Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Penggunaan antibiotik yang tidak sesuai dapat meningkatkan laju mortalitas pada pasien sepsis. Sepsis masih manjadi penyebab kematian tersering di ruang perawatan intensif. Tujuan penelitian ini yaitu untuk mengevaluasi kesesuaian penggunaan antibiotik dengan luaran pasien sepsis, serta faktor-faktor yang mempengaruhinya di ruang perawatan Intensive Unit Care ICU . Penelitian ini merupakan penelitian deskriptif analitik dengan menggunakan metode cross-sectional yang dilakukan pada pasien sepsis di ICU Rumah Sakit Kanker Dharmais, Jakarta, Indonesia, selama bulan Februari sampai Mei 2017. Data dikumpulkan dari rekam medis pasien. Pasien dewasa dengan sepsis dan syok septik yang menerima antibiotik parenteral dimasukkan ke dalam kriteria inklusi. Pasien berusia kurang dari 18 tahun atau dengan lama rawat di ICU kurang dari 24 jam tidak disertakan dalam penelitian ini. Data dianalisis dengan menggunakan program SPSS Versi 23.0. Subjek penelitian yang diperoleh yaitu sebanyak 60 pasien. Hasil penelitian menemukan sebanyak 115 antibiotik diresepkan untuk pasien ini. Penggunaan antibiotik yang tidak sesuai berdasarkan pola kuman lokal sebanyak 45,22 . Pasien yang menerima rejimen antibiotik yang tidak sesuai berdasarkan rekomendasi pedoman Survival Sepsis Campaign SSC tahun 2016 yaitu sebanyak 33,33 dan terdapat 51,67 menerima dosis yang tidak sesuai berdasarkan rekomendasi Drug Information Handbook. Analisis bivariat menunjukkan bahwa ada hubungan yang signifikan antara ketidaktepatan pemberian dosis antibiotik dengan laju mortalitas p=0,034; p

---

An inappropriate antibiotic usage can increase the mortality rate in sepsis patients. Sepsis still the most common cause of death in intensive unit care ICU . This study aims to evaluate the appropriateness of antibiotics use and the factors associated with outcome of sepsis patients in ICU. This study was an analityc descriptive study using cross sectional method for sepsis patients in the ICU of Dharmais Cancer Hospital, Jakarta, during February to May 2017. The data is collected from patient rsquo s medical record files. Inclusion criteria is an adult patients with sepsis and septic shock who received parenteral antibiotics. Patients less than 18 years of ages or with lenght of stay in ICU less than 24 hours were excluded. Then, it analyzed using the SPSS Version 23.0 software program. There are 60 patients act as study subjects. As result, 115 antimicrobial was prescribed for these patients. The inappropriate antibiotic usage reached 45,22 , based on local microbial pattern. Among 60 patients, 33.33 received inappropriate types of antibiotics regimens based on Survival Sepsis Campaign SSC guidelines and 51.67 received inappropriate doses based on Drug Information Handbook. Bivariat analysis showed that there was significant correlation between inappropriate doses of antibiotics and mortality p 0.034 p

Abstrak :
Sepsis merupakan kondisi yang sulit untuk didiagnosis. Definisi sepsis berdasarkan International Consensus Conference on Pediatric Sepsis 2005 terlalu sensitif dan tidak spesifik. Akibatnya sering terjadi underdiagnosed/overdiagnosis terhadap sepsis. Sampai saat ini tidak ada data tentang karakteristik pasien sepsis, kepatuhan diagnosis berdasarkan konsensus yang disepakati, dan luaran sepsis pasien di PICU. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik sepsis di PICU RS dr. Cipto Mangunkusumo. Metode penelitian ini adalah deskriptif retrospektif dari data rekam medis pasien sepsis di PICU periode Januari 2012 sampai April 2016. Didapatkan 85 pasien yang didiagnosis dokter dengan sepsis, 7 pasien diantaranya tidak memenuhi kriteria konsensus. Hanya 1 pasien yang didiagnosis sepsis berat oleh dokter, sedangkan berdasarkan konsensus didapatkan 66 pasien sepsis berat. Infeksi respiratorik adalah penyakit primer penyebab sepsis di PICU (51,3%). Angka kejadian sepsis berat di PICU sebesar 85% dan syok septik 70%. Klebsiella pneumonia kuman gram negatif terbanyak penyebab sepsis (22%). Angka kematian sepsis sebesar 29%, pada sepsis berat 32% dan meningkat pada syok septik 37%. Penelitian ini menunjukkan kepatuhan diagnosis sepsis oleh dokter berdasarkan konsensus masih