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"[ABSTRAKStaphylococcus spp. peragi manitol merupakan flora normal kulit terbanyak dan sering bersifat multiresisten, serta dapat menjadi salah satu penyebab healthcare associated infection (HAI). Di Indonesia, data mengenai Staphylococcus spp. peragi manitol yang resisten metisilin belum tersedia. Penelitian ini bersifat retrospektif untuk mengetahui pola kepekaan dan karakteristik genotipik (mecA dan tipe SCCmec I-V) flora normal Staphylococcus spp peragi manitol yang diisolasi dari pasien ICU Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM) tahun 2011, 2013 dan 2014. Dari 187 isolat, 15% di antaranya merupakan methicillin resistant Staphylococcus aureus (MRSA) yang sebagian besar resisten terhadap gentamisin (64,3%), klindamisin (50%), golongan fluorokuinolon (64,3-71,4%) dan tetrasiklin (57,1%). Sedangkan 55,6% merupakan Staphylococcus koagulase negatif resisten metisilin (MR-CoNS) yang sebagian besar resisten terhadap gentamisin (55%), fluorokuinolon (62,5-88,5%), eritromisin (91,3%), klindamisin (75%) dan rifampisin (82,7%). Resisten metisilin pada MRSA hampir semuanya disebabkan oleh gen mecA (96,4%), sedangkan pada MR-CoNS, gen mecA ditemukan pada 76,9% isolat. Tipe SCCmec yang paling banyak ditemukan pada kedua kelompok yaitu SCCmec tipe I. Dapat disimpulkan bahwa sebagian besar Staphylococcus spp. peragi manitol yang merupakan flora normal pasien yang dirawat di ICU RSUPNCM, merupakan pembawa gen mecA. Surveilens berkelanjutan dibutuhkan untuk mengetahui kecenderungan perubahan pola kepekaan dan pencegahan transmisi di fasilitas kesehatan.

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ABSTRACTStaphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.;Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.;Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities., Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.]"

"Methisilin Resistant Staphylococcus aureus MRSA adalah bakteri S.aureus yang resisten terhadap penisilin dan antibiotik golongan beta-laktam lainnya. Bakteri ini sering menyebabkan berbagai infeksi termasuk infeksi yang serius dengan mortalitas yang tinggi. Infeksi MRSA tidak hanya terbatas pada lingkungan rumah sakit saja, melainkan sudah menyebar ke komunitas. Metode pemeriksaan yang cepat untuk mendeteksi MRSA pada pasien diperlukan agar klinisi dapat segera menangani dengan baik. Metode biakan membutuhkan waktu hingga lebih dari 1 hari, sedangkan pemeriksaan PCR dapat memberikan hasil yang lebih cepat. Pemeriksaan PCR bertujuan untuk mencari gen mecA yang telah diketahui sebelumnya, berperan dalam mekanisme resistensi MRSA. Namun sekarang telah diketahui adanya MRSA dengan gen mecA negatif karena adanya peran gen lain yang juga dapat berperan yaitu mecC dan blaZ. Sehingga diperlukan pemeriksaan PCR yang dapat mendeteksi ketiga gen tersebut. Penelitian ini bertujuan untuk mendapatkan uji skrining dan konfirmasi untuk deteksi MRSA. Optimasi multipleks PCR diawali dengan optimasi unipleks masing-masing gen mecA, mecC, dan blaZ. Uji coba telah dilakukan terhadap 30 isolat MRSA dan 30 isolat MSSA. Dari 30 isolat MRSA yang diuji diperoleh hasil hanya didapatkan perbedaan pada 3 isolat MRSA sedangkan pada isolat MSSA, unipleks dan multipleks PCR memperlihatkan hasil yang sama. Perbedaan yang tampak kemungkinan diakibatkan oleh bias PCR. Berdasarkan uji diagnostik diperoleh sensitivitas tertinggi tampak pada unipleks PCR mecA sensitivitas 95,83 sehingga dapat digunakan sebagai skrining, sedangkan spesifisitas tertinggi tampak pada multipleks PCR spesifisitas 100 sehingga dapat digunakan sebagai konfirmasi. Diperlukan uji lanjutan untuk konfirmasi peran blaZ pada MRSA.

