rinitis alergi pada anak
DESCRIPTION
perbandingan cetirizin dan loratadin pada rinitisTRANSCRIPT
-
Paediatrica IndonesianaVOLUME 52 NUMBER 2March
Original Article
Paediatr Indones, Vol. 52, No. 2, March 2012 61
Efficacy comparison of cetirizine and loratadine for allergic rhinitis in children
Juliana, Rita Evalina, Lily Irsa, M. Sjabaroeddin Loebis
AbstractBackgroundAllergic rhinitis represents a global health problem DIIHFWLQJWRPRUHWKDQRIWKHSRSXODWLRQZRUOGZLGH6HYHUDO VWXGLHV LQ UHFHQW \HDUV KDYH GHVFULEHG WKH HIILFDF\ RIVHFRQGJHQHUDWLRQ DQWLKLVWDPLQHV LQ \RXQJHU FKLOGUHQ ,W LVQRWZHOO HVWDEOLVKHGZKHWKHU FHWLUL]LQH LVPRUH HIIHFWLYH WKDQORUDWDGLQHLQUHGXFLQJV\PSWRPVRIDOOHUJLFUKLQLWLVObjective7KHREMHFWLYHRIWKLVVWXG\ZDVWRFRPSDUHWKHHIILFDF\RIORUDWDGLQHZLWKFHWLUL]LQHIRUWUHDWPHQWRIDOOHUJLFUKLQLWLVMethods:HFRQGXFWHGDUDQGRPL]HGGRXEOHEOLQGFRQWUROOHGWULDO RI FKLOGUHQ DJHG WR \HDUV IURP2FWREHU WR1RYHPEHU DW WZR MXQLRUKLJK VFKRROV LQ0HGDQ*URXS, UHFHLYHGPJRI FHWLUL]LQH DQG JURXS ,, UHFHLYHGPJRIORUDWDGLQH HDFKRQFHGDLO\ LQ WKHPRUQLQJ IRU GD\V'UXJHIILFDF\ZDVDVVHVVHGE\FKDQJHVIURPEDVHOLQHV\PSWRPVFRUHVDQGHYDOXDWLRQRIWKHUDSHXWLFUHVSRQVHVDIWHUGD\VGD\VDQGGD\VRIWUHDWPHQWResults 7KHHIILFDF\RIFHWLUL]LQHFRPSDUHGWRWKDWRIORUDWDGLQHZDVQRW VWDWLVWLFDOO\ VLJQLILFDQW LQGLPLQLVKLQJQDVDO V\PSWRPVDIWHUGD\VGD\VDQGGD\VRIWUHDWPHQW3 3 DQG3 UHVSHFWLYHO\(YDOXDWLRQRIVLGHHIIHFWVKRZHYHUUHYHDOHGVLJQLILFDQWO\IHZHUKHDGDFKHVLQWKHFHWLUL]LQHJURXSDIWHUGD\VDQGGD\VRIWUHDWPHQW3 DQG3 UHVSHFWLYHO\WKDQLQWKH ORUDWLGLQHJURXS,QDGGLWLRQWKH ORUDWDGLQHJURXSKDG VLJQLILFDQWO\PRUH LQVWDQFHVRISDOSLWDWLRQVDIWHUGD\VRIWUHDWPHQW3 FRPSDUHGWRWKHFHWLUL]LQHJURXSConclusion7KHUHZDVQRVLJQLILFDQWGLIIHUHQFHLQFHWLUL]LQHDQGORUDWDGLQHWUHDWPHQWHIIHFWLYHQHVVRQDOOHUJLFUKLQLWLV+RZHYHUORUDWDGLQHZDVIRXQGWRFDXVHPRUHKHDGDFKHVDQGSDOSLWDWLRQVWKDQFHWLUL]LQH[Paediatr Indones. 2012;52:61-6]
Keywords: antihistamines, cetirizine, loratadine, allergic rhinitis