kurang. Diagnosis sepsis pasien di PICU berdasarkan kadar prokalsitonin yang meningkat. ...... Sepsis is a condition that is difficult to diagnose. Definition of sepsis based on the International Consensus Conference on Pediatric Sepsis 2005 is too sensitive and not specific. As a result underdiagnosed/overdiagnosis often occurs in sepsis. Until now there are no data on the characteristics of sepsis patients, compliance to diagnosis based on consensus, and the outcome of sepsis patients in PICU. The aim of this study is to determine the characteristic features of sepsis in PICU of dr. Cipto Mangunkusumo hospital. The methods is descriptive retrospective study from medical records of sepsis patients in PICU from January 2012 until April 2016. There were 85 patients diagnosed with sepsis by physicians, 7 of them did not meet the criteria of consensus. Only one severe sepsis patients diagnosed by a doctor, but based on the consensus, there are 66 patients with severe sepsis. Respiratory infections are the primary cause of sepsis (51.3%). The incidence of severe sepsis in PICU is 85% and of septic shock is 70%. Klebsiella pneumonia, Gram negative bacteria, is the most common cause of sepsis (22%). Sepsis mortality rate is 29%, severe sepsis is 32% and increased in septic shock by 37%. This study describes compliance of diagnosis of sepsis by doctor based on consensus is still lacking. The diagnosis of sepsis patients in PICU based on increased levels of procalcitonin.

Abstrak :
Pemantauan terapi obat (PTO) merupakan kegiatan yang dilakukan di rumah sakit untuk memastikan terapi yang diberikan aman, efektif dan rasional dengan cara pengkajian terapi dari segi obat, dosis, cara pemberian, respon terapi, dan reaksi obat yang tidak dikehendaki serta rekomendasi perubahan atau alternatif terapi yang dapat diberikan untuk mengoptimalkan efek terapi dan meminimalkan efek yang tidak dikehendaki tersebut. PTO dilakukan pada pasien dengan diagnosis utama yaitu sepsis, ulkus pedis sinistra, dan fraktur fibula sinistra. Tujuan dari laporan ini yaitu untuk mengetahui masalah terkait obat berdasarkan klasifikasi Hepler dan Strand dan memberikan rekomendasi penyelesaian masalah untuk meningkatkan kualitas hidup pasien. Metode yang digunakan dalam laporan yaitu mengumpulkan data dari Catatan Perkembangan Pasien Terintegrasi dan melakukan analisis PTO berdasarkan metode Hepler dan Stand. Berdasarkan analisis pemantauan terapi obat dengan metode Hepler dan Strand, dapat disimpulkan bahwa terdapat masalah terkait duplikasi penggunaan obat analgesik, interaksi obat, Reaksi obat yang tidak dikehendaki, dan penggunaan obat ketorolak melebihi batas yang telah ditentukan. Rekomendasi yang dapat dilakukan yaitu melakukan pemantauan lama penggunaan ketorolak, pemantauan penggunaan obat yang dapat menyebabkan interaksi, dan pemantauan efek terapi obat analgesik. ......Drug therapy monitoring is an activity carried out in a hospital to ensure that the therapy given is safe, effective and rational through assessing therapy in terms of drug, dosage, method of administration, therapeutic response, and unwanted drug reactions, as well as recommendations for changes or alternatives. Therapy can be given to optimize the therapeutic effect and minimize these unwanted effects. Drug therapy monitoring was performed in patients with the primary diagnoses of sepsis, left foot ulcer, and left fibula fracture. This report aims to identify drug-related problems based on Hepler and Strand's classification and provide recommendations for problem solving to improve the patient's quality of life. The method used in the report is to collect data from the Integrated Patient Progress Record and perform a drug therapy monitoring analysis based on the Hepler and Stand methods. Based on the analysis of drug therapy monitoring using the Hepler and Strand methods, it can be concluded that there are problems related to the duplication of analgesic drug use, drug interactions, unwanted drug reactions, and the use of ketorolac drugs that exceed predetermined limits. Recommendations that can be made are monitoring the duration of using ketorolac, the use of drugs that can cause interactions, and the effects of analgesic drug therapy.