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Methicillin Resistant Staphylococcus aureus MRSA is S.aureus that resistant to penicillin and other beta lactam antibiotics. This bacteria often cause serious infection with high mortality. Methicillin Resistant Staphylococcus aureus infection is not only found in hospital, but it also spreads into community. Rapid detection of MRSA is needed to help clinicians in giving accurate treatment. The result obtained by culture method takes more than one day, while PCR result can be read in the same day. The common purpose of PCR assay is to detect mecA gene that known to be responsible for the occurance of resistant in MRSA isolates. Nowadays, there are some MRSA with negative mecA. In that case, mecC and blaZ may play an important role in resistant mechanism in MRSA. Therefore, new PCR method that can detect all of the three genes is needed.

The purpose of this study is to develop method for screening and confirming MRSA. First, we conduct uniplex PCR for each gene mecA, mecC, and blaZ, followed by multiplex PCR. Furthermore, assay was performed to detect those genes from 30 MRSA and 30 MSSA isolates. All MSSA gave the same result of uniplex and multiplex PCR. From 30 MRSA isolates, three isolates showed discrepancies between uniplex and multiplex PCR result. It may be due to PCR bias. Uniplex PCR mecA can be used as a screening test since its high sensititivity sensitivity 95,83 , whereas multiplex PCR mecA, mecC, and blaZ may be used as a confirmation test due to its high specificity 100 . Another test is needed to confirm the detection of blaZ gene in MRSA isolates."

"Sejak tahun 2006 terjadi penurunan angka kunjungan di RSKD Duren Sawit khususnya pasien narkoba, yang jika dilihat dari rata-rata kunjungan pasien per hari hanya 1-2 pasien napza. Penelitian ini dilakukan untuk memperoleh informasi mendalam mengenai perilaku pengguna jasa dan penyelenggara jasa pelayanan dalam memanfaatkan pelayanan di poliklinik napza. Penelitian menggunakan metode kualitatif dengan wawancara mendalam terhadap lima orang pasien, dua orang mantan pasien, dan petugas rumah sakit yang terdiri atas wakil direktur pelayanan medis, kepala instalasi rawat jalan, kepala rehabilitasi dan dokter poliklnik napza serta melakukan diskusi kelompok terarah kepada lima orang perawat dan dua orang konselor. Hasil penelitian ini memperlihatkan bahwa rendahnya pemanfaatan pelayanan di poliklinik napza disebabkan oleh faktor eksternal, yaitu keberadaan BNN (Badan Narkotika Nasional) yang memberikan pelayanan gratis kepada pasien napza dan faktor internal yaitu sarana dan prasarana yang kurang memadai bagi pasien dan faktor perilaku petugas yang kurang baik dalam memberikan pelayanan Penelitian ini menunjukkan bahwa sarana prasarana yang menunjang dan adanya perilaku petugas yang ramah dan terampil akan dapat meningkatkan kembali pemanfaatan pelayanan poliklinik napza di RSKD Duren Sawit.

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Since 2006 there is a significant decline of patient visitations at Duren Sawit Mental and Drug Regional Special Hospital, especially the drug abuse patients, it is based on the average number of visitations that is only 1-2 patients per day. This research was done to find out information about the recipients and the care givers behaviour in using the services at the drug abuse policlinic. This qualitative research was done by deep interviews to five patients, two expatients, and hospital care givers that consist of vice director of medical services, head of drug abuse rehabilitation department, doctor from drug abuse policlinic, five nurses and two counselors.

The result of this research showed that the low service usage level was caused by external and internal factors. The external factor is, BNN (Badan Narkotika Nasional) that gives free care to drug abuse patients and the internal factors are, infrastructures that are not suitable for the patients need, and the care givers behaviour that are not friendly while performing their services. This research shown that suitable infrastructures, friendly and skillful care givers behaviour, might improve service usage level of the drug abuse policlinic at Duren Sawit Mental and Drug Regional Special Hospital."

