peresepan kurang (under) sebesar 31,8%, peresepan majemuk (multiple) sebesar 61,875%, peresepan salah (incorrect) sebesar 53,8%, dan peresepan boros (extravagant) sebesar 46,2%. Persentase kemungkinan terjadinya interaksi sebanyak 15,6%. Kesimpulan yang didapat menyatakan bahwa pengobatan pasien demam tifoid di RSUD Sleman belum rasional

EVALUASI PERILAKU PENGOBATAN SENDIRI TERHADAP PENCAPAIAN PROGRAM INDONESIA SEHAT 2010

Latar belakang : Salah satu indikator tercapainya Indonesia Sehat 2010 adalah tercapainya Program Pembangunan Kesehatan. Salah satu upaya agar derajat kesehatan masyarakat lebih optimal adalah pengobatan sendiri. Pengobatan sendiri hanya boleh menggunakan obat yang termasuk golongan obat bebas dan obat bebas terbatas sesuai dengan keterangan yang tercantum pada kemasannya. Tujuan penelitian : Mengevaluasi perilaku pengobatan sendiri yang dilakukan oleh masyarakat. Evaluasi dilakukan untuk melihat apakah perilaku pengobatan sendiri oleh masyarakat sudah rasional atau masih irasional. Metoda: Metode penelitian survei deskriptif dengan menggunakan kuesioner yang disebarkan kepada sampel terpilih dengan multistage random sampling yang dilakukan di Kecamatan Tembalang, Kota Semarang. Jumlah sampel 97 terbagi ke dalam lima kelurahan yang kemudian dari masing-masing kelurahan diambil sampel secara proporsional sesuai dengan jumlah penduduk. Hasil : Rata-rata angka kerasionalan penggunaan obat belum maksimal. Angka rasionalitas pengobatan masing-masing keluhan antara lain; penggunaan obat demam 76,3%; obat nyeri  43,3%; obat batuk kering dan berdahak 13,4%; obat pilek 32,0%; obat flu 93,8%; obat sesak nafas 14,4%; obat maag 70,1%; obat diare 85,6%; obat konstipasi 61,9%, obat jamur 50,5%, obat bisul 38,1%, obat haemoroid 36,1%. Dari hasil penelitian hanya 76,3% masyarakat yang menyatakan pergi ke dokter jika dalam dua hari gejala tidak membaik. Simpulan : Dilihat dari kerasionalitasan penggunaan obat, ternyata hasilnya belum memuaskan.Kata kunci : Pengobatan sendiri, Indonesia Seha

Efek Ekstrak Kulit Manggis Terhadap Gambaran Histopatologi Hepar Tikus Wistar Yang Diinduksi Formalin

Latar Belakang : Jejas kimia formalin dapat memacu terbentuknya senyawa reactive oxygen species (ROS) yang dapat menyebabkan kerusakan seluler jtubuh. Kulit manggis dikenal sebagai antioksidan alamiah dari kandungan xanton di dalamnya.Tujuan: mengetahui efek pemberian ekstrak kulit manggis terhadap gambaran histopatologi hepar pada tikus wistar yang diinduksi larutan formalin.Metode Penelitian: 24 ekor tikus dibagi menjadi 4 kelompok . Kelompok pertama merupakan kelompok kontrol negatif (K-), hanya diberi placebo saja hingga masa terminasi. Kelompok kedua merupakan kelompok kontrol positif (K+) yang diinduksi formalin peroral selama 21 hari, kemudian diberi placebo selama 7 hari. Kelompok ketiga sebagai kelompok Perlakuan 1 (P1) yang diinduksi formalin peroral selama 21 hari kemudian diberi ekstrak kulit manggis 200mg/kg BB/hari selama 7 hari. Kelompok keempat sebagai kelompok Perlakuan 2 (P2) yang diinduksi formalin peroral selama 21 hari kemudian diberi ekstrak kulit manggis 400mg/kg BB/hari selama 7 hari. Setelah itu tikus diterminasi dan diambil organ heparnya untuk dibuat preparat histopatologi.Hasil: Terdapat perbedaan yang signifikan (p=0,008) gambaran histopatologi jaringan hepar pada kelompok tikus yang diberi ekstrak kulit manggis 400mg/kg BB/hari (P2) dengan kelompok kontrol positif (K+). Tidak terdapat perbedaanyang signifikan (p=0,715) gambaran histopatologi jaringan hepar pada kelompok tikus yang diberi ekstrak kulit manggis 200mg/kg BB/hari (P1) dengan kelompok kontrol positif (K+). Terdapat perbedaan yang signifikan (0,00) gambaran histopatologi jaringan hepar kelompok kontrol negatif (K-) dengan ketiga kelompok yang diinduksi formalin, baik diberi ekstrak kulit manggis (P1 dan P2) maupun yang tidak (K+