7KLVVWXG\ZDVSUHVHQWHGDWWKHth,QGRQHVLDQ3HGLDWULF6RFLHW\$QQXDO6FLHQWLILF0HHWLQJ)HEUXDU\0HGDQ)URP WKH'HSDUWPHQW RI&KLOG+HDOWK8QLYHUVLW\ RI1RUWK6XPDWUD0HGLFDO6FKRRO$GDP0DOLN+RVSLWDO0HGDQ
Reprint requests to:-XOLDQD0''HSDUWPHQWRI&KLOG+HDOWK0HGLFDO6FKRRO8QLYHUVLW\RI1RUWK6XPDWHUD$GDP0DOLN+RVSLWDO -O%XQJD/DX1R0HGDQ3K)D[Email: [email protected]
AOOHUJLF UKLQLWLV $5 LV D JOREDO KHDOWKSUREOHP DIIHFWLQJ WRPRUH WKDQ RI WKH SRSXODWLRQ ZRUOGZLGH6\PSWRPDWLF DOOHUJLF UKLQLWLV UHGXFHVTXDOLW\RIOLIHDQGPD\FRQWULEXWHWRLPSDLUPHQWRISV\FKRORJLFDOZHOOEHLQJDQGFRJQLWLYHIXQFWLRQ
$QWLKLVWDPLQHVDUH WKHSKDUPDFRORJLFFRUQHUVWRQH RI WUHDWPHQW IRU DOOHUJLF UKLQLWLV The FRPSDUDWLYH HIIHFWV RI VHFRQG JHQHUDWLRQ DQWLKLVWDPLQHVFHWLUL]LQHDQGORUDWDGLQHDPRQJ\RXQJHUSDWLHQWVKDYHQRWEHHQZHOOGRFXPHQWHG&HWLUL]LQHDQGORUDWDGLQHDUHDQWDJRQLVWVWRWKHKLVWDPLQH+UHFHSWRUDQGWKHLUPHWDEROLVPPD\OHDGWRVHGDWLYHDQGFDUGLRWR[LFHIIHFWV7KXVPRUHUHVHDUFKRQWKHVHGUXJVLVQHHGHG
/RUDWDGLQHLVPHWDEROL]HGLQWKHOLYHUDQGH[FUHWHGE\WKHNLGQH\VZKLOHFHWLUL]LQHPHWDEROLVPGRHVQRWLQYROYHWKHOLYHUWKRXJKLWLVPRVWO\H[FUHWHGE\ WKH NLGQH\V+RZHYHU %XFNV HW DO IRXQG WKDWFHWLUL]LQHLVVL[WLPHVPRUHSRWHQWWKDQORUDWDGLQHWKXVDKLJKHUGRVHRIORUDWDGLQHLVRIWHQUHTXLUHGWR
-
Juliana et al: (IILFDF\FRPSDULVRQRIFHWLUL]LQHDQGORUDWDGLQHIRUDOOHUJLFUKLQLWLVLQFKLOGUHQ
62Paediatr Indones, Vol. 52, No. 2, March 2012
DFKLHYHDVLPLODUUHVXOW2WKHUVHFRQGJHQHUDWLRQDQWLKLVWDPLQHVVXFKDVWHUIHQDGLQHDQGDVWHPL]ROHDOVRKDGVLPLODUHIIHFWVFRPSDUHGWRFHWLUL]LQHEXWWKHVH GUXJV DUHPHWDEROL]HG UDSLGO\ LQ WKH OLYHUDQG KDYH FDUGLRWR[LF HIIHFWV 7KH SXUSRVH RIWKLVVWXG\ZDVWRFRPSDUHWKHHIILFDF\RIFHWLUL]LQHDQG ORUDWDGLQH IRU WUHDWPHQWRI DOOHUJLF UKLQLWLV LQFKLOGUHQ
Methods
:HFRQGXFWHGDUDQGRPL]HGGRXEOHEOLQGFRQWUROOHGWULDOIURP2FWREHUWR1RYHPEHUDWWZRMXQLRU
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
Figure 1. 5VWF[RTQNG
UVWFGPVU
YKVJCNNGTIKETJKPKVKU
'XCNWCVKQPQPFC[UCPFQHVTGCVOGPV
