Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRACT
Purpose: The development of surgical site infection (SSI) after biliary reconstruction is highly influenced by the presence of preoperative bacteria in the bile juice. We selected vancomycin and piperacillin/tazobactam (VCM + PIPC/TAZ) as perioperative prophylactic antibiotics for patients undergoing pancreaticoduodenectomy. This study aimed to retrospectively analyze the effectiveness of VCM + PIPC/TAZ compared to cefmetazole. Methods: Seventy-two patients who underwent pancreaticoduodenectomy between April 2015 and March 2017 at our department were evaluated. Forty patients were administered cefmetazole as the perioperative prophylactic antibiotic, and 32 were administered VCM + PIPC/TAZ. The intraoperative VCM blood concentration (incision, biliary reconstruction, and wound closure) was measured during surgery to confirm the hemodynamics. Results: The frequency of SSIs was significantly lower in the VCM + PIPC/TAZ group (8/32 patients) than in the cefmetazole group (20/40 patients, P = 0.031). Postoperatively, significantly fewer patients in the VCM + PIPC/TAZ group (4/32 patients) required ≥ 15 days of additional antibiotic administration compared to those in the cefmetazole group (14/40 patients, P = 0.033). Six of 32 patients in the VCM + PIPC/TAZ group showed redneck syndrome symptoms. There was no significant difference in the VCM blood concentration between patients with and without SSIs. Conclusions: The use of VCM + PIPC/TAZ can reduce the incidence of SSI after pancreaticoduodenectomy and also reduce the need for the additional administration of antibiotics for ≥ 15 days after surgery.

Abstrak :
Background: the shifting of minimum inhibitory concentration (MIC) of methicillin-resistant Staphylocuccus aureus (MRSA) strains to the higher value has emerged to worsen clinical outcome to the patients particularly critically ill population. The aim of this study was to identify the most appropriate dosage regimen of vancomycin to treat infection caused by MRSA with higher MIC in critically ill Thai population. Methods: 10,000 replications of intermittent vancomycin dosage regimens were performed using Monte Carlo simulation. Pharmacokinetic parameters were derived from a population pharmacokinetic study conducted specifically in Thai population. The probability of target attainment (PTA) and cumulative fraction of response (CFR) of each dosage regimen were calculated. Risk of nephrotoxicity was also calculated and used as a consideration in determining the most appropriate dosage regimen of vancomycin. Results: in order to achieve desired PTA > 80% vancomycin at higher dosing regimens were needed including 3g/day and 4 g/day for MIC 1.5mg/L and 2.0 mg/L, respectively. Highest CFR of 94.40% and 93.57% were from vancomycin 1 g every 6 h and 2 g every 12h. Standard dose of vancomycin and total dose of vancomycin 3 g/day provided approximately 51% and 73% CFR. Risk of nephrotoxicity afforded by giving 1.5g every 12h and 2g every 12h of vancomycin were 26.59% and 31.20%, respectively. Conclusion: the result from this study recommended intermittent dosage regimen 1.5g every 12h and 2g every 12h should be implemented as definite antibiotic treatment when considered infection caused by MRSA with MIC 1.5 and 2.0 mg/L, respectively.