Effects of ciprofloxacin concentrations on the resistance of uropathogen Escherichia coli: in vitro kinetics and dynamics simulation mode

Ciprofloxacin is recommended for complicated urinary tract infection (UTIs) caused by multidrug-resistant pathogens included Escherichia coli. However, its optimum dose for UTIs remains uncertain that may cause the bacterial resistance. This study was conducted to evaluate the effects of ciprofloxacin concentrations on the resistance of E. coli. The in vitro pharmacokinetic/pharmacodynamic (PK/PD) models of ciprofloxacin 750 mg oral dose twice a day for one daywas compared to that dose of 500 mg twice a day for three days.Pharmacokinetic parameters i.e.AUC0-24 and Cmax. and pharmacodynamic parameter i.e. MIC of ciprofloxacin against E. coli which previously had MIC of 0.5 µg/mL were determined. The PK/PD parameters combination of ciprofloxacin included AUC0-24/MIC, Cmax/MIC, and T>MIC ratio were used to evaluate its antimicrobial activities which was measured based on kill and re-growth rates of bacterial colony after the ciprofloxacin administration. The result showed that MIC value against E. coli increase to 8-16 and 32-64 µg/mL after ciprofloxacin 750 and 500 mg administration, respectively, indicating the emergence of resistance. Both doses of ciprofloxacin were able to reduce the number of bacterial colony in the first two hours administration. However, after two hours administration, those both doses could make re-growth of bacterial colony. The value of AUC0-24/MIC (120.42±1.27 vs.92.62±9.36), Cmax/MIC (4.75±0.21 vs. 3.26±0.30), and (T>MIC 89.58±7.22 vs. 76.39±9.39) after ciprofloxacin administration at dose of 750 mg were higher than those at dose of 500 mg. The increase of AUC0-24/MIC and Cmax/MIC values could reduce the number of bacteria colony, however could not for T>MIC value. In conclusion, the AUC0-24/MIC and Cmax/MIC parameters of ciprofloxacincan be used to evaluate its activity. In addition, ciprofloxacin twice per day at dose 500 mg for three days and 750 mg for one day are not different in the inhibition of E. coli resistance emergence

GC-MS Profile of Antioxidant Secondary Metabolites of Red Ginger from Batu Malang with Hepatoprotector Effect on Wistar Rats Exposed to Ethanol

The liver is the organ most susceptible to the adverse effects of alcohol use. Decreased superoxide dismutase can be used as an indicator of liver cell damage due to excessive alcohol consumption. Red ginger (Zingiber officinale var. rubrum) is known to have a hepatoprotective effect through antioxidant and anti-inflammatory mechanisms. The purpose of this study was to prove the effect of red ginger extract to restore normal levels of superoxide dismutase in the liver of Wistar rats induced by ethanol. Metabolite profiling analysis of the red ginger ethanol extract also carried out to ensure the presence antioxidant compounds. Thirty male Wistar rats which were divided into 5 groups. The control group was divided into negative control (C-) which was only given standard feed, and positive control (C+) which was only given 1.8 mL/200g body weight of 40% ethanol orally. Rats in the treatment group were given 40% ethanol as much as 1.8 mL/200 g body weight and red ginger extract at a dose of 250 (T1), 500 (T2), and 750 (T3) mg/kg body weight. Liver organs were taken to examine superoxide dismutase levels after 14 days of treatment in all groups. The metabolite profiling of red ginger ethanol extract was carried out using Gas Chromatography-Mass Spectroscopy (GC-MS). The results of the analysis show that ethanol with a concentration of 40% can reduce superoxide dismutase levels in the liver of rats significantly (p<0.05). All treatment groups that were given red ginger extract had higher superoxide dismutase levels than the positive control (C+) group (p <0.05), but the optimal dose to increase superoxide dismutase levels in Wistar rats induced by oral administration of 40% ethanol is 250 mg/kg body weight. Based on the results of metabolite profiling using GC-MS, found three dominant compounds thought to act as antioxidants, including Zingiberene, Gingerol, and 6-shogaol