Abstrak :
[ABSTRAK
Latar Belakang: Pada anak dengan penyakit jantung bawaan (PJB) yang menjalani operasi jantung terbuka, sepsis merupakan salah satu komplikasi pascaoperasi. Lama prosedur pintas jantung paru, usia, status gizi, timektomi, dan variasi genetik, seperti polimorfisme toll-like receptor (TLR) 2 dan tollinteracting protein (TOLLIP) dapat memengaruhi respons imun. Informasi mengenai peran faktor tersebut terhadap kejadian sepsis dan respons imun pascaoperasi jantung terbuka masih terbatas. Tujuan: Mengetahui peran polimorfisme TLR2, TOLLIP, dan faktor lainnya terhadap kejadian sepsis dan respons imun pascaoperasi jantung terbuka untuk memperoleh strategi paling tepat dalam penanganan kasus bedah jantung pada anak. Metodologi: Studi longitudinal dengan non-probability consecutive sampling dilakukan pada anak <1 tahun yang menjalani operasi jantung terbuka. Pemeriksaan polimorfisme TLR2 Arg677Trp, TLR2 N199N, TOLLIP rs5743867, sel CD4 dan CD8 yang menyekresikan IFN-γ intraselular, sel Dendritik yang mengekspresikan TLR2, dan sel NK. Pasien menjalani operasi jantung terbuka. Setelah operasi, pasien dimonitor untuk menilai sepsis dan respons imun pascaoperasi. Hasil: Dari 108 subjek yang terlibat, 21,3% diantaranya mengalami sepsis. Seluruh subjek adalah mutan TLR2 Arg677Trp, 92,6% pasien adalah mutan TLR2 N199N, dan 52,8% pasien adalah mutan TOLLIP rs5743867. Polimorfisme TLR2 N199N dan timektomi total tidak diikutkan dalam model analisis multivariat. Polimorfisme TOLLIP rs5743867 (p = 0,358) menurunkan resiko sepsis, lama prosedur pintas jantung paru ≥90 menit (p = 0,002), usia neonatus (p = 0,032), dan gizi buruk (p = 0,558) meningkatkan risiko sepsis pascaoperasi. Jumlah respons imun bervariasi antara kategori, namun secara umum komponen respons imun lebih rendah pada pasien yang mengalami sepsis dibanding pada pasien yang tidak mengalami sepsis. Simpulan: Lama prosedur pintas jantung paru dan usia neonatus secara signifikan memengaruhi risiko dan kecepatan sepsis pascaoperasi. Peran polimorfisme TLR2 N199N dan TOLLIP rs5743867 terhadap kejadian sepsis dan respons imun pascaoperasi memerlukan studi komprehensif lebih lanjut.