.QTCVCFKPGn = 50
UVWFGPVCDUGPVHQTGXCNWCVKQPth day)
[TUQNF 4GHWUGFVQLQKP 6CMKPICPVKJKUVCOKPGU
UVWFGPVUEQORNGVGFVTGCVOGPV
%GVKTK\KPGn = 50
UVWFGPVCDUGPVHQTGXCNWCVKQPrd day)
UVWFGPVUEQORNGVGFVTGCVOGPV
'PTQNNGFUVWFGPVUP
-
Juliana et al: (IILFDF\FRPSDULVRQRIFHWLUL]LQHDQGORUDWDGLQHIRUDOOHUJLFUKLQLWLVLQFKLOGUHQ
Paediatr Indones, Vol. 52, No. 2, March 2012 63
LQWHUIHUHQFH LQ GDLO\ DFWLYLWLHV DQGRU VOHHS We H[FOXGHG VXEMHFWV ZLWK D KLVWRU\ RI GRFXPHQWHGDVWKPD VLQXVLWLV FRPPRQ FROG RWLWLV PHGLDQDVDO DQDWRPLF DEQRUPDOLWHV NQRZQ LGLRV\QFUDWLFUHDFWLRQVWRFHWLUL]LQHRU ORUDWDGLQHFRUWLFRVWHURLGXVHZLWKLQWZRZHHNVRIWKHILUVWWHVWGRVHRUDORUWRSLFDOGHFRQJHVWDQWDQGDQWLKLVWDPLQHXVHZLWKLQKRXUVRIWKHILUVWWHVWGRVHDQGWKRVHZKRUHIXVHGWRFRQVXPHWKHGUXJ
3DWLHQWV ZHUH GLYLGHG LQWR WZR JURXSV E\VLPSOHUDQGRPL]DWLRQXVLQJUDQGRPWDEOHV*URXS,UHFHLYHGPJFHWLUL]LQHDQGJURXS,,UHFHLYHGPJORUDWDGLQHZLWKHDFKPHGLFDWLRQWDNHQRQFHDGD\RUDOO\IRUGD\V:HHYDOXDWHGWKHSDWLHQWVDWYLVLWIRUVFUHHQLQJDIWHUGD\VYLVLWDIWHUGD\VYLVLWDQGDIWHUGD\VYLVLWRIWUHDWPHQW6XEMHFWVZHUHQRWDOORZHGWRFRQVXPHRWKHUDQWLKLVWDPLQHVRUFRUWLFRVWHURLGVGXULQJWUHDWPHQWSHULRG
7UHDWPHQW HIILFDF\ ZDV DVVHVVHG E\ FKDQJHVIURPEDVHOLQHV\PSWRPVFRUHVDQGVLGHHIIHFWVZHUHDVVHVVHG DIWHU WKHUDSHXWLF UHVSRQVH DW GD\V GD\V DQG GD\V RI WUHDWPHQW 6\PSWRPVZHUHREVHUYHGDQGSK\VLFDOH[DPLQDWLRQZDVSHUIRUPHGDWHDFKYLVLW7KLVVWXG\ZDVDSSURYHGE\WKH(WKLFV&RPPLWWHH RI WKH0HGLFDO 6FKRRO8QLYHUVLW\ RI1RUWK6XPDWHUD
&KLVTXDUH WHVW ZDV SHUIRUPHG WR DQDO\]HWUHDWPHQWHIILFDF\DQGVLGHHIIHFWV'LIIHUHQFHVZHUHFRQVLGHUHG VLJQLILFDQW LI 3:H XVHG 6366YHUVLRQ IRU GDWD SURFHVVLQJ2XU VWXG\ZDV DQLQWHQWLRQWRWUHDWDQDO\VLV
Results
:HVFUHHQHGVWXGHQWVRIZKLFKVXIIHUHGIURPDOOHUJLFUKLQLWLV)LIW\RIWKHVHVWXGHQWVZHUHH[FOXGHGIRU WKH IROORZLQJ UHDVRQV VWXGHQWVZHUH DJHGEHORZ\HDUVVWXGHQWVUHIXVHGWRSDUWLFLSDWHDQGVWXGHQWVZHUHDOUHDG\WDNLQJDQWLKLVWDPLQHV7KHUHPDLQLQJ VWXGHQWVZHUH UDQGRPL]HG LQWR WZRJURXSVRIHDFKRIZKRPUHFHLYHGWUHDWPHQWZLWKPJORUDWDGLQHRUPJFHWLUL]LQHFigure 1
