studi penggunaan antibiotika di smf bedah ortopedi

8/9/2019 Studi Penggunaan Antibiotika Di Smf Bedah Ortopedi

1/60

KELOMPOK III

MAGISTER FARMASI KLINIK (MFK) 2013/2014

FAKULTAS FARMASI UNAIR

STUDI PENGGUNAAN

ANTIBIOTIKA DI SMF BEDAHORTOPEDI

(BEDAH-B DAN BEDAH-F)


2/60

DISTRIBUSISAMPEL

BEDAH FBEDAH B

F2 F3

2PASIE

N

5PASIE

N

2PASIE

N

KRITERIA:PASIEN BEDAHORTOPEDI YANGMENGGUNAKAN

ANTIBIOTIKA

JUMLAHPASIEN:


3/60

DAFTAR PASIEN DAN DIAGNOSANO RUANG RM/PASIEN DIAGNOSA

1 B 12.34.48.88/DTS/15TH

OF LATERAL CONDLE FEMUR (D) ! OF TIBIAL PLATEAU (D) ! SOFT TISSUEIN"UR

2 B 12.35.#$.%&MS'/2$ TH

NON UNION ULNA (D) POST PLATING !IMPLAN BONE EPOSURE

3 F2 12.3$.88.%

4/SLT/48TH

UNSTABLE PEL*IS STABLE HEMODINAMIK

! CONTUSIO PULMONUM

4 F2 12.3$.#&.##/HRR/45TH

OPEN FRACTURE INTERCANDLER FEMUR(S) ! COR


4/60

DAFTAR PASIEN DAN DIAGNOSA

N! RUANG

RM/PASIEN DIAGNOSA

5 F3 12.3$.84.&$/DAS/32TH

CF EPIFISIOLOGIS FEMUR (D) SH II ! OFSUPRACONDILER FEMUR (D) ! OF SHAFTFEMUR (S) 1/3 MEDIA ! OF MT III PEDIS (D) !OF BASE MT II-I* PEDIS (D) ! OF HEAD MT I-I* PEDIS (D)

& F3 12.3$.#8.81

/ "KG/32TH

OF FEMUR (S) 1/3 DISTAL ! OF

ANTEBRANCHII (S) 1/3 DISTAL

$ F3 12.38.%&.3%/GGP/21TH

OF FEMUR (S) 1/3 TENGAH GR. IIIA

8 F3 12.38.%&.//45TH

INTERNAL BLEEDING HD TRANSCIENTRESPONSE ! OF ILIAC 'ING (D) !SIMFISIOLIS GR. I ! COMTUSIO PULMONUMPOST EPLORASI LAPAROTOMI !HI* (!)

# F3 12.3$.#8.&$/

MNM/1&TH

UNSTABLE PEL*IS STABLE HD ! "OINTDISRUPTUR D/S ! CF PEL*IS SUP (D) POST

REPAIR BULI


5/60

"EN

IS

A

B

NO NO" RM JENIS AB YANG DIGUNAKAN FREKUENSI

1 12"34"4#"##/DTS/15TH

$%&'!*+ *+,%-.* 1

2 12"35""0

MS/2 TH

$%&*'!+ *+,%-.* 1

3 12"3"##"04/SLT/4#TH

$%&*'!+ *+,%-.* 1

4 12"3""/HRR/45TH

$%&'!*+ *+,%-.*G%+'*6*+ *+,%-.*

11

5 12"3"#4"/DAS/32TH

$%&'!*+ *+,%-.*G%+'*6*+ *+,%-.*$%&*'!+ *+,%-.*

111

12"3"#"#1/ JKG/32TH

$%&*'!+ *+,%-.*$%&'!*+ *+,%-.*G%+'*6*+ *+,%-.*

111

12"3#"0"30/GGP/21TH $%&*'!+ *+,%-.*$%&'!*+ *+,%-.*G%+'*6*+ *+,%-.*

111

# 12"3#"0"/7/45TH

$%&*'!+ *+,%-.*M%!+*8'!% *+,%-.*

11

12"3" #"/

1TH

$%&'!*+ *+,%-.*

$%&*'!+ *+,%-.*

1

1


6/60

REKAPITULASIAB

NO

NAMA AB FREK

1 CEFTRIAON $

2 CEFA+OLIN &

3 GENTAMICIN 3

4 METRONIDA9OL 1

GRAFIK PENGGUNAAN AB


7/60

IDENTIFIKASI PROBLEMTERAPI ANTIBIOTIKA

TOTAL PASIEN

DITEMUKANPROBLEM:(35);

4 PASIEN

TIDAKDITEMUKANPROBLEM,(1248#)

5 PASIEN


8/60


9/60

PEMBAHAS

ANK00 .3


10/60

N , N. S (B67 F2)

N. RM , 12.3$.88.99

U: , 48 T

D;?6 P6?@;0 0=>?6 67;; ! SI ;=7;0:=; 76= 0 ! CF 4 :; >;0 ! CF ;??; ;< 0 !; : 6: D 0= ?=;< ! CF ?@;? D 1/3

=6


11/60

T%'?* R%> 4 5 # 10 11 12 13 14 15 1

C6=:; 291< I*

! ! ! ! ! ! ! ! !