---

ABSTRACT
Background: Sepsis is one of the complications in children with congenital heart defect who underwent open heart surgery. Cardiopulmonary bypass (CPB) time, age, nutritional status, thymectomy, and genetic variants, such as toll-like receptor (TLR) 2 and toll-interacting protein (TOLLIP) polymorphism affect immune response. Information regarding those factors in the development of sepsis and immune response after open heart surgery is still limited. Objectives: To understand the role of TLR 2 and TOLLIP polymorphism, as well as other risk factors, in the development of sepsis and immune response following open heart surgery to develop the best strategy in open heart surgery in children. Methods: Longitudinal study with consecutive sampling were done in children <1 year old who underwent open heart surgery. Blood sample was obtained to check for TLR2 Arg677Trp polymorphism, TLR2 N199N polymorphism, TOLLIP rs5743867 polymorphism, the numbers of intracellular interferon γ CD4 and CD8, TLR2 expression in Dendritic cells, and NK cells. Patient then underwent open heart surgery. Thymectomy was done as indicated and CPB time was recorded. After surgery, patient was monitored for signs of sepsis and immune response was checked. Results: Out of 108 patients involved in this study, 21.3% developed postoperative sepsis. TLR2 Arg677Trp polymorphism was found in all patients, TLR2 N199N polymorphism was found in 92.6% of the patients, and TOLLIP rs5743867 polymorphism was found in 52.8% of the patients. TLR2 N199N polymorphism and thymectomy were not included in multivariate analysis. TOLLIP rs5743867 polymorphism (p = 0.358) reduced the risk of sepsis, CPB time ≥90 menit (p = 0.002), neonates (p = 0.032), and severe malnutrition (p = 0.558) increased the risk of postoperative sepsis. Immune response?s counts vary in each category, but were generally lower in patients who developed postoperative sepsis. Conclusion: Cardiopulmonary bypass time and neonates significantly influenced the risk and hazard of postoperative sepsis. Further investigation on the role of TLR2 N199N and TOLLIP rs5743867 polymorphism are necessary to provide more comprehensive explanation on the development of postoperative sepsis and the immune response after open heart surgery;Background: Sepsis is one of the complications in children with congenital heart defect who underwent open heart surgery. Cardiopulmonary bypass (CPB) time, age, nutritional status, thymectomy, and genetic variants, such as toll-like receptor (TLR) 2 and toll-interacting protein (TOLLIP) polymorphism affect immune response. Information regarding those factors in the development of sepsis and immune response after open heart surgery is still limited. Objectives: To understand the role of TLR 2 and TOLLIP polymorphism, as well as other risk factors, in the development of sepsis and immune response following open heart surgery to develop the best strategy in open heart surgery in children. Methods: Longitudinal study with consecutive sampling were done in children <1 year old who underwent open heart surgery. Blood sample was obtained to check for TLR2 Arg677Trp polymorphism, TLR2 N199N polymorphism, TOLLIP rs5743867 polymorphism, the numbers of intracellular interferon γ CD4 and CD8, TLR2 expression in Dendritic cells, and NK cells. Patient then underwent open heart surgery. Thymectomy was done as indicated and CPB time was recorded. After surgery, patient was monitored for signs of sepsis and immune response was checked. Results: Out of 108 patients involved in this study, 21.3% developed postoperative sepsis. TLR2 Arg677Trp polymorphism was found in all patients, TLR2 N199N polymorphism was found in 92.6% of the patients, and TOLLIP rs5743867 polymorphism was found in 52.8% of the patients. TLR2 N199N polymorphism and thymectomy were not included in multivariate analysis. TOLLIP rs5743867 polymorphism (p = 0.358) reduced the risk of sepsis, CPB time ≥90 menit (p = 0.002), neonates (p = 0.032), and severe malnutrition (p = 0.558) increased the risk of postoperative sepsis. Immune response?s counts vary in each category, but were generally lower in patients who developed postoperative sepsis. Conclusion: Cardiopulmonary bypass time and neonates significantly influenced the risk and hazard of postoperative sepsis. Further investigation on the role of TLR2 N199N and TOLLIP rs5743867 polymorphism are necessary to provide more comprehensive explanation on the development of postoperative sepsis and the immune response after open heart surgery;Background: Sepsis is one of the complications in children with congenital heart defect who underwent open heart surgery. Cardiopulmonary bypass (CPB) time, age, nutritional status, thymectomy, and genetic variants, such