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Diarrhea has the potential to cause an Extraordinary Event (KLB) and is currently a leading cause of mortality in Indonesia, especially in children. Antibiotics are necessary for diarrhea caused by bacteria, but irrational antibiotic prescribing can increase the risk of antibiotic resistance. This literature review was conducted to provide an overview of the level of rationality of antibiotic use in pediatric patients with diarrhea in several Indonesian health facilities. The literature review was conducted by reviewing articles obtained through a Google Scholar search using the keywords "rationality of antibiotic use," "diarrhea," "children," and "evaluation of antibiotic use." Articles were selected using inclusion and exclusion criteria, resulting in 10 suitable articles. The study results indicate that the evaluation methods for antibiotic use include the Gyssens criteria, World Health Organization criteria, Ministry of Health Decree Standards, the 2012 World Gastroenterology Organization Guidelines, and the Rational Drug Use Module. Commonly used evaluation parameters include appropriate indication, appropriate drug, appropriate dose, and appropriate patient. Most parameters have obtained rational results, but there are several studies that are not rational in the appropriate indication, appropriate drug, and appropriate dose categories. Variations in the results of rational antibiotic use at each health facility are influenced by patient characteristics, policies at the health care facility, and the level of compliance of health workers with therapy guidelines.

Diarrhea has the potential to cause an Extraordinary Event (KLB) and is currently a leading cause of mortality in Indonesia, especially in children. Antibiotics are necessary for diarrhea caused by bacteria, but irrational antibiotic prescribing can increase the risk of antibiotic resistance. This literature review was conducted to provide an overview of the level of rationality of antibiotic use in pediatric patients with diarrhea in several Indonesian health facilities. The literature review was conducted by reviewing articles obtained through a Google Scholar search using the keywords "rationality of antibiotic use," "diarrhea," "children," and "evaluation of antibiotic use." Articles were selected using inclusion and exclusion criteria, resulting in 10 suitable articles. The study results indicate that the evaluation methods for antibiotic use include the Gyssens criteria, World Health Organization criteria, Ministry of Health Decree Standards, the 2012 World Gastroenterology Organization Guidelines, and the Rational Drug Use Module. Commonly used evaluation parameters include appropriate indication, appropriate drug, appropriate dose, and appropriate patient. Most parameters have obtained rational results, but there are several studies that are not rational in the appropriate indication, appropriate drug, and appropriate dose categories. Variations in the results of rational antibiotic use at each health facility are influenced by patient characteristics, policies at the health care facility, and the level of compliance of health workers with therapy guidelines.

Antimicrobial resistance is a persistent threat to hospital care, particularly when empirical therapy relies on broad-spectrum antibiotics without continuous evaluation of local use and susceptibility patterns. This literature review aimed to synthesize evidence from four Indonesian hospital-based studies regarding antibiotic utilization, rationality assessment, and bacterial resistance profiles. A structured narrative review was conducted using four selected articles provided by the author. Data were extracted for study design, setting, population, antibiotic evaluation method, dominant antibiotic classes, rationality indicators, resistance profile, and stewardship implications. The four studies were descriptive and hospital-based, using retrospective records, concurrent observation, ATC/DDD with DU 90%, qualitative rationality criteria, and antibiogram data. The synthesis showed a consistent concentration of antibiotic use in broad-spectrum groups, especially third-generation cephalosporins, penicillins, quinolones, and macrolides. In a Bandung public hospital, total antibiotic consumption reached 95,719.01 DDD, with penicillins, cephalosporins, quinolones, macrolides, and sulfonamides included in the DU 90% segment. In intensive care, ceftriaxone was the most frequently used antibiotic and most rationality indicators were appropriate, although clinically significant drug interactions were still identified. In pediatric acute respiratory infection inpatients, cefotaxime and ceftriaxone dominated empirical therapy. Resistance mapping in Denpasar highlighted relevant Gram-positive and Gram-negative pathogens and recommended antibiotics according to susceptibility levels. Overall, the reviewed evidence supports an integrated antimicrobial stewardship model combining ATC/DDD-DU 90% surveillance, qualitative rationality evaluation, antibiogram-based empirical guidance, and periodic feedback to prescribers.