EMERGENCE RESISTANT UROPATOGEN Escherichia coli SETELAH PEMBERIAN SIPROFLOKSASIN DAN -MANGOSTIN SECARA in vitro

Emergence resistant on uropatogen Escherichia coli can occur shortly after the start of therapy using subtherapeutic doses of ciprofloxacin. Ciprofloxacin is an antibiotic that works depends on the level of concentration, higher ratio Cmax / MIC will give increases in effectiveness. When the ratio of Cmax / MIC <1, then the risk of emergence resistant will be increased. One of the herbs that are abundant in Indonesia and has anti-bacterial activity is mangosteen (Garcinia mangostana L.), which has an active compound -mangostin. Administration of the active compound α-mangostin is expected to help prevent the emergence resistant of uropatogen E. coli due to the use of subtherapeutic ciprofloxacin. This research was conducted by giving treatment to uropatogen E. coli in vitro. Bacterial strains used are uropatogen E. coli resistant to ciprofloxacin with MIC values of 128 μg / mL. Treatment is divided into (I) treatment groups using ciprofloxacin concentration Cmax at a dose of 750 mg (4.3 μg / mL), (II) treatment groups using ciprofloxacin concentration of 4.3 μg / mL and -mangostin 0.18 μg / mL, and (III) the negative control group. The study states that the administration of the combination of α-mangostin and ciprofloxacin delayed the growth of uropatogen E. coli resistant strains (MIC value of 128 μg / mL) compared to administration of ciprofloxacin alone (p 0.000). But the combination of α-mangostin and ciprofloxacin can not prevent an increased in resistance strain uropatogen E. coli, which is characterized by an increased in the value of the MIC to be 256 μg / mL after 2 hours of treatment.Keywords: ciprofloxacin, resistance, -mangostin, uropatogen E. col

Efek Pemberian Kombinasi Siprofloksasin dan A-Mangostin Secara In Vitro Terhadap Eradikasi Uropatogen Escherichia Coli

Background: The percentage of resistance Escherichia coli (E. coli) in patients with UTI to ciprofloxacin reached 73.04%. Various attempts to maximize the use of antibiotics have been done, including optimizing the parameters pharmacokinetics/pharmacodynamics (PK / PD) of each antibiotic. Another effort is needed to optimize the use of antibiotic treatment that has been available, one of which combines the use of compounds derived from herbs, eg active compounds a-mangostin.Objective: The purpose of this study is to find the effect of the combination of á-mangostin and ciprofloxacin on uropathogen E. coli (UPEC) eradication.Methods: This research was carried out by treating the bacteria uropathogenE. coli (UPEC) in vitro. Treatment is divided into (a) treatment groups using ciprofloxacin concentration Cmax at 500 mg dose (2,4 μg/mL), (b) treatment groups using ciprofloxacin concentration Cmax at 750 mg dose (4,3 μg/mL), (c) treatment groups using ciprofloxacin concentration 2,4 μg/mL and a-mangostin concentration 0,18 μg/mL, (d) treatment groups using ciprofloxacin concentration 4,3 μg/mL and a-mangostin concentration 0,18 μg/mL.Result: states that a combination of á-mangostin and ciprofloxacin can prevent the growth of uropathogen E. coli ciprofloxacin-resistant strains (MIC value of 128 μg/mL) compared to administration of ciprofloxacin alone, but the effect was not significant. On uropathogen E coli sensitive to ciprofloxacin (MIC 0,008 μg/mL) and intermediate (MIC 0,5 μg/mL), there was no difference effect of decreasing the number of colonies between awarding a combination of ciprofloxacin and á-mangostin compared administering ciprofloxacin only.Conclusion: Provision of á-mangostin grading 0,18 μg/mL combined with ciprofloxacin had no real benefit in eradicating uropathogen E. coli, which is tested in vitro