as toll-like receptor (TLR) 2 and toll-interacting protein (TOLLIP) polymorphism affect immune response. Information regarding those factors in the development of sepsis and immune response after open heart surgery is still limited. Objectives: To understand the role of TLR 2 and TOLLIP polymorphism, as well as other risk factors, in the development of sepsis and immune response following open heart surgery to develop the best strategy in open heart surgery in children. Methods: Longitudinal study with consecutive sampling were done in children <1 year old who underwent open heart surgery. Blood sample was obtained to check for TLR2 Arg677Trp polymorphism, TLR2 N199N polymorphism, TOLLIP rs5743867 polymorphism, the numbers of intracellular interferon γ CD4 and CD8, TLR2 expression in Dendritic cells, and NK cells. Patient then underwent open heart surgery. Thymectomy was done as indicated and CPB time was recorded. After surgery, patient was monitored for signs of sepsis and immune response was checked. Results: Out of 108 patients involved in this study, 21.3% developed postoperative sepsis. TLR2 Arg677Trp polymorphism was found in all patients, TLR2 N199N polymorphism was found in 92.6% of the patients, and TOLLIP rs5743867 polymorphism was found in 52.8% of the patients. TLR2 N199N polymorphism and thymectomy were not included in multivariate analysis. TOLLIP rs5743867 polymorphism (p = 0.358) reduced the risk of sepsis, CPB time ≥90 menit (p = 0.002), neonates (p = 0.032), and severe malnutrition (p = 0.558) increased the risk of postoperative sepsis. Immune response?s counts vary in each category, but were generally lower in patients who developed postoperative sepsis. Conclusion: Cardiopulmonary bypass time and neonates significantly influenced the risk and hazard of postoperative sepsis. Further investigation on the role of TLR2 N199N and TOLLIP rs5743867 polymorphism are necessary to provide more comprehensive explanation on the development of postoperative sepsis and the immune response after open heart surgery;Background: Sepsis is one of the complications in children with congenital heart defect who underwent open heart surgery. Cardiopulmonary bypass (CPB) time, age, nutritional status, thymectomy, and genetic variants, such as toll-like receptor (TLR) 2 and toll-interacting protein (TOLLIP) polymorphism affect immune response. Information regarding those factors in the development of sepsis and immune response after open heart surgery is still limited. Objectives: To understand the role of TLR 2 and TOLLIP polymorphism, as well as other risk factors, in the development of sepsis and immune response following open heart surgery to develop the best strategy in open heart surgery in children. Methods: Longitudinal study with consecutive sampling were done in children <1 year old who underwent open heart surgery. Blood sample was obtained to check for TLR2 Arg677Trp polymorphism, TLR2 N199N polymorphism, TOLLIP rs5743867 polymorphism, the numbers of intracellular interferon γ CD4 and CD8, TLR2 expression in Dendritic cells, and NK cells. Patient then underwent open heart surgery. Thymectomy was done as indicated and CPB time was recorded. After surgery, patient was monitored for signs of sepsis and immune response was checked. Results: Out of 108 patients involved in this study, 21.3% developed postoperative sepsis. TLR2 Arg677Trp polymorphism was found in all patients, TLR2 N199N polymorphism was found in 92.6% of the patients, and TOLLIP rs5743867 polymorphism was found in 52.8% of the patients. TLR2 N199N polymorphism and thymectomy were not included in multivariate analysis. TOLLIP rs5743867 polymorphism (p = 0.358) reduced the risk of sepsis, CPB time ≥90 menit (p = 0.002), neonates (p = 0.032), and severe malnutrition (p = 0.558) increased the risk of postoperative sepsis. Immune response?s counts vary in each category, but were generally lower in patients who developed postoperative sepsis. Conclusion: Cardiopulmonary bypass time and neonates significantly influenced the risk and hazard of postoperative sepsis. Further investigation on the role of TLR2 N199N and TOLLIP rs5743867 polymorphism are necessary to provide more comprehensive explanation on the development of postoperative sepsis and the immune response after open heart surgery, Background: Sepsis is one of the complications in children with congenital heart defect who underwent open heart surgery. Cardiopulmonary bypass (CPB) time, age, nutritional status, thymectomy, and genetic variants, such as toll-like receptor (TLR) 2 and toll-interacting protein (TOLLIP) polymorphism affect immune response. Information regarding those factors in the development of sepsis and immune response after open heart surgery is still