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Abstrak :
Meningkatnya jumlah pasien lanjut usia dan pasien disfungsi imun berkontribusi terhadap tingginya beban infeksi jamur invasif di Indonesia. Keterbatasan informasi dan pedoman penggunaan antijamur sistemik di Indonesia menyebabkan penggunaannya berkaitan dengan masalah terkait obat (MTO). Di Indonesia, antijamur sistemik bentuk injeksi memiliki biaya yang tinggi dan ketersediaan yang terbatas. Penelitian cross-sectional ini bertujuan untuk mengevaluasi profil penggunaan dan MTO antijamur sistemik bentuk injeksi di RSUPN dr. Cipto Mangunkusumo Gedung A periode Januari-Desember tahun 2022. Pengambilan sampel menggunakan metode quota sampling pada data sekunder berupa rekam medis. Analisis MTO terhadap regimen pengobatan pasien difokuskan pada ketepatan dosis, ketepatan durasi, potensi interaksi obat, dan efek samping obat. Flukonazol merupakan antijamur sistemik bentuk injeksi yang paling sering digunakan (63,6%) dengan indikasi penggunaan empiris yang paling umum (41,1%). Kandidiasis merupakan jenis infeksi jamur invasif yang paling umum terjadi (26,2%) dengan median durasi pengobatan antijamur sistemik selama 9 (4-26) hari. Terdapat 45 pasien yang mengalami MTO. Termasuk dosis terlalu rendah sebanyak 4 (3,7%), durasi pengobatan terlalu singkat sebanyak 10 (9,3%), durasi pengobatan terlalu lama sebanyak 3 (2,8%), potensi interaksi obat sebanyak 19 (17,8%), dan efek samping obat sebanyak 18 (16,8%) pasien. Hasil uji Chi-square menunjukkan bahwa pasien dengan durasi pengobatan  >9 hari (p = 0,041) dan berusia >60 tahun (p = 0,005) lebih tinggi 2,438 dan 3,646 kali mengalami MTO antijamur sistemik bentuk injeksi. Temuan terkait efek samping obat dan interaksi obat memerlukan pemantauan oleh tenaga kesehatan dan implementasi protokol de-eskalasi antijamur untuk MTO terkait durasi dapat mengurangi biaya perawatan pasien di rumah sakit. ......The rising population of elderly and immunocompromised patients contributes to Indonesia's high burden of invasive fungal infections. Limited information and guidelines on systemic antifungal agents in Indonesia contribute to drug-related problems (DRPs). Moreover, in Indonesia, injectable forms of systemic antifungals have high costs and limited availability. This cross-sectional study aims to assess the utilization profile and DRP of injectable systemic antifungal medicines at dr. Cipto Mangunkusumo Hospital Building A between January and December 2022. This study utilized quota sampling of secondary data from medical records. The DRP evaluation of patient treatment regimens focused on dosage accuracy, duration accuracy, possible drug interactions, and adverse drug events (ADE). Fluconazole was the most frequently administered intravenous antifungal drug (63,66%), with empirical therapy being the primary indication for treatment (41,1%). Candidiasis was the most prevalent invasive fungal infection (26,2%), and the median duration of intravenous antifungal treatment was 9 (4-26) days. A total of 45 patients experienced DRPs, encompassing dosage too low in 4 (3,7%), treatment duration too short in 10 (9,3%), treatment duration too long in 3 (2,8%), potential drug interactions in 19 (17,8%), and ADE occurring in 18 (16,8%) patients. Chi-square analysis indicated that patients with treatment duration >9 days and those >60 years of age were 2,438 and 3,646 times more likely to experience DRPs (p = 0,041 and p = 0,005, respectively). Findings concerning ADE and potential drug interactions require monitoring by healthcare providers, and antifungal de-escalation protocols for duration-associated DRPs help reduce hospitalization costs.

Abstrak :
During their storage, the traditional ready-to-eat food, such as sticky rice cake, are easily contaminated by spoilage pathogens. Hence, this study aims to evaluate the effect of Citrus hystrix extract in reducing spoilage pathogens in sticky rice cake during storage. The experimental sticky rice cake was prepared and formulated with Citrus hystrix extract at varied level of concentrations of 0.65%, 1.26% and 1.82% (w/w). Treated samples were stored at room temperature for 28 days and evaluated periodically for their microbial activity (total plate count), thiobarbituric acid reactive substances (TBARS), and sensory analysis. For its antifungal activity, the Citrus hystrix extract was also compared against Penicillium sp. and Aspergillus nidulans prior to formulation. Results exhibited a significant advantage of the added extracts to the sticky rice cake. All extract levels effectively eliminated the spoilage microorganism and significantly lowered the TBARS values. The physico-chemical properties of sticky rice cake including pH, water activity, and moisture content were equal among all the formulated samples and slightly different at 1.82% (w/w) extract level. Moreover, the addition of Citrus hystrix extract up to 1.82% did not affect the acceptability sensory attributes of the sticky rice cake as compared to the control which has no Citrus hystrix extracts (p > 0.05).