A=:; 391< I*

! ! ! ! ! ! ! ! !

P:06=?

4 91<

PO

! ! !

R;=;7;

295%

<

I*

! ! ! ! ! ! ! ! ! ! ! ! !

K*+*-/L' 4 5 # 10 11 12 13 14 15 1S 3#3 3# 3

#3# 3 3#1 3

3 34 3# 3 3 3

'BC 1 20 153

LED 5# 1%&

12%

C: 103 10# #

P6:0? R6670;

1. A=;>;=; =;7 7;>6:; ?;

=6:; ?; = 06:= =;>;=;76;=; 06;


12/60

C6=:;9, 291 @0

192


13/60

%% F''-!-*+%*- 8'+ F''-!8*+'*-

$%&*'!+%

• C6=:;960 PK :=6:;0=;0 ,

– *7 &-14 L

– T J 5 # :


14/60

P'@!>%+ S=6:;66 1 2 4

H6;?0 ;66 2 - -

N6;006:;


15/60

PERHITUNGAN

QT MIC P6:06=06 ;=6:@? 70;0 7;=0 ?6@6? MIC I=6:@? D0;0

MIC M;; ;;>;=: 6=:=; ('I+%' D!.*. : 12 ,'

*7 (L) T J(")

QTMIC

& 5 2&58$

14 # 38&88

10 3223

D!.*. : 2 >'I+%' D!.*. : 24 ,'

*7 (L) T J(")

QTMIC

& 5 153$$

14 # 23%#4

10 13#


16/60

.


17/60

PEMBAHAS

ANK00 .5


18/60

CF E;0;?;0;0 6: (D) SH 2

OF S:7;?6: 6: (D) AO 33C3

CF S= 6: (S) 1/3 67;

OF MT III 67;0 (D)OF B06 MT II-I* 67;0 (D)

OF 67 MT I-1* 67;0 (D)

P:? T6:; A=;>;=;


19/60

P:? T6:; A=;>;=;

1#

N''A+**!*-

D!.*.R%>*%+

R>' P%%*'+ (D%.%% 2014)

1 OP 2 3 4 5 #

C6=:;96 2< ;.@ C6?; 391 < ;.@

G6=;; 298% < ;.@

C6=:;96 291 < ;.@

N''A+**!*- D!.*.R%>*%+

R


20/60

L: K?=:S60;6 , P0 7 ? 6: T= C6?;

C6=;7; C6=9; C6=:;9 C66:0?>= C=:;0? C?:6;?C;:9; L6@9;

A *+%*%+ , P;6:0;?; 0?>=


21/60

N , E9=6:? F;00; ! D6>:;766

21

L'?!'+ O?%'.*


22/60

L P6>6:;

NDMK

D;= P66?0

123$84&$

CF E;0;?;0;06: (D) SH 2OFS:7;?6:6: (D) AO33C3

CF S= 6:(S) 1/3 67;OF MT III 67;0

(D)OF B06 MT II-

I* 67;0 (D)

OF 67 MT I-1* 67;0 (D)

C6=:;96 291< ;@ (&-1&/12/14)

C6=:;9 7;


23/60

A=;>;=; P:?0;0 B67 O:=67;, 6=:;9

J%+*.

O?%'.*

K6:; 7 6;0 OF =;7?6>; 7:; 3 06=6? =6:7;

=:(06>6?76>:;766=) .R60; >;?7;>6:; 3

06=6?

=:

P6;;?;7;>6:; >;?=6:=;0;

?0=:;7; 0

P67 P6


24/60

R6670; 70;0 AB :?0;07 6 :=: 60=:6;=0


25/60

S6=; B7;. 2%11. The Role of Prophylactic Antibiotics in Preventing Perioperative Infection"D6:=6= I=6:? M67;;6 F?= M67;;6 U;@6:0;= I760; . 2&2-2&&


26/60

$F7 !+% ?%+%'*!+ '. ?!! (V15Q) ; =6 :=;? :=6=

7 0=;0=: ; =6 :6 @0?:;67 6??0 >6.