"Upaya untuk memaksimalkan penggunaan antibiotik yang rasional merupakan salah satu tanggung jawab penting dari pelayanan farmasi. Penggunaan obat dikatakan rasional jika obat yang digunakan sesuai indikasi, kondisi pasien dan pemilihan obat yang tepat terkait jenis, sediaan, dosis, rute, waktu dan lama pemberian, mempertimbangkan manfaat dan resiko dari obat yang digunakan. Penggunaan antibiotik yang tidak tepat dapat menyebabkan pengobatan lebih mahal, efek samping lebih toksik, meluasnya resistensi dan timbulnya kejadian superinfeksi yang sulit diobati. Setelah melakukan pemantauan terapi obat pada pasien di ruang ICU RSUP Fatmawati, kesimpulan yang didapat: Pengobatan yang diterima oleh Nn. TRA sudah sesuai dengan indikasi penyakit, yaitu abses submandibularis, dengan frekuensi pengobatan dan dosis antibiotik juga dinilai sudah tepat. Pada Ny. AAH, didapatkan adanya obat yang tidak sesuai indikasi, yaitu tigecycline dan penggunaan meropenem serta levofloxacin juga tidak tepat dosis dan tidak tepat frekuensi pemakaian. Sepanjang penggunaan tigecycline, kondisi pasien justru memburuk hingga kemudian dinyatakan meninggal pada tanggal 11 April 2022 akibat gagal ventilasi dan sepsis pneumonia. Penggunaan tigecycline kemungkinan tidak efektif. Perhitungan DDD/100 patient-days, meropenem memiliki nilai DDD tertinggi,  kemudian disusul oleh amikasin, levofloxacin, metronidazole, dan tigecycline secara berurutan. Pada perhitungan DU 90 %, meropenem, amikacin, dan levofloxacin termasuk dalam segmen tersebut. Antibiotik yang memiliki nilai DDD/100 patient-days yang tinggi dan termasuk dalam segmen 90 % perlu diawasi penggunaannya dengan baik karena penggunaan yang tinggi dapat meningkatkan resiko terjadinya resisten antibiotik.

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Efforts to maximize the rational use of antibiotics is one of the important responsibilities of pharmaceutical services. The use of drugs is said to be rational if the drugs used are according to the indications, the patient's condition and the selection of the right drug regarding type, preparation, dose, route, time and duration of administration, considering the benefits and risks of the drug used. Inappropriate use of antibiotics can cause more expensive treatment, more toxic side effects, widespread resistance and the emergence of superinfections that are difficult to treat. After monitoring drug therapy on patients in the ICU at Fatmawati Hospital, the conclusion was obtained: The treatment received by Ms. TRA is in accordance with the indications of the disease, namely submandibular abscess, with the frequency of treatment and dosage of antibiotics also considered to be appropriate. To Mrs. AAH, it was found that there were drugs that were not according to indications, namely tigecycline and the use of meropenem and levofloxacin, which also included incorrect doses and incorrect frequency of use. Throughout the use of tigecycline, the patient's condition worsened until he was declared dead on April 11 2022 due to ventilation failure and pneumonia sepsis. The use of tigecycline may not be effective. Calculating DDD/100 patient-days, meropenem has the highest DDD value, followed by amikacin, levofloxacin, metronidazole, and tigecycline in sequence. In the 90% DU calculation, meropenem, amikacin, and levofloxacin are included in this segment. Antibiotics that have a high DDD/100 patient-days value and are included in the 90% segment need to be monitored carefully because high use can increase the risk of antibiotic resistance."

