EVALUASI KESESUAIAN ANTIBIOTIK DEFINITIF TERHADAP CLINICAL OUTCOME PADA PASIEN ANAK DENGAN MENINGITIS BAKTERIAL DI BANGSAL RAWAT INAP RUMAS SAKIT UMUM PUSAT

https://doi.org/10.22146/jmpf.346

Wihda Yanuar(1*), Ika Puspitasari(2), Titik Nuryastuti(3)

(1) Fakultas Farmasi, Universitas Gadjah Mada
(2) Fakultas Farmasi, Universitas Gadjah Mada
(3) Fakultas Kedokteran, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Meningitis bacterial merupakan infeksi sistem saraf pusat (SSP), terutama menyerang anak pada usia <2 tahun, dengan puncak angka kejadian pada usia 6-18 bulan. Penyakit ini diperkirakan mencapai  1,2 juta kasus tiap tahunnya dengan mortalitas pasien berkisar antara 2%-30% diseluruh dunia. Kasus meningitis bakteri di Indonesia mencapai 158/100,000 kasus pertahun, dengan etiologi Haemophilus influenza tipe b (H. influenza) 16/100.000 dan bakteri lain 67/100.000. Pasien dengan meningitis bakteri yang bertahan hidup beresiko mengalami komplikasi. Komplikasi utama meningitis bakterial terjadi karena adanya kerusakan pada otak. Pasien yang bertahan hidup dari meningitis dapat mengalami gangguan saraf. Oleh karena itu, pasien meningitis bakterial khususnya pada anak perlu mendapatkan terapi  yang optimal. Penelitian ini bertujuan untuk mengetahui kesesuaian penggunaan antibiotik definitif terhadap cinical outcome pasien anak dengan meningitis bakterial di bangsal rawat inap RSUP Dr. Sardjito Yogyakarta serta gambaran antibiogramnya. Penelitian ini dilakukan dengan rancangan deskriptif observasional dengan pengumpulan data secara retrospektif terhadap rekam medis pasien yang memenuhi kriteria inklusi dan eksklusi. Penyusunan antibiogram dilakukan berdasarkan perhitungan persentase sensitivitas antibiotik. Hasil penelitian menunjukkan bahwa penggunaan antibiotik definitif 63,33% sesuai dengan hasil uji kultur dan sensitivitas antibiotik. Clinical outcomepenggunaan antibiotik definitif sesuai dengan hasil uji kultur dan sensitivitas 100% (19 pasien) membaik. Antibiogram pada pasien anak dengan meningitis bakterial di RSUP Dr. Sardjito adalah: pola bakteri Gram positif sebesar 63,33% dan bakteri Gram negatif 36,67%, dimana antibiotik yang memliki sensitivitas tinggi terhadap bakteri Gram positif adalah vankomisin 89% dan siprofloksasin 83% sedangkan untuk bakteri Gram negatif adalah meropenem 100%  dan amikasin 83%.

Keywords


meningitis bakterial, , antibiogram, cinical outcome, bacterial meningitis



References

Abdinia, B., Ahangarzadeh Rezaee, M., dan Abdoli Oskouie, S., 2014. Etiology and Antimicrobial Resistance Patterns of Acute Bacterial Meningitis in Children: A 10-Year Referral Hospital-Based Study in Northwest Iran. Iranian Red Crescent Medical Journal, 16:

Baylan, O., 2012. [An opportunistic pathogen frequently isolated from immunocompromised patients: Burkholderia cepacia complex]. Mikrobiyoloji Bülteni, 46: 304–318.

Boehme, M.S., Somsel, P.A., dan Downes, F.P., 2010. Systematic review of antibiograms: a national laboratory system approach for improving antimicrobial susceptibility testing practices in Michigan. Public Health Reports, 125: 63.

El Bashir, H., Laundy, M., dan Booy, R., 2003. Diagnosis and treatment of bacterial meningitis. Archives of disease in childhood, 88: 615–620.

Fiore, A.E., Moroney, J.F., Farley, M.M., Harrison, L.H., Patterson, J.E., Jorgensen, J.H., dkk., 2000. Clinical Outcomes of Meningitis Caused by Streptococcus pneumoniae in the Era of Antibiotic Resistance. Clinical Infectious Diseases, 30: 71–77.

Goldman, J.A. dan Kearns, G.L., 2011. Fluoroquinolone Use in Paediatrics: Focus on Safety and Place in Therapy. World Health Organization, Geneva, Switzerland, .

Greenhill, A.R., Phuanukoonnon, S., Michael, A., Yoannes, M., Orami, T., Smith, H., dkk., 2015. Streptococcus pneumoniae and Haemophilus influenzae in paediatric meningitis patients at Goroka General Hospital, Papua New Guinea: serotype distribution and antimicrobial susceptibility in the pre-vaccine era. BMC Infectious Diseases, 15: .

Haque, N., Bari, M.S., Haque, N., Khan, R.A., Haque, S., Kabir, M.R., dkk., 2011. Methicillin resistant Staphylococcus epidermidis. Mymensingh medical journal: MMJ, 20: 326–331.

Isaacs, D., 2003. A ten year, multicentre study of coagulase negative staphylococcal infections in Australasian neonatal units. Archives of Disease in Childhood - Fetal and Neonatal Edition, 88: F89–F93.

Kaur, M., Rai, J., dan Randhawa, G., 2013. Recent advances in antibacterial drugs. International Journal of Applied and Basic Medical Research, 3: 3.

