Rasionalitas Regimen Dosis Gentamisin Pada Pasien Rawat Inap Di RSUP Dr. Kariadi Semarang (Kajian Terhadap Efektivitas Terapi Dan Peningkatan Serum Kreatinin)

https://doi.org/10.22146/farmaseutik.v19i1.67189

Fita Rahmawati(1*), Arroyani Asa Dilaga(2), Djoko Wahyono(3)

(1) Universitas Gadjah Mada
(2) Universitas Gadjah Mada
(3) Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Gentamisin merupakan antibiotik pada terapi empiris khususnya infeksi bakteri gram negatif. Gentamisin memiliki indeks terapi sempit serta bersifat nefrotoksik. Pencegahan nefrotoksisitas dan peningkatan efektivitas terapi gentamisin dapat dilakukan dengan penyesuaikan regimen dosis berdasarkan nilai klirens kreatinin pasien. Penelitian bertujuan mengevaluasi rasionalitas dosis gentamisin  serta mengetahui hubungan rasionalitas dosis dengan efektivitas terapi gentamisin dan efek peningkatan serum kreatinin.

Penelitian ini menggunakan rancangan cross sectional  dilakukan di RSUP Kariadi Semarang. Sejumlah 129 rekam medis pasien rawat inap tahun 2018- 2019 dipilih menggunakan tehnik purpusive sampling. Kriteria inklusi meliputi usia pasien 18 tahun ke atas,  menggunakan gentamisin injeksi minimal 3 hari, terdapat data serum kreatinin minimal sebanyak dua kali (sebelum dan sesudah penggunaan injeksi gentamisin). Efektivitas terapi  terbagi menjadi membaik dan tidak membaik berdasarkan rekam medis pasien. Peningkatan serum kreatinin ditunjukkan dengan kenaikan sebesar 0,5 mg/dl atau lebih. Statistik bivariat Fisher exact test digunakan untuk mengetahui hubungan kedua variabel.

Hasil penelitian menunjukkan dosis rasional terdapat pada 19 (14,73% ) pasien dimana 15 (11,63%) pasien  memberikan hasil terapi membaik dan terjadi  peningkatan sCr  lebih dari 0,5 mg/dl pada 5 (3,88 %) pasien. Sedangkan dosis tidak rasional terdapat pada 110 (85,27%) pasien dimana 52 (40,31%) pasien memberikan hasil terapi membaik dan 31 (24,03%) pasien  terjadi peningkatan sCr. Rasionalitas regimen dosis memiliki hubungan signifikan dengan efektitivitas terapi (p<0,05) namun tidak memiliki hubungan signifikan dengan peningkatan serum kreatinin   (p>0,05). Peran farmasis diperlukan dalam monitoring terapi pasien sehingga diharapkan dapat meningkatkan optimasi terapi dan menurunkan efek samping.


Keywords


Rasionalitas dosis, gentamisin, efektivitas terapi, peningkatan serum kreatinin

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DOI: https://doi.org/10.22146/farmaseutik.v19i1.67189

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