"Narkotika, Psikotropika dan Zat Adiktif lainnya (Napza) merupakan sekelompok zat yang umumnya mempunyai risiko kecanduan (adiksi) dan ketergantungan (dependensi). Penyalahgunaan Napza tidak hanya beraldbat buruk terhadap fisik, tetapi juga mental, perilaku dan ekonomi masyarakat. Target utama penyalahgunaan Napza adalah remaja, hal ini disebabkan karena remagia merupakan fase yang sangat rawan dengan kondisi kepribadian yang masih Sangat labil dan mudah terpengaruh lingkungan dan dalam banyak hal mereka biasa memuaskan keingintahuannya dengan coba-coba, termasuk Napza. Pcnelitian ini bertujuan untuk mengetahui gambaran perilaku pencegahan siswa tcrhadap pcnyalahglmaan Napza serta hubunganya dengan faktor sosio-psiko demografi (jenis kelamin, tingkat pengetahuan, konsep diri dan dukungan teman sebaya), faktor persepsi (kerentanan, keseriusan, manfaat dan rintangan) serta faktor dukungan (dari keluarga, sekolah dan media massa). Metode pcnelitian yang digunakan adalah observasional melalui pendekatan kuantitatif dengan disain potong lintang (cross sectional). Data yang digunakan adalah data primer, yang dikumpulkan rnclalui angket. Penelitian ini dilakukan pada siswa kelas satu dan dua di enam SMU di Kota Depok dengan jumlah sampel sebanyak 411 orang dan dilaksanakan pada bulan Februari-Maret 2008. Hasil penelitian menunjukkan lebih separuh dari responden sudah memiliki perilaku pencegahan yang baik (54,5%). Variabel yang ditemukan berhubungan secara bcrmakna dcngan perilaku pencegahan adalah variabel jenis kelamin, konsep diri, tingkat pengetahuan, dukungan teman sebaya, persepsi manfaat, persepsi rintangan dan dukungan keluarga. Faktor yang dominan berhubungan adalah dukungan keluarga,jenis kelamin, dan dukungan teman sebaya. Kesimpulan dari penelitian ini adalah, responden yang memiliki dukungan keluarga yang baik, akan berpeluang melakukan pencegahan 2,2 kali dibandingkan responden yang rnemiliki dukungan keluarga kurang baik, responden perempuan memiliki peluang 2,0 kali untuk berperilaku pencegahan baik dibandingkan rcspondcn laki-Iaki dan responden dengan dukungan tcman sebaya yang baik berpeluang 1,9 kali untuk melakukan perilaku pencegahan dibandingkan responden yang memiliki dukungan teman sebaya kurang baik. Disarankan kepada Dinas Kesehatan, Dinas Pendidikan, Badan Narkotika Depok dan pihak lainnya seperti LSM, komite sekolah dan keluarga bekerjasama dalam meningkatkan perilaku pencegahan terhadap penyalahgmmaan Napza antara lain dengan peningkatan pemberian informasi tentang Napza yang tepat dan benar, melalui mata pelajaran, penyuluhan, konseling, seminar, pelatihan/training of trainers siswa untuk menjadi konselor bagi teman-temannya, serta meningkatkan pengawasan terhadap pergaulan dan perilaku siswa baik disekolah maupun di rumah.

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Narcotics, Psychotropics and Others Additive?s Substances (drugs), are the groups of essences that generally have may cause addicted and depended. Drugs abuse not only make physic disorder, but also mental, behavior, and public economic, Main target of drugs abuses is adolescent, it is caused adolescent is a gristle period with personality condition is still really unstable and easy effected by their social life or environmental and In so many occasions, they are so eager to try new things, including drugs abuse.

This research is performed on student first and second class in senor high school at Depok City with the purpose to know behavior preventive student to drug's abuse and its relations to socio-psycho demogtaphy factors (sex, intelligence, self concept and peer group support), perception factors (perceived of susceptibility, and seriousness, perceived of benefits and barriers) and support factors (of family, school and mass media). Data which is utilized is primary data as questionnaire through quantitative observation approach, with design cross sectional. The research perforrned on February to March 2008.

The result show that more than half of respondent has had good prevention behavior (54, 5%). Found variable concerning with variable preventive is sex variable, self concept, intelligence, peer group support, perceived of benefit, and barrier and family support (p<0,05). The dominant factor which is related was family support, sex and peer group support.

The conclusion of this research are respondent who has good family support, will get opportunity to perfomr prevention 2,l time tl1an respondent who have poor family support, female have opportunity 2,0 time to get good prevention behavior than male, and respondent with good peer group support will gets opportunity 1,9 times to do prevention than who have poor peer group support.

Suggested to Dinas Kesehatan, Dinas Pendidikan, Badan Narkotika Depok and another party as NGO, school committee and family collaborates to improves prevention behavior to drug?s abuse for example with increasing information distribution concerning about drugs clearly, through studies, counseling, seminar, training/training of trainers student to become counselor for its friend, and increases observation to their social life and behavior even at school and also at the house."

"Penelitian ini bertujuan untuk mengkaji pengaruh perilaku merokok terhadap penggunaan narkoba dan konsumsi minuman beralkohol pada remaja di Indonesia dengan menggunakan data Survei Kesehatan Reproduksi Remaja Indonesia (SKRRI) 2007. Remaja pada penelitian ini adalah 18.396 remaja laki-laki dan perempuan yang belum menikah berusia 15-24 tahun saat survei. Metode analisis yang digunakan dalam penelitian ini adalah regresi logistik biner untuk model pertama yaitu penggunaan narkoba regresi logistik multinomial untuk model kedua, yaitu konsumsi minuman beralkohol. Variabel bebas yang digunakan untuk kedua model adalah perilaku merokok, perilaku seksual pranikah, kelompok umur, daerah tempat tinggal, tingkat pendidikan, status bekerja, tingkat kekayaan rumah tangga, pengetahuan tentang HIV/AIDS, dan pengetahuan tentang IMS. Jenis kelamin remaja disertakan hanya dalam model kedua. Dari hasil model pertama ditemukan bahwa perilaku merokok, perilaku konsumsi minuman beralkohol dan perilaku seksual pranikah semua memiliki pengaruhsignifikan yang kuat dan positif terhadap penggunaan narkoba. Menurut karakteristik dari remaja, mereka yang memiliki kecenderungan lebih tinggi untuk penyalahgunaan narkoba adalah yang saat ini merokok, pernah melakukan seksual pranikah, pernah mengkonsumsi alkohol, berusia 20-24 tahun, tinggal di perkotaan, tingkat pendidikan tinggi, bekerja, memiliki pengetahuan HIV/AIDS dan IMS, dan memiliki status ekonomi rendah. Untuk model konsumsi alkohol, ditemukan bahwa penyalahgunaan narkoba, perilaku merokok, dan perilaku seksual pranikah juga memiliki pengaruh yang signifikan positif pada yang tiga bulan terakhir mengkonsumsi minuman beralkohol dan yang pernah mengkonsumsi minuman beralkohol.

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This study aims to examine the influence of smoking on drug use and alcohol consumption among adolescents in Indonesia using the 2007 Adolescent Reproductive Health Survey Indonesia (SKRRI) data of 18,396 youth in Indonesia is used. Adolescents in this study are unmarried males and females aged 15-24 years during the survey.The methods of analysis are binary logistic regression for the first model on drug use and multinomial logistic regression on the second model, which is the consumption of alcoholic beverages. Independent variables that are analyzed for both models are the smoking behavior, premarital sexual intercourse, age group, area of residence, education level, work status, household wealth index, knowledge about HIV/AIDS and knowledge about STIs. The sex of adolescents is included only in the second model.

The results of the first model show that smoking, alcoholic consumption and premarital sexual behavior all have strong positive significant effects on drug abuse. According to the characteristics of adolescents, those who have higher propensity for drug abuse are the ones who are currently smoking, ever had premarital sex, consumed alcoholic drinks, aged 20-24 years, living in urban areas, with high level of education, working, have knowledge of HIV/AIDS and STIs, and have low economic status. For drinking behavior, it is also found that drug abuse, smoking behavior, and premarital sexual behavior has a significant positive influence on consuming alcoholic beverages in the last three months and ever consumed alcoholic beverages."

"Infeksi Saluran Pernapasan Akut (ISPA) termasuk penyakit yang menyebabkan kematian tertinggi pada anak, terutama di negara berkembang seperti Indonesia. Penelitian ini bertujuan untuk mengidentifikasi masalah terkait obat (MTO) pada pasien ISPA anak berdasarkan parameter MTO dari Cipolle, Strand, Morley, meliputi ketepatan pemilihan obat yaitu terapi obat tambahan dan terapi obat kurang, ketepatan indikasi, kesesuaian dosis terdiri dari dosis berlebih dan dosis kurang, serta kemungkinan reaksi yang tidak diinginkan (ROTD) berupa interaksi obat. Desain penelitian menggunakan metode cross-sectional bersifat deskriptif dengan pengambilan data retrospektif. Sampel pada penelitian ini meliputi resep pasienpasien di Poli MTBS (Manajemen Terpadu Balita Sakit) Puskesmas Kecamatan Tebet pada periode Juli – Desember 2018, dengan teknik pengambilan data total sampling. Sampel yang diperoleh sejumlah 179 lembar resep pasien dengan total 498 peresepan obat. Hasil penelitian MTO pada pasien ISPA anak untuk masing – masing parameter antara lain ketidaktepatan pemilihan obat (9,5%), ketidaktepatan indikasi (12,8%), ketidaksesuaian dosis (79,9%), dan potensi interaksi obat (0,6%). Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa tingginya kejadian MTO pada pasien ISPA anak menyebabkan perlu dilakukan perbaikan peresepan obat dan pemantauan penggunaan obat untuk meminimalisasi kejadian MTO dan mengaplikasikan penggunaan obat yang rasional.