Abstrak :
Pseudomonas aeruginosa dan Staphylococcus aureus merupakan dua bakteri umum penyebab penyakit infeksi di masyarakat. Pencarian senyawa dari tanaman sebagai antibakteri banyak dilakukan karena meningkatnya kasus resistensi antibiotik. Diospyros nigra atau buah kesemek hitam mengandung senyawa fenol, flavonoid, dan karotenoid yang telah terbukti memiliki aktivitas antibakteri. Pada buah tua D. nigra terjadi penurunan kadar fenol dan peningkatan kadar karotenoid. Penelitian ini bertujuan untuk mengetahui senyawa fitokimia; kadar fenol, flavonoid, dan karotenoid total; aktivitas antibakteri terhadap ekstrak etanol 70% buah muda dan tua D. nigra yang diekstraksi dengan metode Microwave Assisted Extraction (MAE) dan Ultrasound Assisted Extraction (UAE). Berdasarkan hasil identifikasi, buah D. nigra mengandung fenol, tanin, flavonoid, saponin, terpenoid, antrakuinon, dan glikosida. Penetapan kadar fenol total dilakukan menggunakan metode Folin-Ciocalteu dengan hasil pada buah muda sebesar 24,22 mgEAG/g (MAE) dan 21,79 mgEAG/g (UAE), serta buah tua sebesar 19,83 mgEAG/g (MAE) dan 18,36 mgEAG/g (UAE). Penetapan kadar flavonoid total dilakukan menggunakan metode kolorimetri AlCl3 dengan hasil pada buah muda sebesar 6,85 mgEK/g (MAE) dan 5,73 mgEK/g (UAE), serta buah tua sebesar 2,65 mgEK/g (MAE) dan 1,84 mgEK/g (UAE). Penetapan kadar karotenoid total dilakukan menggunakan metode fraksinasi dengan hasil pada buah muda sebesar 45,59 mg/g (MAE) dan 43,67 mg/g (UAE), serta buah tua sebesar 55,71 mg/g (MAE) dan 51,10 mg/g (UAE). Pengujian aktivitas antibakteri dilakukan dengan metode mikrodilusi. Hasil pengujian menunjukkan aktivitas antibakteri paling potensial dihasilkan oleh ekstrak buah tua D. nigra metode MAE pada konsentrasi 16 mg/mL dengan persentase penghambatan pada P. aeruginosa sebesar 94% dan S. aureus sebesar 86,11%. ......Pseudomonas aeruginosa and Staphylococcus aureus are two common bacteria that cause infectious diseases in the community. The search for compounds from plants as antibacterials is widely conducted due to the increasing cases of antibiotic resistance. Diospyros nigra (black persimmon fruit) contains phenol, flavonoid, and carotenoid compounds which have been shown to have antibacterial activity. In ripe D. nigra fruit there is a decrease in phenol compounds and an increase in carotenoids levels. This study aims to determine the phytochemical compounds; total phenol, flavonoid, and carotenoid content; as well as the antibacterial activity of the 70% ethanol extract of unripe and ripe D. nigra fruit using the Microwave Assisted Extraction (MAE) and Ultrasound Assisted Extraction (UAE) methods. Based on the identification, D. nigra fruit contains phenols, tannins, flavonoids, saponins, terpenoids, anthraquinones, and glycosides. Determination of total phenol content was carried out using the Folin-Ciocalteu method with results in unripe fruit is 24,22 mgGAE/g (MAE) and 21,79 mgGAE/g (UAE), while in ripe fruit is 19,83 mgGAE/g (MAE) and 18,36 mgGAE/g (UAE). Determination of total flavonoid content was carried out using the colorimetric AlCl3 method with results in unripe fruit is 6,85 mgQE/g (MAE) and 5.73 mgQE/g (UAE), while in ripe fruit is 2,65 mgQE/g (MAE) and 1,84 mgQE/g (UAE). Determination of total carotenoid content was carried out using the fractionation method with results in unripe fruit 45,59 mg/g (MAE) and 43,67 mg/g (UAE), while in ripe fruit is 55,71 mg/g (MAE) and 51,10 mg/g (UAE). Antibacterial activity testing was carried out using the microdilution method. The results showed that the most potential antibacterial activity was produced by ripe D. nigra fruit extract using the MAE method at a concentration of 16 mg/mL with an inhibition percentage of 94% for P. aeruginosa and 86,11% for S. aureus.

Abstrak :
Interactions of yeasts, moulds, and antifungal agents : how to detect resistance covers the available antifungal agents, how to perform in vitro testing and how those results should be interpreted for the most common fungal pathogens.