Antibiotic resistance is a global health problem that requires international efforts to prevent the ineffectiveness of existing antibiotics and support the development of new antimicrobial agents. The increasing use of antibiotics in the community must be accompanied by proper understanding regarding rational antibiotic use to minimize the risk of resistance. This community service activity aimed to provide education on rational antibiotic use and the dangers of antibiotic resistance to undergraduate nutrition students at STIKes Adila, Bandar Lampung. The activity was conducted through educational sessions using flyers, presentation slides, and interactive discussions to encourage active participation and improve understanding of the topic. Evaluation was carried out using pre-test and post-test assessments to measure changes in participants’ knowledge levels. Descriptive analysis showed an improvement in participants’ knowledge, with the high knowledge category increasing from 0% during the pre-test to 85% in the post-test, while the low knowledge category decreased from 35.5% to 0% after the intervention. These findings indicate that educational interventions can effectively enhance awareness and understanding of rational antibiotic use and the prevention of antibiotic resistance. Therefore, continuous educational programs are important to promote responsible antibiotic use and support public health efforts in combating antibiotic resistance.

Antibiotic resistance is a global health problem that requires international efforts to prevent the ineffectiveness of existing antibiotics and support the development of new antimicrobial agents. The increasing use of antibiotics in the community must be accompanied by proper understanding regarding rational antibiotic use to minimize the risk of resistance. This community service activity aimed to provide education on rational antibiotic use and the dangers of antibiotic resistance to undergraduate nutrition students at STIKes Adila, Bandar Lampung. The activity was conducted through educational sessions using flyers, presentation slides, and interactive discussions to encourage active participation and improve understanding of the topic. Evaluation was carried out using pre-test and post-test assessments to measure changes in participants’ knowledge levels. Descriptive analysis showed an improvement in participants’ knowledge, with the high knowledge category increasing from 0% during the pre-test to 85% in the post-test, while the low knowledge category decreased from 35.5% to 0% after the intervention. These findings indicate that educational interventions can effectively enhance awareness and understanding of rational antibiotic use and the prevention of antibiotic resistance. Therefore, continuous educational programs are important to promote responsible antibiotic use and support public health efforts in combating antibiotic resistance.

Bacterial infections are diseases that can be transmitted by bacteria from sufferers to others, either directly or indirectly. Cases of bacterial infections are more common among children. The use of antibiotics is needed to treat life-threatening conditions caused by bacteria by killing bacteria or making it difficult for bacteria to grow and reproduce. Antibiotics are a type of drug given to prevent bacterial infections, or are drugs given to high-risk patients. This research method is a descriptive study by collecting medical record data to find out the description of bacterial infections and the use of antibiotics in pediatric inpatients at RSU Cut Meutia Aceh Utara in 2022. This research technique used purposive sampling with a sample size of 183 samples. The results of this study showed that 183 children suffered from bacterial infections and received injection antibiotic therapy, the majority were boys, namely 106 children (57%), the age group with the most number of sufferers, namely aged 0‒5 years, totaling 76 children (41%), the percentage of bacterial infections most commonly found in pediatric inpatient wards at RSU Cut Meutia Aceh Utara in 2022, namely typhoid fever as much as 33%, the class of antibiotics most commonly used at RSU Cut Meutia is cephalosporins (93%).