In Vitro Effect of Alfa Mangostin on Multiresistant Uropathogenic Escherichia Coli

Introduction: In Indonesia, the most commom uropatogen E. coli resistance has been to ampicillin (91.9%), ciprof loxacin (83.7%) and cefixime (67.6%). α-mangostin, a chemical compound, has been developed as a new antibiotics isolaated from herbal Garcinia mangostana L, but its effectiveness against multiresistant uropathogenic E. Coli has not been established.Objective: This study examined the effect of α-mangostin on growth of multiresistant E. coliMethods: α-mangostin Treatment of E. coli uropatogen bacteria was administered in vitro, using 14 levels of concentration 14; 28,13; 56.25; 112.5;225; And 450 μg/mL with 4 times replication at each concentration. The antibacterial activity of α-mangostin was determined by evaluating bacterial growth at each concentration using the indirect method by sample absorbance reading. The Samples of uropatogen of E. coli treated with various doses of α-mangostin were incubated for 18-20 hours and then subjected to the absorbance reading using a UV-Vis spectrophotometer λ 625 nm.Results: Minimum inhibitory concentration (MIC) in this study was 450 mg/mL. Based on linear regression (STATA 13.1) relationship betweenα-mangostin concentrations and bacterial growth inhibition activity showed 0.0001 <0.05 showing that all concentrations of α-mangostin simultaneously had a significant effect on the growth of uropathogenic E. coli.Conclusion: α-mangostin has not been effective to inhibit the growth of multiresistent uropathogentic E. coli due to a relatively high MIC (450 mcg/mL).a Potentially relevant activity in the clinical setting will occur if the value of the MIC of a substance in vitro <100 μg /mL. Even the pharmaceutical industry prefers the development of antibiotics with in vitro MIC value of ≤ 2 μg/mL

EVALUASI PERILAKU PENGOBATAN SENDIRI TERHADAP PENCAPAIAN PROGRAM INDONESIA SEHAT 2010

Latar belakang : Salah satu indikator tercapainya Indonesia Sehat 2010 adalah tercapainya ProgramPembangunan Kesehatan. Salah satu upaya agar derajat kesehatan masyarakat lebih optimal adalahpengobatan sendiri. Pengobatan sendiri hanya boleh menggunakan obat yang termasuk golongan obatbebas dan obat bebas terbatas sesuai dengan keterangan yang tercantum pada kemasannya. Tujuanpenelitian : Mengevaluasi perilaku pengobatan sendiri yang dilakukan oleh masyarakat. Evaluasidilakukan untuk melihat apakah perilaku pengobatan sendiri oleh masyarakat sudah rasional atau masihirasional. Metoda: Metode penelitian survei deskriptif dengan menggunakan kuesioner yang disebarkankepada sampel terpilih dengan multistage random sampling yang dilakukan di Kecamatan Tembalang,Kota Semarang. Jumlah sampel 97 terbagi ke dalam lima kelurahan yang kemudian dari masing-masingkelurahan diambil sampel secara proporsional sesuai dengan jumlah penduduk. Hasil : Rata-rata angkakerasionalan penggunaan obat belum maksimal. Angka rasionalitas pengobatan masing-masing keluhanantara lain; penggunaan obat demam 76,3%; obat nyeri 43,3%; obat batuk kering dan berdahak 13,4%;obat pilek 32,0%; obat flu 93,8%; obat sesak nafas 14,4%; obat maag 70,1%; obat diare 85,6%; obatkonstipasi 61,9%, obat jamur 50,5%, obat bisul 38,1%, obat haemoroid 36,1%. Dari hasil penelitianhanya 76,3% masyarakat yang menyatakan pergi ke dokter jika dalam dua hari gejala tidak membaik.Simpulan : Dilihat dari kerasionalitasan penggunaan obat, ternyata hasilnya belum memuaskan.Kata kunci : Pengobatan sendiri, Indonesia Seha