6XEMHFWV FKDUDFWHULVWLFV DUH VKRZQ LQTable 17KHPHDQDJHLQWKHFHWLUL]LQHJURXSZDV\HDUVZKLOHLQWKDWRIWKHORUDWDGLQHJURXSZDV\HDUV7KHUHZHUHIHPDOHVLQWKHFHWLUL]LQHJURXSDQGLQWKHORUDWDGLQHJURXS$WWKH
ILUVWYLVLWVWXGHQWV LQWKHFHWLUL]LQHJURXSKDGDPRGHUDWH DOOHUJLF UKLQLWLV VFRUHZKLOH VWXGHQWVKDGDVHYHUHVFRUH,QWKHORUDWDGLQHJURXSKDGPRGHUDWHDQGKDGVHYHUHVFRUHV7KHPDMRULW\RIVXEMHFWVKDGVHYHUHDOOHUJLFUKLQLWLVVFRUHVDWEDVHOLQH
Table 2 VKRZV VFRUHV RI DOOHUJLF UKLQLWLV DWGD\V DQGRI WUHDWPHQW2QGD\V DQGWKHUHZHUHGHFUHDVHGV\PSWRPVRIUKLQLWLV LQERWKJURXSV EXW WKHUH ZDV QR VWDWLVWLFDOO\ VLJQLILFDQWGLIIHUHQFHEHWZHHQWKHWZRJURXSV3 IRUGD\
Table 2. 5EQTGUQHCNNGTIKETJKPKVKUCVFC[UCPFQHVTGCVOGPV
'XCNWCVGFUEQTGUTJKPKVKU
%GVKTK\KPGP
.QTCVCFKPGP P
&C[ /KNF /QFGTCVG 5GXGTGDay-7 0QU[ORVQOU /KNF /QFGTCVG 5GXGTGDay-14 0QU[ORVQOU /KNF /QFGTCVG 5GXGTG
Table 1. $CUGNKPGEJCTCEVGTKUVKEU
%JCTCEVGTKUVKEU %GVKTK\KPGP
.QTCVCFKPGP
5GZ /CNG (GOCNG#IG [GCTUQNF [GCTUQNF [GCTUQNF/GCPCIG[GCTU5[ORVQOU 4WPP[PQUG 5PGG\KPI 5VWHPGUU '[GKVEJKPGUU '[GTGFPGUU5NGGRFKUVWTDCPEG+ORCKTGFUEJQQNRGTHQTOCPEG5EJQQNCDUGPEG
#NNGTIKETJKPKVKUUEQTG /QFGTCVG 5GXGTG
-
Juliana et al: (IILFDF\FRPSDULVRQRIFHWLUL]LQHDQGORUDWDGLQHIRUDOOHUJLFUKLQLWLVLQFKLOGUHQ
64Paediatr Indones, Vol. 52, No. 2, March 2012
DQG3 IRUGD\2QGD\WKHPDMRULW\RIVXEMHFWVLQERWKJURXSVZHUHIUHHIURPV\PSWRPVEXWGLIIHUHQFHLQWKHWZRJURXSVZDVDOVRQRWVWDWLVWLFDOO\VLJQLILFDQW3
Table 3 UHSRUWV WKH REVHUYDWLRQ RI V\PSWRPVDIWHU DQG GD\V RI WUHDWPHQW 7KHUHZDVLPSURYHPHQWLQV\PSWRPVLQHDFKJURXSEXWWKHUHZHUHQRVWDWLVWLFDOO\ VLJQLILFDQWGLIIHUHQFHVEHWZHHQWKHWZRJURXSV
Table 4VKRZVWKHLQFLGHQFHRIVLGHHIIHFWVDIWHUDQGGD\VRIWUHDWPHQW7KHUHZHUHVLJQLILFDQWGLIIHUHQFHVEHWZHHQWKHWZRJURXSVDIWHUGD\VDQGGD\VRIWUHDWPHQW+HDGDFKHVZHUHPRUHIUHTXHQWO\SUHVHQW LQ WKH ORUDWDGLQH JURXS FRPSDUHG WR WKHFHWLUL]LQHJURXSGD\3 DQGGD\3 ,QDGGLWLRQDWGD\VZHREVHUYHGPRUHSDOSLWDWLRQVLQWKHORUDWDGLQHJURXSWKDQLQWKHFHWLUL]LQHJURXS3