Antibiotics are one of the main pillars in the treatment of bacterial infections and have contributed significantly to increasing human life expectancy. However, long-term use of antibiotics has serious consequences for the balance of the body's microbiome, especially the gut microbiome which plays an important role in maintaining homeostasis through the regulation of the immune system, metabolism, and protection against pathogens. This literature review aims to comprehensively analyze the impact of long-term antibiotic use on the structure, diversity, and function of the human microbiome. The scientific articles reviewed were obtained from PubMed, Scopus, ScienceDirect, and Google Scholar databases, including empirical research, systematic review, and meta-analysis published in the last ten years. The results showed that prolonged exposure to antibiotics consistently decreased microbiota diversity, altered the composition of bacterial communities, and triggered dysbiosis, which is often persistent even when therapy is stopped. Dysbiosis is associated with impaired immune system function, increased systemic inflammation, risk of allergic and metabolic diseases, and potential disorders on the intestinal-brain axis. This impact is more pronounced in vulnerable groups such as neonates and children, especially when exposure occurs during a critical period of development. In conclusion, long-term antibiotic use has broad systemic implications, so a more rational, prudent, and sustainable use strategy is needed to maintain the health of the human microbiome.

Appendicitis is a common health problem in Indonesia. Appendicitis requires surgery because it's an acute inflammation. Appendicitis can be treated with surgery to remove the appendix, namely appendectomy, by performing surgery on the abdominal tract. Appendectomy is a clean-contaminated surgery that can cause surgical wound infection in around 5-15% of cases. Prophylactic antibiotics are included in infection prevention. It is important to evaluate the use of prophylactic antibiotics in appendicitis surgery patients to reduce drug side effects and prevent surgical site infections. Infections can be caused by microorganisms such as pathogenic bacteria, and antibiotics are the most commonly used drugs to treat such infections. SSI can cause morbidity, mortality, increased length of stay, and increased patient care costs. The researchers chose Arun Lhokseumawe Hospital as the research site because no research had ever been conducted at Arun Lhokseumawe Hospital on the use of prophylactic antibiotics in appendicitis surgery patients. Preliminary survey results based on Arun Lhokseumawe Hospital medical records from 2020 to 2022 showed that 202 patients underwent surgery. The purpose of this study was to determine the profile of prophylactic antibiotic use in appendicitis surgery patients using the Gyssens method at Arun Lhokseumawe Hospital from 2020 to 2022. This study was observational in nature, using total sampling as the sampling technique. The Results of the study showed that the most frequently used type of prophylactic antibiotic was Cefotaxime (53.5%) and the appropriateness of antibiotic use was category 0 (97%) because it was appropriate and category IVA (3%) because there were other antibiotics that were more effective. It can be concluded that Cefotaxime is the most frequently used antibiotic, and the appropriateness of prophylactic antibiotics at Arun Hospital in Lhokseumawe City is already appropriate.

Acinetobacter baumannii is a major pathogenic bacterium causing nosocomial infections, known to exhibit high levels of resistance to various antibiotic classes, including β-lactams and aminoglycosides. This widespread resistance poses a significant challenge in hospital patient management, particularly in cases of severe and difficult-to-treat infections. This study aimed to analyze the resistance patterns of A. baumannii to four types of antibiotics in patients with various blood types at Dr. Soeradji Tirtonegoro General Hospital, Klaten. The research method used was a qualitative approach with a case study design. Data were obtained through in-depth interviews with healthcare workers, analysis of patient medical records, and limited observation of clinical practice. The focus of the study was directed at the relationship between patient blood type and the level of antibiotic resistance of A. baumannii. The results showed variations in resistance patterns based on blood type. Patients with blood type AB showed the highest level of resistance to all tested antibiotics, with a prevalence of multidrug resistance (MDR) reaching 85%. In contrast, patients with blood type O showed the lowest resistance and the highest proportion of non-MDR isolates compared to other groups. These findings indicate the role of host factors, namely blood type, in influencing the level of resistance of A. baumannii. The suspected mechanisms involved include differences in surface antigens that influence bacterial adhesion, biofilm formation, and the host immune response. The practical implication of this study is the need to consider blood type as a factor in empirical antibiotic therapy, especially in cases of nosocomial infections caused by A. baumannii.