limited. Objectives: To understand the role of TLR 2 and TOLLIP polymorphism, as well as other risk factors, in the development of sepsis and immune response following open heart surgery to develop the best strategy in open heart surgery in children. Methods: Longitudinal study with consecutive sampling were done in children <1 year old who underwent open heart surgery. Blood sample was obtained to check for TLR2 Arg677Trp polymorphism, TLR2 N199N polymorphism, TOLLIP rs5743867 polymorphism, the numbers of intracellular interferon γ CD4 and CD8, TLR2 expression in Dendritic cells, and NK cells. Patient then underwent open heart surgery. Thymectomy was done as indicated and CPB time was recorded. After surgery, patient was monitored for signs of sepsis and immune response was checked. Results: Out of 108 patients involved in this study, 21.3% developed postoperative sepsis. TLR2 Arg677Trp polymorphism was found in all patients, TLR2 N199N polymorphism was found in 92.6% of the patients, and TOLLIP rs5743867 polymorphism was found in 52.8% of the patients. TLR2 N199N polymorphism and thymectomy were not included in multivariate analysis. TOLLIP rs5743867 polymorphism (p = 0.358) reduced the risk of sepsis, CPB time ≥90 menit (p = 0.002), neonates (p = 0.032), and severe malnutrition (p = 0.558) increased the risk of postoperative sepsis. Immune response’s counts vary in each category, but were generally lower in patients who developed postoperative sepsis. Conclusion: Cardiopulmonary bypass time and neonates significantly influenced the risk and hazard of postoperative sepsis. Further investigation on the role of TLR2 N199N and TOLLIP rs5743867 polymorphism are necessary to provide more comprehensive explanation on the development of postoperative sepsis and the immune response after open heart surgery]

Abstrak :
Latar belakang: Persalinan prematur semakin banyak dan memiliki tingkat morbiditas dan mortalitas yang tinggi. Prematur menyumbang angka kematian tertinggi selain asfiksia, infeksi dan kelainan kongenital. Korioamnionitis merupakan salah satu penyebab persalinan prematur dan berhubungan dengan kejadian sepsis neonatal awitan dini pada bayi prematur atau berat lahir rendah. Penelitian dilakukan untuk mengetahui korioamnionitis sebagai prediktor sepsis neonatal awitan dini. Metode : Penelitian kohort prospektif dilakukan bekerja sama dengan Departemen Obstetri dan Ginekologi RSCM dan RSUD Koja. Pengumpulan sampel dilakukan selama periode Maret-September 2022. Dilakukan evaluasi terhadap gejala klinis dan pemeriksaan penunjang ibu yang terkait korioamnionitis, dihubungkan dengan gejala klinis dan pemeriksaan penunjang bayi terkait sepsis neonatal awitan dini yang dirawat di NICU. Hasil : Insidens korioamnionitis sebesar 90% dan sepsis neonatus awitan dini 16%. Jenis persalinan spontan dan section caesarea dengan KPD tidak berhubungan dengan kejadian korioamnionitis (RR:1,049; IK 95% 0,982-1,120; p=1,000) and (RR:1,091; IK 95% 0,967-1,231; p=1,000).Korioamnionitis tidak berhubungan dengan sepsis neonatal awitan dini dengan p=0,358. Demam pada ibu berhubungan dengan kejadian SNAD EONS (RR:3,333: CI 95% 1,399-7,942; p=0,022) Simpulan : Korioamnionitis bukan prediktor sepsis neonatal awitan dini pada bayi usia gestasi ≤32 minggu atau bayi berat lahir ≤ 1500 gram. ......Background: Increasing number of preterm birth correlated with high morbidity and mortality rates. Prematurity contributed in high mortality rates alongside asphyxia, infections and congenital malformations. Chorioamnionitis were associated with preterm birth and early onset sepsis in preterm or low birth weight infants. Research was aimed to determine chorioamnionitis as a predictor of early onset neonatal sepsis (EONS) in preterm or low birth weight. Methodes : Multicentre, Cohort prospective study conducted in collaboration with Obstetrics and Gynaecology Department of Cipto Mangunkusumo National Hospital (CMH) and Koja General Hospital. Samples were obtained in NICU Unit during March - September 2022. Maternal clinical symptoms and diagnostic tests for chorioamnionitis evaluated as a predictor to early onset neonatal sepsis. Results : The incidence of chorioamnionitis and early onset neonatal sepsis were 90% and 16% respectively. Spontaneous and caesarean section delivery with PPROM is not associated with the incidence of chorioamnionitis (RR:1,049; CI 95% 0,982-1,120; p=1,000) and (RR:1,091; CI 95% 0,967-1,231; p=1,000). Chorioamnionitis is not a predictor of early onset neonatal sepsis with p=0,358. Maternal fever is associated with the incidence of EONS (RR:3,333: CI 95% 1,399-7,942; p=0,022). Conclusion : Chorioamnionitis is not a predictor on early onset neonatal sepsis in gestational age ≤32 weeks or birth weight of ≤ 1500 grams.