Abstrak :
Epidemiologi dari penyakit menular atau infeksi di Indonesia memiliki angka yang cukup tinggi, termasuk infeksi bakteri Methicillin-Resistant Staphylococcus aureus MRSA . Menurut National Nosocomial Infection Surveillance System, terdapat lebih dari 60 isolat Staphylococcus aureus dari pasien intensive care unit yang merupakan bakteri MRSA. Vankomisin merupakan antibiotik yang dapat mengatasi infeksi MRSA, namun baru-baru ini ditemukan golongan bakteri yang bersifat kurang sensitif terhadap obat tersebut, sehingga perlu dicari zat lain sebagai terapi alternatif. Daun suren Toona sureni Blume Merr. merupakan salah satu tumbuhan Indonesia yang telah digunakan di bidang kesehatan sejak dahulu kala. Ekstrak daun suren telah diketahui memiliki senyawa metil galat yang dapat menghambat pertumbuhan bakteri Staphylococcus aureus. Pada penelitian ini, dilakukan uji eksperimental dengan metode makrodilusi untuk mengetahui peran daun suren sebagai antibakteri terhadap bakteri MRSA. Vankomisin yang diketahui dapat mengobati infeksi MRSA digunakan sebagai pembanding untuk melihat sensitivitas bakteri yang diuji. Dari penelitian ini didapatkan bahwa ekstrak daun suren Toona sureni Blume Merr. pada konsentrasi 1280 g/mL hingga 0,625 g/mL tidak memiliki kemampuan sebagai antibakteri terhadap MRSA. Peran ekstrak daun terhadap bakteri MRSA perlu diteliti lebih lanjut dengan menggunakan konsentrasi yang lebih tinggi. ......Epidemiology of infectious disease or infection, including Methicillin Resistant Staphylococcus aureus MRSA infection, in Indonesia has a high rate. According to the National Nosocomial Infection Surveillance System, more than 60 of Staphylococcus aureus isolates from patients in intensive care units was represented by MRSA infection. Vancomycin is an antibiotic that can treat MRSA infection, but there are some bacterial strains show less sensitivity to the drug, recently, so it is necessary to find other substances as an alternative therapy. Suren leaves Toona sureni Blume Merr. is one of the Indonesian plant that has been use for medicinal purposes by the ancestors. Suren leaf extract contains methyl gallate which can inhibit the growth of Staphylococcus aureus. In this experimental study, macrodilution methode was conducted to determine the role of suren leaf extract as an antibacterial against MRSA. Vancomycin as a chosen therapy for MRSA infection is used as a comparison to see the sensitivity of the bacterium. From this study, it was found that the suren leaf extract at a consentration 1280 g mL up to 0,625 g mL has no ability as an antibacterial against MRSA. The role of suren leaf extract as antibacterial against MRSA needs further research using higher concentrations.

Abstrak :
Infeksi bakteri Methicillin-resistant Staphylococcus aureus MRSA merupakan salah satu masalah kesehatan dengan prevalensi yang tinggi di Asia, khususnya Indonesia dengan kepadatan penduduk yang juga tinggi sehingga berpengaruh terhadap penyebaran penyakit infeksi ini. Hingga saat ini, vankomisin merupakan antibiotik yang dapat digunakan untuk menangani infeksi MRSA. Untuk itu, perlu dikembangkan alternatif antibiotik agar dapat mencegah peningkatan penyakit infeksi akibat MRSA. Penelitian ini dilakukan untuk mengetahui aktivitas antibakteri ekstrak daun kayu ulin Eusideroxylon zwageri terhadap MRSA dengan melihat konsentrasi hambat minimum KHM dan konsentrasi bunuh minimum KBM. Penelitian menggunakan metode makrodilusi ekstrak daun kayu ulin Eusideroxylon zwageri dan antibiotik vankomisin sebagai pembanding. Konsentrasi bakteri MRSA dalam penelitian ini sesuai dengan Mc Farland 0,5. Hasil penelitian menunjukkan terjadi kekeruhan pada tabung di setiap konsentrasi dan tumbuh koloni bakteri pada agar Mueller Hinton yang menunjukkan adanya bakteri MRSA. Oleh karena itu, dari penelitian ini dapat disimpulkan bahwa ekstrak daun kayu ulin Eusideroxylon zwageri pada konsentrasi 1280 g/mL hingga 0,625 g/mL tidak memiliki aktivitas antibakteri terhadap MRSA. ......Bacterial infection of Methicillin resistant Staphylococcus aureus MRSA is one of the health problem with high prevalence in Asia, especially Indonesia with high population density that influence the spread of this infectious disease. Until now, vancomycin is an antibiotic that can be used to treat MRSA infection. It is necessary to develop alternative antibiotic in order to prevent the increase of infection due to MRSA. This study was conducted to determine the antibacterial activity of ironwood Eusideroxylon zwageri leaf extract against MRSA to see the minimum inhibitory concentration MIC and the minimum bactericidal concentration MBC. This research used macrodilution method with ironwood Eusideroxylon zwageri leaf extract and vancomycin as a comparison. Concentration of MRSA in this study based on Mc Farland 0,5. The results showed turbidity occured in tubes at each concentrations and bacterial colonies grown on Mueller Hinton Agar that indicate the presence of MRSA. Therefore, from this study we can conclude that the ironwood Eusideroxylon zwageri leaf extract at concentration of 1280 g mL until 0,625 g mL do not have antibacterial activity against MRSA.