β-lactam antibiotics are a very important group of drugs and are most frequently used in the treatment of bacterial infections, both in healthcare facilities and for self-medication. The advantages of β-lactams lie in their effectiveness and broad spectrum of action. However, the development of pharmaceutical preparations containing β-lactams still faces significant challenges, particularly related to the physicochemical stability of these compounds. The reactive ring structure of β-lactams makes them highly susceptible to degradation, particularly through hydrolysis. This degradation process can be accelerated by various environmental factors such as high temperature, changes in pH, humidity, and the presence of certain excipients and solvents in drug formulations. This article comprehensively reviews the various factors that influence the stability of β-lactams, both in solid and liquid pharmaceutical dosage forms, as well as in microbiological media. Furthermore, it also examines various innovative formulation approaches that have been developed to improve the stability of these compounds. These approaches include film coating technology, encapsulation, and crystal engineering, which have been shown to reduce the rate of degradation and extend product shelf life. Literature studies have shown that solid dosage forms are generally more stable than liquid dosage forms, primarily because exposure to water and solvents can accelerate hydrolysis. Distribution and storage of these preparations are also important aspects to consider in maintaining the quality and effectiveness of β-lactam antibiotic therapy. Therefore, β-lactam product development requires a holistic approach, encompassing not only formulation and production technology but also optimal distribution and storage strategies. The use of appropriate analytical methods is also necessary to monitor degradation products and ensure product safety and effectiveness throughout the shelf life.

Pneumonia ialah penyakit Infeksi Saluran Pernapasan Bawah yang bersifat akut pada parenkim paru meliputi alveolus dan jaringan interential yang dikarenakan mikroorganisme seperti jamur, virus dan bakteri. Mikroorganisme yang masuk ke saluran pernafasan bagian bawah dapat mengganggu proses pernapasan serta membuat saluran pernapasan tidak berfungsi secara optimal, sehingga proses keluar masuk oksigen juga terhambat dan mengakibatkan gangguan pada pola napas. Beberapa permasalahan lain yang ditimbulkan dari pneumonia seperti adanya penumpukan sputum, otot bantu pernapasan, penurunan ekspansi thoraks dan juga nyeri dada. Dalam perawatanya, tenaga medis berperan dalam pemberian antibiotik selama 8 jam setelah pasien mengalami perawatan serta fisioterapi berperan dalam pemberian intervensi penyinaran Infrared, Chest physiotherapy, dan Myofascial release. Penelitian ini bersifat studi kasus yang mengangkat satu kasus pasien serta mengumpulkan data melalui proses fisioterapi. Intervensi fisioterapi dilakukan sebanyak 4 kali pertemuan di Rumah Sakit dr. Ario Wirawan, Salatiga dengan menggunakan Infrared, Chest physiotherapy yang meliputi Postural Drainage, Clapping, Vibrasi, Latihan Batuk Efektif, Pursed Lip Breathing dan Myofascial release. Setelah menjalani 4 kali terapi, diperoleh hasil kondisi pasien yang mengalami penurunan nyeri dada, penurunan tingkat sesak napas, peningkatan ekspansi thoraks, berkurangnya spasme otot bantu pernapasan dan retensi sputum.

Antibiotic resistance (AR) has emerged as a critical global public health concern, particularly due to the spread of antibiotic-resistant bacteria (ARB) and their genes in natural environments. The oceans, which host diverse ecosystems and serve as major food sources, are increasingly affected by ARB pollution, originating from human, agricultural, and industrial activities. Simultaneously, climate change (CC) exacerbates the situation by raising ocean temperatures, lowering pH, and altering marine biodiversity—creating optimal conditions for bacterial survival and gene transfer. This review explores the interconnectedness between ocean pollution and CC and how both factors influence the distribution and persistence of ARB and antibiotic resistance genes (ARGs) in marine ecosystems. Through a systematic literature review of 174 peer-reviewed articles, the study highlights how anthropogenic pollutants—especially antibiotics, heavy metals, and plastics—contribute to resistance emergence. Furthermore, it discusses the transmission pathways from pollution hotspots (e.g., hospitals, agriculture, wastewater) to the oceans. The One Health (OH) strategy is presented as a comprehensive solution to address the environmental, human, and animal health risks posed by antibiotic pollution. This paper serves as a basis for future research into surveillance, mitigation, and policy interventions for controlling AR in marine environments.