Abstrak :
Pendahuluan: Pasien yang dirawat di ICU berisiko tinggi terserang kandidiasis invasif. Pemberian antijamur empirik dini dapat memperbaiki kondisi klinis pasien dan menurunkan angka kematian. Candida Score dari Leon mempunyai sensitifitas dan spesifisitas yang baik untuk menggolongkan pasien ICU yang memang benar membutuhkan terapi empirik antijamur. Penelitian ini menganalisis kesesuaian kriteria Candida Score dan hasil kultur darah dengan pemberian antijamur pada pasien sepsis di ICU RSCM. Metodologi: Studi potong lintang dilakukan pada pasien sepsis di ICU RSCM pada Maret 2015-Oktober 2015. Dilakukan kultur pada spesimen darah, urin, dan sekret saluran nafas, selanjutnya dibiakkan. Karakteristik pasien dan riwayat klinisnya dicatat. Candida Score dihitung pada setiap pasien kemudian diuji asosiasinya dengan terapi yang didapatkan. Hasil: Dari 100 pasien 57 pasien mendapatkan antijamur. Proporsi pasien yang mendapat antijamur yaitu 50 , 17 , 57 , 83 , dan 100 pada kelompok pasien dengan Candida score 0-4 berturut-turut. Dalam penelitian ini tidak kami dapatkan pasien dengan Candida score=5. Hasil kultur darah positif Candida didapatkan pada 4 orang pasien dengan angka kematian sebesar 100 . Tiga pasien kandidemia dengan Candida score >3 mendapatkan antijamur setelah hasil kultur darah positif Candida. Kesimpulan: Terdapat asosiasi bermakna antara kriteria Candida score dengan pemberian antijamur pada pasien sepsis di ICU RSCM p3 tidak mendapatkan terapi empirik.

---

Introduction Prompt empirical antifungal therapy is essential for controling invasive candidiasis and has been shown to reduce mortality. Candida Score, established by Leon, has a good sensitivity and specivicity to distinguish critically ill patients whose invasive candidiasis is highly probable. This study analyzed the conformity between candida score criteria and blood culture results with the antifungal administration in patients with sepsis at the ICU of Dr. Cipto Mangunkusumo General Hospital RSCM Methods A cross sectional study was conducted from March October 2015 at the ICU of RSCM. Critically ill patients who exhibited sepsis were included in this study. The urine, blood, and respiratory secrete were collected and were cultured in the microbiology laboratory. Each patient rsquo s characteristics and medical history were also recorded. The candida score was calculated and then tested for their association with treatment obtained. Results Of the 100 patients, 57 patients received antifungal therapy, with the proportion of 50 , 17 , 57 , 83 , and 100 in the patients group broken by the Candida Score of 0 to 4 respectively. There rsquo s no patient with Candida Score of 5. Candida positive blood culture results candidaemia were observed in 4 patients, with a mortality rate of 100 . Three of which had the score of 3 but received antifungal therapy after the positive blood culture results were obtained. Conclusion There is a significant association between Candida Score criteria with antifungal administration in septic patients in the ICU of RSCM p 3 did not get empiric antifungal therapy.