T6 TMIC 7 AUC/MIC :=;0 0;=; 690:6 >6 0>=;? ; =6 ;6=67 :=;?:=6= 7 7:< 66=:=; >6 ;;:67 ;= 6:=; >6 706W60=6:0 :7;? 0:


27/60

AB :?0;0 7 6 :=:,G6=;;

$!+%+*!+', 1-2.5


28/60

T6 :6? =9;;= ;


29/60

C6=:=; D6676=P:6:=;60 A=;>;=;0

C6=:=; 76676= =;>;=;0 6 ==;


30/60

C6=:=; D6676= A;


31/60

P0= A=;>;=; E[6= A;


32/60

A;


33/60

A;


34/60

A?;0 T6:;

C6=:;96 = :?0;0 6:0; 6:=:6,PPRA 2%%#D0;0 < 7;:6670;, 7? 291 < ;@ (S6=; 6= ? 2%11) Z

70;0 2< 07 060;M;;6:;

C6?; 391 < ;@ 06? 5 :; 0= :761 =;7 7 0? (S6=; 6= ? 2%11)

D0;0 G6=;0; < 7;=6:; 0;6 07


35/60

ANALISA KASUS & $

P0;6 " G:;=


36/60

P0;6 " G:;=D9. OF F6: 0 \ 7;0=? ! OF =6>:;; 0 \ 7;0=?

O>= D0;0 R=6 T


37/60

P0;6 G7;D9. OF 6: . \ =6


38/60


39/60


40/60

G6=;; D0


41/60


42/60

TERIMA KASIH


43/60

S:>; L. T6::6? C.L. 7 E70 R. 2%11. G66:? P:;;?60 A=;;:>;? T6:. &ayo Clin Proc 8&(2),15&-1&$.

'6;00 C. P6:06?? S.D. '76:; R.G. 7 B6: D.'. 2%12.E;:; =;>;=; 6;? @6=;?=; 7 6=:? @60=6=6: 7:=; 0 =6=;? =:0 67;=;< =6 6[6= 6?;0= :=;< ;=6:@6=; :=?;=, 69?:=:

?0;0. B&C $ealth 'ervices Research 12,1#8.


44/60

R66:660

K=


45/60


46/60

OD M76? H:=:7 H0;=? H:=:7 C6=;=

OD ;0 = :66767 : ,O :; 6:;=6? 7;?0;0 : H/DP:6:0(2%Q) 0;=60 : 6=6:?

67:7;=;0D0;< ;=6:@?,243&48 : : C:

&%4%-&% 7 2%-4% ?/;


47/60

K00 1

KASUS 1: NON UNION ULNA (D) POST PLATING ! IMPLANT BONE


48/60

TGL 5/11 #/12

1%/12 11/12

12/12

13/12

14/12

15/12

CEFTRIAON

TAO (OP) (//) KRS

EPOSURE PROFIL

TERAPI

PARAMETER

/1215/12

KU CUKUP

*S STABIL

DATAKLINIK

PARAMETER

10/11

PPT 1%$/11$

APTT 28&/2&4

GDA ##

SGOT 25

SGPT $5

ALBUMIN 42

BUN 1%

DATA

LAB

PARAMETER

10/11

SC: 1%

K 3&

N 13&

C? 1%%

CRP K;; %4

LED 12


49/60


50/60

P:?0;0,6=:;9

291<

$%&*'!+ : *%8%?%+8%+A8' *'' *+&%-.*.%%


51/60

K00 2

N , DTS (B67 B)


52/60

N RM , 12.34.48.99 ";0 K6?; , L;-?;U0;/>6:= , 15 =/ K<D;;? P?=6 (D) ! S=

T;006 I: R66:; 7; GBPTP0= , ;. C6?; 3 91 <

E9=6:? 00; ! 7;0=:0;6:; 7; GBPTP0= , ;. C6?; 3 91 <

A[


53/60


54/60

P6>6:; =;>;=;:?0;0 :6

C6?; 0= >;07;=6:0 3-$ :;

P6>6:;=;>;=; 07 =6=


55/60

K00 4

P! T%'?* A+**!*-


56/60

P! T%'?* A+**!*-

5&

Data IRD Fam!o"a#

5/12 6/12 7/12 8/12

$u%u 36,4 36,8 36,8 37,1 &a'i 110 92 90 88

RR 22 24 20 20

(D 130/90 130/70 120/80 120/80

Data 5/12 6/12

)*C 10,8 10,9

*+&$C

80,7

N!" N'' O' D!.*. R%>*%+R*

#/12.*'+>

1 C6?;2


57/60


58/60

G6=;; D0


59/60

A?;0 T6:;

P0;6 6G:76 IIIA 66:; C6?; !G6=;;

I7;0; 70;0 7 ? 6>6:; 07060;.

T;7 7;=6; =7-=7 SIRS ? ;?;RFT :?

5#


60/60

D0

La", et al , 2009, Drug Information Handbook , 17t% E'itio#

Lei-Com

ies, :;;, Doussou, PC, and a '4(6).399-410

&%

studi penggunaan antibiotika di smf bedah ortopedi

Documents