Industri farmasi menghasilkan limbah cair dan padat yang mengandung senyawa aktif seperti antibiotik, hormon, NSAID, logam berat, dan pelarut organik yang tergolong limbah B3 dan berpotensi mencemari lingkungan serta membahayakan kesehatan. Studi ini bertujuan untuk mengevaluasi dan membandingkan efektivitas metode pengolahan limbah farmasi di Indonesia dan luar negeri, meliputi pendekatan fisik, kimia, biologi, hingga insinerasi. Hasil kajian menunjukkan bahwa kombinasi metode Advanced Oxidation Processes (AOP) dengan sistem biologi seperti reaktor anaerob-aerob memberikan efisiensi lebih tinggi dalam menurunkan kadar Chemical Oxygen Demand (COD) dan senyawa farmasi aktif yang resisten terhadap degradasi. Di Indonesia, pengelolaan limbah masih terfokus pada IPAL konvensional dengan keterbatasan infrastruktur dan SDM, berbeda dengan negara maju seperti Jerman dan Swiss yang telah menerapkan sistem audit risiko berkala, teknologi pengolahan mutakhir, dan harmonisasi standar. Oleh karena itu, Indonesia perlu mengintegrasikan teknologi pengolahan lanjutan, memperkuat regulasi, serta meningkatkan kapasitas pengelolaan untuk memastikan pengolahan limbah farmasi yang aman, efisien, dan berkelanjutan.

Fermentation is one of the traditional food processing techniques that not only functions as a preservation method, but also plays a role in improving the nutritional quality and safety of food. One example of a typical Indonesian fermented food that has survived from generation to generation is naniura, a traditional dish of the Batak Toba people made from carp (Cyprinus carpio) which is processed without a cooking process. The fermentation process in naniura is carried out spontaneously by soaking in a solution of citrus (Citrus Sp.) and a mixture of local spices, thus creating an acidic environment that supports the growth of fermentative microorganisms, especially lactic acid bacteria (LAB). The purpose of this study was to isolate and identify LAB from naniura, as well as to carry out morphological characteristics, Gram staining, and sensitivity tests to several commonly used antibiotics. Isolation was carried out using MRS media in anaerobic conditions, while sensitivity tests were carried out using the disc diffusion method. The results showed that isolates from naniura had Gram-positive characteristics, rod-shaped, catalase negative, and showed varying inhibition zones against antibiotics. Some isolates showed resistance to amoxicillin and cefataxim, but were sensitive to erythromycin and gentamicin. These results indicate that LAB from naniura has potential as a probiotic candidate, but it is necessary to monitor the possibility of antibiotic resistance gene transfer.  

Infections and antibiotic resistance pose significant challenges to global healthcare. This study aims to evaluate the antibacterial potential of endophytic fungi isolated from betel leaves (Piper betle L.) against Staphylococcus aureus and Staphylococcus epidermidis. The research involved isolating endophytic fungi using Potato Dextrose Agar (PDA), purifying the isolates, and testing their antibacterial activity through the disk diffusion method. The results revealed that three endophytic fungal isolates produced inhibition zones, with the highest average diameter of 17.46 mm against Staphylococcus aureus and 18.66 mm against Staphylococcus epidermidis. These findings indicate the potential of betel leaf endophytic fungi as a natural source of antibacterial agents. This study underscores the role of endophytic fungi in developing new antibiotics to combat bacterial resistance.    

Antibiotic resistance is a worldwide threat that is largely caused by the inappropriate use of antibiotics. The purpose of this community service is carried out in order to increase knowledge about the wise and correct use of antibiotics. This community service was given to 20 patients with counseling using leaflets. In general, the implementation of this community service was categorized as successful and went well. There was an increase in knowledge about the importance of using antibiotics correctly after counseling.