Discussion
$QHVWLPDWHGWRPLOOLRQ$PHULFDQVDUHDIIHFWHGE\ DOOHUJLF UKLQLWLV 7KH DFWXDO SUHYDOHQFH RI WKHFRQGLWLRQLVGLIILFXOWWRGLVFHUQDVPDQ\VXIIHUHUVVHOIPHGLFDWHZLWKRXWVHHNLQJPHGLFDOFDUH$FFRUGLQJWR WKH ,QWHUQDWLRQDO6WXG\RQ$VWKPDDQG$OOHUJ\LQ&KLOGKRRG ,6$$& WKH SUHYDOHQFH RI DOOHUJLFUKLQLWLVLVDWWKHDJHRIWR\HDUV,QDJUHHPHQWZHIRXQGRIVWXGHQWVVFUHHQHGWRKDYHWKLVFRQGLWLRQ2XUVXEMHFWVPHDQDJHZDV\HDUV
7KHGLDJQRVLVRIDOOHUJLFUKLQLWLVLVXVXDOO\PDGHRQWKHEDVLVRIWKHSDWLHQWVKLVWRU\DQGWKHUHVXOWVRISK\VLFDOH[DPLQDWLRQ,QDGGLWLRQWRFODVVLFV\PSWRPVRIQDVDOFRQJHVWLRQLWFK\QRVHVQHH]LQJUKLQRUUKHDDQGLWFK\ZDWHU\H\HVRWKHULPSRUWDQWFRQVLGHUDWLRQVLQFOXGHDIDPLO\KLVWRU\RIDOOHUJLFUKLQLWLVDKLVWRU\RI
Table 3. %NKPKECNU[ORVQOUGXCNWCVKQPQPFC[UCPFCHVGTEGVKTK\KPGQTNQTCVCFKPGVTGCVOGPV
5[ORVQOU&C[
PDay 7
PDay 14
PEGVKTK\KPGP
NQTCVCFKPGP
EGVKTK\KPGP
NQTCVCFKPGP
EGVKTK\KPGP
NQTCVCFKPGP
4WPP[PQUG5PGG\KPI5VKHHPGUU'[GKVEJKPGUU'[GTGFPGUU5NGGRFKUVWTDCPEG+ORCKTGFUEJQQNRGTHQTOCPEG5EJQQNCDUGPEG
2 4)
Table 4. 5KFGGHHGEVUQPFC[CPFQHEGVKTK\KPGQTNQTCVCFKPGVTGCVOGPV
5KFGGHHGEVU&C[
PDay 7
PDay 14
PEGVKTK\KPGP
NQTCVCFKPGP
EGVKTK\KPGP
NQTCVCFKPGP
EGVKTK\KPGP
NQTCVCFKPGP
5GFCVKQP&K\\KPGUU%QPHWUKQP$KVVGTVCUVG0CWUGC8QOKVKPI&T[OQWVJ*GCFCEJGU$TGCVJKPIFKHEWNV[7TKPCT[KPEQPVKPGPEG6KTGFPGUU2CNRKVCVKQPU$NWTTGFXKUKQP
-
Juliana et al: (IILFDF\FRPSDULVRQRIFHWLUL]LQHDQGORUDWDGLQHIRUDOOHUJLFUKLQLWLVLQFKLOGUHQ
Paediatr Indones, Vol. 52, No. 2, March 2012 65
RWKHUDWRSLFGLVHDVHVSUHYLRXVWUHDWPHQWH[SHULHQFHVDQG VXVSHFWHG WULJJHUV )RU WKH SXUSRVHV RI RXUVWXG\WKHGLDJQRVLVRIDOOHUJLFUKLQLWLVZDVPDGHIURPDVVHVVLQJFODVVLFV\PSWRPVREWDLQLQJDIDPLO\KLVWRU\RIDOOHUJLFUKLQLWLVDKLVWRU\RIRWKHUDWRSLFGLVHDVHVDQGSK\VLFDOH[DPLQDWLRQ
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
