antibiotik pada anak balita, apakah memang perlu? · antibiotik pada anak balita, apakah memang...

Antibiotik pada anak balita,

apakah memang perlu?

５歳未満の子どもに抗生剤を投与する，必要ですか？

Sendai, 27 Juli 2019

“Acara Ngopi PPI Sendai”

Raihana Nadra Alkaff

Jika anak sakit batuk/pilek, diare atau demam…

Di bawa kefasilitas

kesehatan

• Tanpa Obat• Obat bukan

antibiotik• Obat antibiotik

Di rawat di rumah

•Tanpa obat•Obat bukan antibiotik•Obat antibiotik

Source of pics: Raras istrinya Angga, Ibunya Rangga alias Arsyad

VirusBakteri

Lainnya

2 Penyakit yang menyebabkan kematian dankesakitan pada balita:

Pneumonia dan Diare

Pneumonia: S.PneumoniaeHaempphilus influenza BStaphyloccous aureusDiare: SalmonellaShigellosisE. ColiVibrio cholera

Pneumonia: RSVParainfluenza virusesRhinovirusDiare: RotavirusNorovirus

Batuk/pilek/diare/demam

VirusBakteri

Lainnya


Pneumonia dan Diare

Antibiotik

Tunggu sembuh/pencegahan lewat vaksin

VirusBakteri

Lainnya


Pneumonia dan Diare

Antibiotik

Resistensi antibiotik

Source: https://www.niaid.nih.gov/research/antimicrobial-resistance-causes

Resistensi antibiotik adalah keadaan di mana bakteri tidak dapatlagi dibunuh dengan antibiotik akhir dari pengobatan modern

https://www.niaid.nih.gov/research/antimicrobial-resistance-causes

Factors associated with Antibiotic Resistant

Irrational use for illness treatment

Agricultural use

Overuse in livestock and fish farming

The Burden of Drug-Resistant Bacteria

• The level of antimicrobial resistance for common bacteria has reached to the alarming level (more than 50%)1

• Overuse and misuse of antibiotics are a major driving force for developing drug-resistant bacteria2

• It is estimated that 700 000 annual deaths are associated withinfections by drug-resistant pathogens3

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1.WHO, Antimicrobial resistance: global report on surveillance, 2014.2.Gonzales, R., et al., Clin Infect Dis, 2001.3.O'Neill, J., The review on antimicrobial resistance, 2016.

Jika anak sakit batuk/pilek, diare atau demam…

Di bawa kefasilitas

kesehatan

• Tanpa Obat• Obat bukan

antibiotik• Obat antibiotik

Di rawat di rumah



Penelitian saya…

Di bawa ke fasilitas

kesehatan

•Obat bukan antibiotik•Obat antibiotik

(49.3%)

Di rawat di rumah


(11.8%)


Fever only (n=36)

Diarrhea + Fever (n=4)

Diarrhea only (n=4)

Respiratory symptoms + Fever (n=100)

Respiratory symptoms + Diarrhea (n=2)

Respiratory symptoms+Diarrhea+Fever(n=37)

Respiratory symptoms only (n=20)

Results Higher use of antibiotics in children with fever as compare to children without fever

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Figure 1 Proportions of antibiotic use by illness category (n = 203)

• The high prevalence of antibiotic use (49% children in 30 days) was observed, which is equivalent to 4.9 courses per child per year in another study4

• A half of children with common clinical symptoms including fever, respiratory symptoms, and diarrhea received antibiotics, which might not be necessary

• Antibiotics is recommended only for pneumonia, bloody diarrhea and cholera

• Having fever might be used as an indication to prescribe antibiotics, which are also shown in other studies4, 13

Discussion Antibiotics prescribed by health professional might not be necessary

4. Rogawski E.T., et.al., Bull World Health Organ 2017.13. Statistics Indonesia, B.P.S., et al., Indonesia Demographic and Health Survey 2012., 2013.

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Doumo Arigatou Gozaimashita

Thank you – Terima Kasih

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Acknowledgement

Proffesor Hitoshi Oshitani, MD, PhD, MPHMayuko Saito, MD, PhD, MPHTaro Kamigaki, MD, PhDMari Sato, PhDClyde Dapat, PhDAll Virology Department members

Lembaga Pengelola Dana Pendidikan (LPDP), Ministry of Finance, The Republic of Indonesia

Japan Society for the Promotion of Science (JSPS), Core to Core Program B, Asia Africa Science Platform

Head of primary health center and staffsAll midwifes and cadresFajar Ariyanti, PhDDewi Utami Iriani, PhDFieldwork staffsFamily and friends 33

antibiotik pada anak balita, apakah memang perlu? · antibiotik pada anak balita, apakah memang...

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