Knowledge is the result of the process of understanding and recognizing something obtained through sensing an object. Beta-lactam antibiotics are a type of broad-spectrum antibiotic commonly used to treat bacterial infections, but their use still has the potential to cause side effects in the form of Adverse Drug Reactions (ADRs). This study aims to assess the level of patient knowledge regarding ADRs due to the use of beta-lactam antibiotics at Bendan Pekalongan Regional Hospital in 2024. This study used a prospective correlation design with a non-experimental approach. A total of 29 outpatients taking beta-lactam antibiotics were sampled, selected using a purposive sampling technique. Data were collected through questionnaires, medical records, and analyzed descriptively using Microsoft Excel. The results showed that 41% of respondents had low knowledge regarding ADRs, 28% had sufficient knowledge, and 31% had good knowledge. These findings indicate the need for more intensive education regarding the risks of ADRs in order to improve the safety of antibiotic use.

An adequate understanding on health workers on use antibiotics can prevent the treatment ineffective. Increased risk for the security patient and the spread resistence. The purpose of this research that is, to know the knowledge of midwives in provision of antibiotics for the patient. The kind of research non experiment by using the method case study a qualitative approach. The data using a method of in- depth interviews. The determination of inform with purposive technique. Inform were 6 people consisting of 3 informants midwives and 3 informants patients. Based on the results of the study, the knowledge of midwives' knowledge of rationality in the administration of antibiotics based on 4 T (exact patient, precise indication, proper drug, correct dose) and 1 W (side effect) is still not appropriate because in midwife antibiotics using empirical therapy, the use of antibiotics for empirical therapy is the use of antibiotics in cases of infection that have not been known to the type of bacteria the cause. And rician drug information submitted is the name of the drug, the purpose of therapy, how to take medication with a time interval of 3 x 1 in a day, the drug should be spent and back in case of abnormalities when taking the drug.

This literature review examines the increase in antibiotic resistance in Escherichia coli, a Gram-negative bacterium that frequently causes infections in humans and animals. Although most E. coli strains are harmless, some pathogenic strains have shown resistance to various antibiotics, posing a significant challenge in the healthcare field. This study highlights the various resistance mechanisms found in E. coli, including the production of β-lactamase enzymes that can inactivate antibiotics, modification of antibiotic targets, changes in membrane permeability, and increased activity of efflux pumps that expel antibiotics from bacterial cells. Additionally, this review discusses factors contributing to the spread of resistance, such as the excessive and inappropriate use of antibiotics in medicine and livestock, and the transfer of resistance genes through mobile genetic elements. The literature highlights recent research efforts to address this issue, including the development of new antibiotics, the use of antibiotic combinations, and alternative therapies such as bacteriophages and specific enzyme inhibitors. This review emphasizes the importance of strict surveillance and prudent antibiotic use policies to prevent the further spread of antibiotic resistance in E. coli, ensuring the effectiveness of bacterial infection treatments in the future.

Based on the International Diabetic Federation (IDF), in 2017, the number of people suffering from DM in Indonesia was 10.3 million people, Indonesia was ranked 6th with the highest number of DM patients. Foot ulcers are often the main cause of hospitalization in DM patients, and DM is the main cause of lower extremity amputation in non-traumatic cases. Currently, Indonesia does not yet have a consensus for the management of diabetic foot infections. Management of diabetic foot infections currently uses guidelines from the Infectious Disease Society of America (IDSA) and the International Working Group of Diabetic Foot (IWGDF) for empirical selection of antibiotics. The basic principles of healing diabetic ulcers are adequate arterial perfusion, proper control of infection, and offloading the ulcer area. Empirical selection of antibiotics often coincides with inadequate information regarding microbiological patterns. Choosing an antibiotic with a spectrum that is too narrow will cause pathogens to be overlooked in infections which are often caused by polymicrobial, and cause clinical deterioration in the patient. Unnecessary selection of broad-spectrum antibiotics can contribute to the increasing problem of antibiotic resistance. Mild and moderate infections can be given antibiotics with a narrower spectrum. Severe infections require parenteral administration to reach therapeutic levels immediately.