'LDJQRVWLF WHVWV LQFOXGH VNLQ SULFN WHVWLQJLQWUDGHUPDO WHVWLQJ DQG LQ YLWUR EORRG WHVWV1DVDO FKDOOHQJH WHVWLQJ QDVDO VPHDUV VLQXVWUDQVLOOXPLQDWLRQ DQG QDVRSKDU\QJRVFRS\ DUHQRQVSHFLILF WHVWV 1RQVSHFLILF WHVWV DUH QRWUHFRPPHQGHG IRU URXWLQH HYDOXDWLRQ EXWPD\ EHXVHIXOLQVHOHFWHGFDVHVZKHQDOOHUJHQVSHFLILFWHVWVKDYHIDLOHGWRFODULI\WKHFDXVHVRIUKLQLWLV
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
7KHPDMRULW\RIRXUSDUWLFLSDQWVVXIIHUHGIURPVHYHUH DOOHUJLF UKLQLWLV EDVHGRQ WKH VFRULQJ V\VWHPZHXVHG:HFODVVLILHGWKHDOOHUJLFUKLQLWLVV\PSWRPVLQWRFDWHJRULHVRIPLOGPRGHUDWHDQGVHYHUH0LOGZDVGHILQHGDVQRLQWHUIHUHQFHZLWKGDLO\DFWLYLWLHVDQGRUVOHHS0RGHUDWHZDVGHILQHGDVVRPHLQWHUIHUHQFHZLWKGDLO\DFWLYLWLHVDQGRUVOHHS$QGVHYHUHZDVGHILQHGDVVLJQLILFDQWPDMRULQWHUIHUHQFHZLWKGDLO\DFWLYLWLHVDQGRUVOHHS
:HIRXQGQRVLJQLILFDQWGLIIHUHQFHLQVHGDWLYHHIIHFWEHWZHHQWKHFHWLUL]LQHJURXSDQGWKHORUDWDGLQHJURXSDIWHUDQGGD\VRIWUHDWPHQW3 3 3 UHVSHFWLYHO\,QFRQWUDVWVWXGLHVLQ0H[LFRDQGWKH86$UHSRUWHGDVLJQLILFDQWO\KLJKHUVHGDWLYH VLGHHIIHFWV LQ WKHFHWLUL]LQHJURXS WKDQ LQWKHORUDWDGLQHJURXS3$QRWKHUUHYLHZVKRZHGWKHVLGHHIIHFWVVXFKDVKHDGDFKHVRIERWKFHWLUL]LQHDQGORUDWDGLQHZHUHDERXWWR%XWDFOLQLFDOVWXG\RQORUDWDGLQHUHSRUWHGQRVHGDWLYHRUDQWLFKROLQHUJLFHIIHFWZKLFKZDVFOLQLFDOO\VLJQLILFDQWZKHQWKLVGUXJZDVFRPSDUHGWRSODFHER
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
6HFRQGJHQHUDWLRQ DQWLKLVLWPLQHV VXFK DVFHWLUL]LQH ORUDWDGLQH IH[RIHQDGLQH DQG HEDVWLQHDUH WKRXJKW WR KDYH FDUGLRWR[LF HIIHFWV VXFK DVK\SHUWHQVLRnK\SRWHQVLRnpalpitationVXSUDYHQWULFXODU WDFK\DUUK\WKPLD V\QFRSH DQG WDFK\FDUGLaWKRXJKSODVPDFRQFHQWUDWLRQVDUHKLJKHUFRPSDUHGWR DVWHPL]RO DQG WHUIHQDGLQ2XU VWXG\ IRXQGVWDWLVWLFDOO\ VLJQLILFDQW GLIIHUHQFHV LQ WKH SUHVHQFHRISDOSLWDWLRQVEHWZHHQWKHWZRJURXSVRQGD\RIWUHDWPHQW
:HFRQFOXGHWKHUHZDVQRVLJQLILFDQWGLIIHUHQFHEHWZHHQ FHWLUL]LQH DQG ORUDWDGLQH LQ WUHDWPHQWHIIHFWLYHQHVVRIDOOHUJLFUKLQLWLV+RZHYHUORUDWDGLQHZDVPRUH IUHTXHQWO\ DVVRFLDWHGZLWK VLGH HIIHFWV RIKHDGDFKHVDQGSDOSLWDWLRQV
References