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Acute Respiratory Tract Infection (ARTI) were common to cause the highest death rate in children, especially in growing countries such as Indonesia. The aim of the research is to identify DRPs in ARTI paediatric based on DRPs classification by Cipolle, Strand, Morley, that were being categorized as unnecessary drug therapy, need additional therapy, ineffective drug, dosage adjustments such as too low or too high,  and adverse drug reaction which is drug interaction. The design of the study was cross-sectional with a retrospective method and descriptive study. The sample of the study was the overall prescription to URTI (Upper Respiratory Tract Infection) patient in Puskesmas Kecamatan Tebet Period July – December 2018 that fulfilled all the inclusion criteria, using total sampling method. Total sample that was analysed from 179 sheets of prescription with total prescription of 498 prescription. The result of the research based on each parameter: inaccurate drug selection (9.5%), inaccurate indication (12.8%), mismatched dose (79.9%), and drug interaction (0.6%). To conclude, DRPs in ARTI paediatric were in a high risk condition so the health facilities needed to improve their prescription, monitor and manage each therapy, also to do a routine prescription assessment to minimize the condition and to achieve a rational drug usage."

"PendahuluanPasien anak, termasuk di Pediatric Intensive Care Unit (PICU), tergolong rentan menerima peresepan obat off-label, yang berpotensi menimbulkan kejadian efek samping obat. Penelitian ini bertujuan mengevaluasi penggunaan obat off-label pada pasien anak di PICU RSCM, yang belum pernah diteliti.MetodeSampel merupakan peresepan yang diambil dari rekam medis secara consecutive sampling. Perhitungan jumlah sampel menggunakan proporsi tunggal dan beda dua proporsi. Kriteria inklusi adalah pasien anak <18 tahun yang dirawat di PICU RSCM tahun 2018. Kriteria eksklusi adalah pasien dengan data pengobatan yang sulit dibaca atau tidak lengkap, obat luar, elektrolit, dan suplemen. Data ditabulasi berdasarkan nama obat, jenis kelamin, usia, status off-label obat berdasarkan usia pasien, dan klasifikasi Anatomical Therapeutic Chemical (ATC). Uji Chi-Square dipakai untuk mengetahui beda proporsi penggunaan obat off-label antar kelompok.HasilDari 400 peresepan yang dievaluasi, 23,8% tergolong off-label kategori usia. Berdasarkan klasifikasi ATC, peresepan di PICU didominasi oleh obat kardiovaskular (25,25%). Obat muskuloskeletal paling sering diresepkan secara off-label (84,6%). Tidak ada perbedaan signifikan proporsi penggunaan obat off-label pada kelompok laki-laki (21%) dan perempuan (26,5%) (p = 0,196,). Proporsi off-label pada kelompok usia bayi (0-2 tahun) 33,8%, anak (2-12 tahun) 18,6%, dan remaja (12-18 tahun) 14,3%. Peresepan off-label pada bayi lebih tinggi secara signifikan dibandingkan anak (p = 0,002) dan remaja (p = 0,001)KesimpulanSebanyak 23,8% peresepan pada pasien PICU diberikan secara off-label berdasarkan usia, dan yang tersering adalah obat muskuloskeletal. Perbedaan proporsi obat off-label antar jenis kelamin tidak signifikan, sedangkan antar kelompok usia signifikan.

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Introduction

Pediatric patients, including Pediatric Intensive Care Unit (PICU) patients, are prone to off-label drug prescriptions, which potentially lead to adverse drug reactions. This study aimed to assess the use of off-label drugs on PICU patients at RSCM, which has never been studied before.

Methods

Samples were prescriptions taken from medical records connsecutively. Sample size were calculated using single proportion and difference between two proportions. The inclusion criteria were <18 years old PICU patients at RSCM admitted in 2018. The exclusion criteria were patients with unclear or incomplete data, external drugs, electrolytes, and supplements. Data were tabulated by drug name, sex, age, off-label drug status based on patient age, and Anatomical Therapeutic Chemical (ATC) classification. Difference in proportions between groups were tested using Chi-Square.

Results

Of the 400 prescriptions evaluated, 23.8% were off-label by age. Based on the ATC classification, PICU prescription was dominated by cardiovascular drugs (25.25%). Musculoskeletal drugs were most often prescribed off-label (84.6%). There was no significant difference in off-label prescription between males (21%) and females (26.5%) (p = 0.196). The proportion of off-label in the infant age group (0-2 years) was 33.8%, in children (2-12 years) 18.6%, and in adolescents (12-18 years) 14.3%. Infants were given off-label drugs significantly higher than children (p = 0.002) and adolescents (p = 0.001)

Conclusion

Off-label prescription in PICU patients is 23.8%. Musculoskeletal drugs are most often prescribed off-label. The difference in the proportion of off-label drugs between sexes was not significant, whereas between age groups was significant"