REFERAT Anak Tasia
REFERAT Anak Tasia
REFERAT Anak Tasia
INTRODUCTION
Antibiotics are the most important weapons for the treatment of many infectious
diseases caused by bacteria. 1 Antibiotics are substances that destroy the bacterial
without harming the host, human. Antibiotics are either natural substances that are
respective concentrations of the antibiotic in the body. To date, at least 4,000 antibiotics have
been isolated from cultures of microbes and 30,000 have been prepared semisynthetic.1
Antibiotics may be wide spectrum and narrow spectrum. Wide spectrum kill many
types of bacteria e.g. penicillin.The broad spectrum antibiotics are active against
many types of microbes such as bacteria, rickettsia, mycoplasmas, protozoa, and spirochetes.
Narrow spectrum which kill certain types of bacteria e.g. isoniazid and should be used
where possible to reduce the risk of colonization and super infection with resistant bacteria.1
normal flora, selection of drug resistant organisms, increased of untoward side effects. 2,3 In
children with bacteria, antibiotic therapy must be started immediately. Inappropriate antibiotic
treatment may lead to greater expense, toxic side effects, antibiotic resistance, and
superinfections that are difficult to treat. Irrational use of antibiotics significantly increased
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Antibiotics are one of the most commonly used group of d rugs. In USA, 23 million
kg used annually, 50% for medical reasons.4 Studies worldwide has shown a high incidence
of innaproriate use. 4
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LITERATURE REVIEW
Nairobi 1985defined that rational use of drugs requires that patient receive medications
appropriately to their clinical needs, in dose that meet their own individual requirements
1,2
for an adequate period of time, at the lowest cost to them and their community. The
rational use of antibiotics is therefore, like any other therapeutic intervention in daily
practice and it should not be random. It requires reflection and thought and should be
based on rules. If used irrationally, it will be increased treatment cost, interference with
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patient’s normal flora, selection of drug resistant organisms, increased of untoward side
effects. 1,2
Although medicines are one of our most cost- effective health-care interventions
and antibiotics are one of our most effective therapeutic classes of medicine, few low-
and middle- income countries are monitoring how they are used. 3,4 Data on medicines
contrast, developed rich regions, such as Europe, are now monitoring antibiotic
This tabel shows data from the same countries on antibiotic prescribing .5 Overall
about 45% of the patients were prescribed antibiotics. However, in Indonesia (1990),
Pakistan (1998) and West Bengal, India, (1999) rates in excess of 70% were observed.
Analysis of data from Uzbekistan, Pakistan, Indonesia and Eritrea revealed that 75%-
99% of patients diagnosed with an upper respiratory tract infection (URTI) received
anti-biotics. In E ritrea, for example, it was confirmed that 75% of the adults and
children diagnosed with URTI were prescribed antibiotics even though the cause of the
infection may have been viral. Results from Indonesia demonstrated that 46% of patients
aged under five years received oral rehydration salts (ORS) for the treatment of diarrhrea
while 73% of these same patients received oral antibiotics. Among patients aged over
five years, 36% received ORS, 91% received oral antibiotics, and 25% of patients
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Reference: Essentials Medicines and Health Products Information Portals . Rational use of
average, 66.5% of the countries had drugs available. At the top end of the scale, Nepal
reported having up to 90% of its drugs currently in stock, while at the bottom end, Ecuador
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Reference: Essentials Medicines and Health Products Information Portals . Rational use of
Awareness Day for Rational Use of Antibiotics, and efforts are made using
raise awareness and to reduce the consumption of antimicrobials, but above all,
and thought and should be based on rules. The correct diagnosis, the patient's
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condition, the location of the infection, the severity of the microbial cause
antimicrobials, the side effects and cost are the main elements which must be
Inappropriate antibiotic treatment may lead to greater expense, toxic side effects,
antibiotic resistance, and superinfections that are difficult to treat.6 Irrational use
bacterial infections. 6
and can contribute to the spread of bacteria from person to person. Despite this,
tract infections are one of the most common bacterial infections seen in primary
care.7
while results of culture and sensitivity testing are awaited. Young children are
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C. Antibiotics Resistance
potential development of resistance tothat agent from the time it is first employed.
Alexander Fleming, who won a Nobel Prize for his discovery of Penicillin, had
Penicillin.8
prescribed antibiotics given to children in primary care and to quantify the relation
between previous exposure to antibiotics in primary care and bacterial resistance. 7,8
in these groups. In the more developed OECD countries antibiotics are obtained
antibiotics, including those commonly used to treat urinary tract infection, can be
The most frequently isolated microorganism was E. coli, found in 129 (82%)
children in the first period and in 77 (77%) in the second period. The resistance rate
of E. coli to several antibiotics during these two periods is described in Table 2.4.
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There was no significant change in antimicrobial resistance rate between the two
periods, Aminoglicosides and 3rd generation cephalosporins were the most efficient
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Table 2.4 Bacterial resistance of E.colli tested in two studies in Sao Paulo, Brazil
Figure 2.1 summarises the 25 studies included from non-OECD studies that
control, and three cross sectional. All 25 non-OECD studies reported information on
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Figure 2.1 Geographical distribution of urinary E coli resistance
coli and association with routine use of antibiotics in primary care: systematic review
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No. (%) resistant:
Ampicillin 22 (100)
Amoxicillin 23 (95,7)
Cefoxitin 20 (87)
Gentamicin 18 (78,3)
Doxycycline 21 (91,3)
Cholaramphenicol 22 (95,3)
Nalidixic acid 1 (4,3)
Norfloxacin 0 (0)
Trimethropim – sulphamehtoxazole 1(4,3)
the most prevalent organisms for each age group as well as on local resistance
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Reference: Pick A, Sweet D C, Begley K J. A review of pediatric bacterial meningitis. US
Pharm 2016;41:41-45
1. Unnecessary antibiotics.
Smaller dose
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resistant. 1,10
III
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CONCLUSION
Resistant bacteria can be transmitted from animals to humans through the food
problem for the patient, but also for the environment as the members of the
household are populated by the same pathogen and are more likely to become ill
due to this. So doctors and other professionals should prescribe antibiotics only
REFERENCES
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1. Kourkouta L, Kotsiftopoulos CH, Papageorgiou ,M.Iliadis, CH. Monios, A. The
2. Amer FA. Rational use of antibiotics in hospital and community acquired nfections.
ArAPUA 2012.;32:244-59
3. Yusuf Yusuf, Murni I, Setyati A. Irrational use of antibiotics and clinical outcomes in
Pharmacy, 2014.
2011;15:122-30.
http://apps.who.int/medicinedocs/en/d/Js6160e/10.html
coli and association with routine use of antibiotics in primary care: systematic review
and meta-analysis. BMJ 2016;352:1-17 [Cited 2018 March 13] Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793155/
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9. Guidoni E et al. Antibiotic resistance patterns of pediatric community-
acquired urinary infections. Braz J Infect Dis 2018;12:1-4 [Cited 2018 March 11]
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2016;41:41-45
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