6WUDFKDQ'6LEEDOG%:HLODQG6O:RUOGZLGHYDULDWLRQVLQSUHYDOHQFHRIV\PSWRPVRIDOOHUJLFUKLQRFRQMXQFWLYLWLVLQ FKLOGUHQ 7KH ,QWHUQDWLRQDO 6WXG\ RI $VWKPD DQG$OOHUJLHVLQ&KLOGKRRG,6$$&3HGLDWU$OOHUJ\,PPXQRO
-
Juliana et al: (IILFDF\FRPSDULVRQRIFHWLUL]LQHDQGORUDWDGLQHIRUDOOHUJLFUKLQLWLVLQFKLOGUHQ
66Paediatr Indones, Vol. 52, No. 2, March 2012
0HOLW]HU(2(YDOXDWLRQRIWKHRSWLPDORUDODQWLKLVWDPLQHIRU SDWLHQWV ZLWK DOOHUJLF UKLQLWLV0D\R &OLQLF 3URF
7KRPSVRQ$. -XQLSHU(0HOW]HU(24XDOLW\ RI OLIH LQSDWLHQWVZLWKDOOHUJLFUKLQLWLV$QQ$OOHUJ\$VWKPD,PPXQRO
6LHQUD0RQJH --*D]FD$TXLODU$'HO5LR1DYDUUR%'RXEOH EOLQG FRPSDULVRQ RI FHWLUL]LQH DQG ORUDWDGLQH LQFKLOGUHQDJHVWR\HDUVZLWKSHUHQQLDODOOHUJLFUKLQLWLV$P-7KHU
%XVNH /0 3KDUPDFRNLQHWLFVSKDUPDFRG\QDPLFV DQGSV\FKRPRWRUSHUIRUPDQFHDVSHFWVRIDQWLKLVWDPLQHWKHUDSLHV&OLQ$SSO,PPXQRO
%XFN0/7KHVHFRQGJHQHUDWLRQDQWLKLVWDPLQHVLQFKLOGUHQ>FLWHG2FW@$YDLODEOH IURPhttp://www.healthsystem.virginia.edu/alive/pediatrics/PharmNews/200104.pdf.
&DQWDQL$0RFLQL9$QWLKLVWDPLQHV DQG WKH WRUVDGHGH SRLQW LQ FKLOGUHQZLWK DOOHUJLF UKLQLWLV (XU5HY0HG3KDUPDFRO6FL
&RQQHU6-(YDOXDWLRQ DQG WUHDWPHQW RI WKHSDWLHQWZLWKDOOHUJLFUKLQLWLV-)DP3UDFWLFH
7HQ(LFN$3%OXPHU-/5HHG0'6DIHW\RIDQWLKLVWDPLQHVLQFKLOGUHQ'UXJ6DIHW\
0DWWLOD0- 3DDNNDUL ,9DULDWLRQV DPRQJ QRQVHGDWLQJDQWLKLVWDPLQHV DUH WKHUH UHDO GLIIHUHQFHV" (XU - &OLQ3KDUPDFRO
/HH 676 $PLQ0- (IILFDF\ DQG VDIHW\ RI ORUDWDGLQHFRPSDUHG ZLWK DVWHPL]ROH LQ0DOD\VLDQ SDWLHQWV ZLWKDOOHUJLFUKLQLWLV6LQ0HG-
'D\-+%ULVFRH0:LGOLW]0'&HWLUL]LQH ORUDWDGLQHRUSODFHERLQVXEMHFWVZLWKVHDVRQDODOOHUJLFUKLQLWLVHIIHFWVDIWHUFRQWUROOHG UDJZHHGSROOHQ FKDOOHQJH LQ DQ HQYLURQPHQWDOH[SRVXUHXQLW-$OOHUJ\&OLQ,PPXQRO
2OLQ%5'UXJIDFWVDQGFRPSDULVRQ6W/RXLV)DFWVDQG&RPSDULVRQV,QFS
.UHPHU % 'HQ+DUWRJ +0 -ROOHV - 5HODWLRQVKLSEHWZHHQ DOOHUJLF UKLQLWLV GLVWXUEHG FRJQLWLYH IXQFWLRQDQG SV\FKRORJLFDO ZHOO EHLQJ &OLQ ([S$OOHUJ\
'DYLOD,6DVWUH-%DUWUD-&XYLOOR$-DXUHJXL/0RQWRUR-HWDO(IIHFWRIDQWLKLVWDPLQHVXSRQWKHFDUGLRYDVFXODUV\VWHP-,QYHVWLJ$OOHUJ\&OLQ,PPXQRO