Kim, B.-N., Peleg, A.Y., Lodise, T.P., Lipman, J., Li, J., Nation, R., dkk., 2009. Management of meningitis due to antibiotic-resistant Acinetobacter species. The Lancet infectious diseases, 9: 245–255.

Kutlu, S.S., Sacar, S., Cevahir, N., dan Turgut, H., 2008. Community-acquired Streptococcus mitis meningitis: a case report. International Journal of Infectious Diseases, 12: e107–e109.

Meisadona, G., Soebroto, A.D., dan Estiasari, R., 2015. 'Diagnosis dan Tatalaksana Meningitis Bakterialis', . CDK-224, 42: 15–19.

Mengistu, A., Gaeseb, J., Uaaka, G., Ndjavera, C., Kambyambya, K., Indongo, L., dkk., 2013. Antimicrobial sensitivity patterns of cerebrospinal fluid (CSF) isolates in Namibia: implications for empirical antibiotic treatment of meningitis. J Pharm Policy Pract, 6: .

Molyneux, E. dan Njiram’madzi, J., 2015. Prevention and Treatment of Bacterial Meningitis in Resource Poor Settings: The Pediatric Infectious Disease Journal, 34: 441–443.

Montagnani, C., Pecile, P., Moriondo, M., Petricci, P., Becciani, S., Chiappini, E., dkk., 2015. First Human Case of Meningitis and Sepsis in a Child Caused by Actinobacillus suis or Actinobacillus equuli. Journal of Clinical Microbiology, 53: 1990–1992.

Motamedifar, M., Sedigh Ebrahim-Saraie, H., Mansury, D., Nikokar, I., dan Hashemizadeh, Z., 2015. Prevalence of Etiological Agents and Antimicrobial Resistance Patterns of Bacterial Meningitis in Nemazee Hospital, Shiraz, Iran. Archives of Clinical Infectious Diseases, 10: .

Namani, S., Milenković, Z., dan Koci, B., 2013. A prospective study of risk factors for neurological complications in childhood bacterial meningitis. Jornal de Pediatria, 89: 256–262.

Nigrovic, L.E., Malley, R., Macias, C.G., Kanegaye, J.T., Moro-Sutherland, D.M., Schremmer, R.D., dkk., 2008. Effect of Antibiotic Pretreatment on Cerebrospinal Fluid Profiles of Children With Bacterial Meningitis. Pediatrics, 122: 726–730.

Paterson, D.L. dan Bonomo, R.A., 2005. Extended-Spectrum β-Lactamases: a Clinical Update. Clinical Microbiology Reviews, 18: 657–686.

Paul, M., Bishara, J., Yahav, D., Goldberg, E., Neuberger, A., Ghanem-Zoubi, N., dkk., 2015. Trimethoprim-sulfamethoxazole versus vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial. BMJ, 350: h2219–h2219.

Plebani, M., 2012. Quality Indicators to Detect Pre-Analytical Errors in Laboratory Testing. The Clinical Biochemist Reviews, 33: 85–88.

Prasad, K., Kumar, A., Singhal, T., dan Gupta, P.K., 2007. Third generation cephalosporins versus conventional antibiotics for treating acute bacterial meningitis, dalam: The Cochrane Collaboration (Editor), Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd, Chichester, UK.

Sivanandan, S., Soraisham, A.S., dan Swarnam, K., 2011. Choice and Duration of Antimicrobial Therapy for Neonatal Sepsis and Meningitis. International Journal of Pediatrics, 2011: 1–9.

Swann, O., Everett, D.B., Furyk, J.S., Harrison, E.M., Msukwa, M.T., Heyderman, R.S., dkk., 2014. Bacterial Meningitis in Malawian Infants &lt;2 Months of Age: Etiology and Susceptibility to World Health Organization First-Line Antibiotics. The Pediatric Infectious Disease Journal, 33: 560–565.

Tajdin, F., Rasheed, M.A., Ashraf, M., Rasheed, H., Ejaz, H., dan Khan, G.J., 2013. Antibiotic Therapy in Pyogenic Meningitis in Paediatric Patients. Journal of the College of Physicians and Surgeons Pakistan, 23: 703–707.

Thigpen, M.C., Whitney, C.G., Messonnier, N.E., Zell, E.R., Lynfield, R., Hadler, J.L., dkk., 2011. Bacterial meningitis in the United States, 1998–2007. New England Journal of Medicine, 364: 2016–2025.

Tunkel, A.R., Hartman, B.J., Kaplan, S.L., Kaufman, B.A., Roos, K.L., Scheld, W.M., dkk., 2004. Practice guidelines for the management of bacterial meningitis. Clinical infectious diseases, 39: 1267–1284.

Upadhyay, A., Chawla, D., Joshi, P., dan Davis, P.G., 2016. Short-duration versus standard-duration antibiotic regimens for the treatment of neonatal bacterial infection, dalam: Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd.

Wee, L.Y.J., Tanugroho, R.R., Thoon, K.C., Chong, C.Y., Choong, C.T., Krishnamoorthy, S., dkk., 2016. A 15year retrospective analysis of prognostic factors in childhood bacterial meningitis. Acta Paediatrica, 105: e22–e29.



DOI: https://doi.org/10.22146/jmpf.346

Article Metrics

Abstract views : 2983 | views : 12162

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

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

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats