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Diabetes melitus tipe 2 (DMT2) merupakan penyakit metabolik kronis yang ditandai oleh hiperglikemia akibat resistensi insulin dan gangguan sekresi insulin. Kondisi hiperglikemia yang tidak terkontrol dalam jangka panjang dapat menyebabkan berbagai komplikasi kronis, seperti neuropati diabetik, penyakit kardiovaskular, dan penyakit ginjal kronis hingga end-stage renal disease (ESRD). Komplikasi tersebut berkontribusi terhadap peningkatan angka morbiditas, mortalitas, serta penurunan kualitas hidup pasien. Laporan kasus ini bertujuan untuk menggambarkan manifestasi klinis dan penatalaksanaan pasien DMT2 tidak terkontrol dengan komplikasi multisistem. Dilaporkan seorang wanita berusia 52 tahun dengan riwayat DMT2 tidak terkontrol yang datang dengan keluhan lemas, mual, dan muntah. Pemeriksaan laboratorium menunjukkan hiperglikemia berat dengan kadar glukosa darah sewaktu 650 mg/dL, disertai gangguan fungsi ginjal, anemia, dan gangguan elektrolit. Pemeriksaan ultrasonografi abdomen menunjukkan adanya kolesistitis. Pasien didiagnosis dengan DMT2 tidak terkontrol disertai komplikasi hiperglikemia berat, neuropati diabetik, end-stage chronic kidney disease, dan kolesistitis. Penatalaksanaan dilakukan melalui pemberian terapi cairan, insulin, antibiotik, koreksi elektrolit, serta terapi suportif lainnya. Selama perawatan, kondisi klinis pasien menunjukkan perbaikan secara bertahap. Kasus ini menegaskan bahwa pengendalian glikemik yang optimal, pemantauan rutin, serta penatalaksanaan komprehensif sangat penting dalam mencegah progresivitas komplikasi kronis dan multisistem pada pasien DMT2.

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.