Evaluasi Kesesuaian Dosis dan Clinical Outcome Amikasin dan Gentamisin di Bangsal Nicu (Neonatal Intensive Care Unit) RSUP Dr. Sardjito Yogyakarta

https://doi.org/10.22146/farmaseutik.v1i1.58243

Zita Dhirani Pramono(1), Ika Puspitasari(2*), Ida Safitri Laksanawati(3)

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Faculty of Pharmacy, Universitas Gadjah Mada
(3) Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada/ RSUP Dr. Sardjito, Yogyakarta
(*) Corresponding Author

Abstract


Penggunaan amikasin dan gentamisin menjadi pilihan antibiotik golongan aminoglikosida dengan indeks terapi sempit dalam terapi infeksi untuk neonatus dan penggunaannya perlu diikuti dengan monitoring terapi agar dapat mencegah toksisitas terjadi. Penelitian ini bertujuan untuk mengevaluasi kesesuaian dosis amikasin dan gentamisin pasien NICU (Neonatal Intensive Care Unit) dan mengevaluasi hasil terapinya yang dilihat dari perbaikan respon klinis pasien. Penelitian ini dilakukan dengan desain cross sectional dan dilakukan penelusuran data rekam medik pasien neonatus mendapatkan terapi amikasin atau gentamisin saat menjalani rawat inap di NICU RSUP Dr. Sardjito Yogyakarta periode 1 Januari 2017 - Desember 2018. Estimasi kadar didapatkan dari dosis pemberian dan dilakukan perhitungan farmakokinetika. Clinical outcome yang diamati yakni tanda-tanda vital dan  Analisis chi square dilakukan untuk mengetahui hubungan keduanya.  Pasien yang menerima amikasin dan gentamisin mengalami clinical outcome membaik berturut-turut sebanyak 18 pasien dan 28 pasien. Analisis bivariat menunjukkan tidak ada hubungan estimasi Cmax/MIC amikasin dan gentamisin terhadap clinical outcome (p 0,05). Selain itu hasil analisis bivariat pada variabel perancu didapatkan terdapat hubungan lama infeksi dan length of stay terhadap clinical outcome. Analisis multiple logistic regression didapatkan ada hubungan length of stay terhadap clinical outcome (p =0,021).


Keywords


aminoglikosida; estimasi kadar; clinical outcome; NICU

Full Text:

PDF


References

Avent, M.L., Rogers, B.A., Cheng, A.C., Paterson, D.L., 2011. Current use of aminoglycosides : indications , pharmacokinetics 41, 441–449. https://doi.org/10.1111/j.1445-5994.2011.02452.x. Badan Penelitian dan Pengembangan Kesehatan, 2013. RISET KESEHATAN DASAR. Bauer, L.A., 2008. Applied Clinical Pharmacokinetics 2nd Ed. The MacGraw-Hill Medical. Camacho-gonzalez, A., Spearman, P.W., Diseases, P.I., Stoll, B.J., Brumley, G.W., Drive, U., 2013. Neonatal infections Disease: Evuluation of Neonatal Sepsis. Pediatr. Clin. North Am. North Am. 60, 367–389. https://doi.org/10.1016/j.pcl.2012.12.003.Neonatal. Cantey, J.B., Wozniak, P.S., Sánchez, P.J., 2015. Prospective Surveillance of Antibiotic Use in the Neonatal Intensive Care Unit : Results From the SCOUT Study 34, 267–272. https://doi.org/10.1097/INF.0000000000000542. Fuchs, A., Bielicki, J., Mathur, S., Sharland, M., Van Den Anker, J.N., 2018. Reviewing the WHO guidelines for antibiotic use for sepsis in neonates and children. Paediatr. Int. Child Health 38, S3–S15. https://doi.org/10.1080/20469047.2017.1408738. Hadinegoro, S.R.S., Chairulfatah, A., Latief, A., H.Pudjiadi, A., Malisie, R.F., Alam, A., 2016. Diagnosis dan tatalaksana sepsis pada anak. Pedoman Nas. pelayanan Kedokt. Ikat. Dr. Anak Indones. 1–47. Hakim, L., 2015. Farmakokinetika Klinik. Bursa llmu Yogyakarta. Ikatan Dokter Anak Indonesia, 2011. Pedoman Pelayanan Medis Ikatan Dokter Anak Indonesia 81, 230–233. https://doi.org/10.1097/pec.0b013e31822c9b4c Katarnida, S.S., Karyanti, M.R., Oman, D.M., Katar, Y., 2016. Pola Sensitifitas Bakteri dan Penggunaan Antibiotik. Sari Pediatr. 15, 122. https://doi.org/10.14238/sp15.2.2013.122-6. KemenKes RI, 2018. Data dan Informasi Profil Kesehatan Indonesia. Kuppala, V.S., Meinzen-Derr, J., Morrow, A.L., Schibler, K.S., 2011. Prolonged Initial Empirical Antibiotic Treatment is Associated with with Adverse Outcomes in Premature Infants. Bone 159, 720–725. https://doi.org/10.1038/jid.2014.371. Levison, M.E.L., Levison, J.H., 2013. Pharmacokinetics and Pharmacodynamics of Antibacterial Agents 23, 1–2. https://doi.org/10.1016/j.idc.2009.06.008.Pharmacokinetics. Li, P.K.T., Szeto, C.C., Piraino, B., de Arteaga, J., Fan, S., Figueiredo, A.E., Fish, D.N., Goffin, E., Kim, Y.L., Salzer, W., Struijk, D.G., Teitelbaum, I., Johnson, D.W., 2016. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit. Dial. Int. 36, 481–508. https://doi.org/10.3747/pdi.2016.00078. Maulida, M., 2016. POLA RESISTENSI BAKTERI TERHADAP ANTIBIOTIK PADA PENDERITA SEPSIS BAYI DI RUANG PICU DAN NICU RSUP Dr. SOERADJI TIRTONEGORO KLATEN PERIODE AGUSTUS 2013-AGUSTUS 2015. Universitas Muhammadiyah Surakarta. McKinnon, P.S., Davis, S.L., 2004. Pharmacokinetic and pharmacodynamic issues in the treatment of bacterial infections diseases. Eur. J. Clin. Microbiol. Infect. Dis. 23, 271–288. https://doi.org/10.1007/s10096-004-1107-7. NHS, 2013. Antimicrobial Policy for Neonates age 1 day to 1 month The Rotherham NHS Foundation Trust Barnsley Hospital NHS Foundation Trust 2013 15 Penicillin Allergy I Neonates 15, 1–48. Pacifici, G.M., Pacifici, G.M., 2010. Clinical pharmacokinetics of aminoglycosides in the neonate : a review To cite this version : HAL Id : hal-00534935 Clinical pharmacokinetics of aminoglycosides in the neonate : a review. https://doi.org/10.1007/s00228-008-0599-y. Pérez, V., Saénz, D., Madriz, J., Harhay, M., Feoli, J., Castro, M., Odio, C., 2011. A double-blind study of the efficacy and safety of multiple daily doses of amikacin versus one daily dose for children with perforated appendicitis in Costa Rica. Int. J. Infect. Dis. 15, 569–575. https://doi.org/10.1016/j.ijid.2011.04.012. Raymond, S.L., Hawkins, R.B., St. Peter, S.D., Downard, C.D., Qureshi, F.G., Renaud, E., Danielson, P.D., Islam, S., 2020. Predicting Morbidity and Mortality in Neonates Born With Gastroschisis. J. Surg. Res. 245, 217–224. https://doi.org/10.1016/j.jss.2019.07.065. Raymond, S.L., Rincon, J.C., Wynn, J.L., Moldawer, L.L., Larson, S.D., 2017. Impact of early-life exposures to infections, antibiotics, and vaccines on perinatal and long-term health and disease. Front. Immunol. 8, 1–7. https://doi.org/10.3389/fimmu.2017.00729. Rózańska, A., Wójkowska-Mach, J., Adamski, P., Borszewska-Kornacka, M., Gulczyńska, E., Nowiczewski, M., Helwich, E., Kordek, A., Pawlik, D., Bulanda, M., 2015. Infections and risk-adjusted length of stay and hospital mortality in Polish Neonatology Intensive Care Units. Int. J. Infect. Dis. 35, e87–e92. https://doi.org/10.1016/j.ijid.2015.04.017. Schmatz, M., Srinivasan, L., Grundmeier, R.W., Elci, O.U., Weiss, S.L., Masino, A.J., Tremoglie, M., Ostapenko, S., Harris, M.C., 2020. Surviving Sepsis in a Referral Neonatal Intensive Care Unit: Association between Time to Antibiotic Administration and In-Hospital Outcomes. J. Pediatr. 217, 59-65.e1. https://doi.org/10.1016/j.jpeds.2019.08.023. Simonsen, K.A., Anderson-Berry, A.L., Delair, S.F., Dele Davies, H., 2014. Early-onset neonatal sepsis. Clin. Microbiol. Rev. 27, 21–47. https://doi.org/10.1128/CMR.00031-13. Smith, P.B., Benjamin, D.K., 2011. Choosing the right empirical antibiotics for neonates. Arch. Dis. Child. Fetal Neonatal Ed. 96, 1–3. https://doi.org/10.1136/adc.2010.188938. Tzialla, C., Borghesi, A., Serra, G., Stronati, M., Corsello, G., 2015. Antimicrobial therapy in neonatal intensive care unit. Ital. J. Pediatr. 41, 1–6. https://doi.org/10.1186/s13052-015-0117-7. Wang, C.H., Du, L.Z., Ma, X.L., Shi, L.P., Tong, X.M., Liu, H., Ding, G.F., Yi, B., Pan, X.N., Zhong, D.N., Liu, Ling, Li, M., Liu, C.Q., Xia, S.W., Wang, H.Y., He, L., Liang, K., Zhou, X.Y., Han, S.P., Lyu, Q., Qiu, Y.P., Shan, R.B., Mu, D.Z., Liu, X.H., Zhuang, S.Q., Guo, J., Liu, Li, Zhu, J.J., Xiong, H., 2016. Analysis of in-hospital neonatal death in the tertiary neonatal intensive care unit in China: A multicenter retrospective study. Chin. Med. J. (Engl). 129, 2652–2658. https://doi.org/10.4103/0366-6999.193458.



DOI: https://doi.org/10.22146/farmaseutik.v1i1.58243

Article Metrics

Abstract views : 2465 | views : 2530

Refbacks

  • There are currently no refbacks.


Majalah Farmaseutik Indexed by:

   
 
Creative Commons Licence
 
 
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.