Diare Akibat Penggunaan Antibiotik pada Anak: Apa Saran yang Diberikan oleh Apoteker Komunitas?

Virginia Johanes Putri; Adji Prayitno Setiadi; Abdul Rahem; Cecilia Brata; Yosi Irawati Wibowo; Eko Setiawan; Steven Victoria Halim

doi:10.25077/jsfk.7.3.218-228.2020

Diare Akibat Penggunaan Antibiotik pada Anak: Apa Saran yang Diberikan oleh Apoteker Komunitas?

Virginia Johanes Putri, Adji Prayitno Setiadi, Abdul Rahem, Cecilia Brata, Yosi Irawati Wibowo, Eko Setiawan, Steven Victoria Halim

10.25077/jsfk.7.3.218-228.2020

Abstrak

Diare akibat penggunaan antibiotik (antibiotic-associated diarrhea; AAD) merupakan salah satu gangguan klinis yang seringkali terjadi pada anak dan perlu mendapat intervensi dari dokter untuk mengatasi masalah tersebut. Dengan mempertimbangkan bahwa swamedikasi seringkali menjadi pilihan masyarakat ketika menghadapi kasus diare, apoteker di komunitas memiliki peran penting dalam mengarahkan masyarakat ke dokter untuk mengatasi masalah terkait AAD. Tujuan penelitian ini adalah untuk mengetahui jenis dan ketepatan rekomendasi apoteker dalam menanggapi permintaan swamedikasi terkait kasus AAD pada anak. Penelitian ini merupakan penelitian potong lintang yang dilakukan di wilayah Timur kota Surabaya. Sebuah kuesioner yang berisi pertanyaan terkait karakteristik peserta dan sebuah kasus digunakan pada proses pengambilan data. Validasi isi dari kasus serta penentuan kunci jawaban dilakukan melalui diskusi yang melibatkan pakar farmasi klinis, farmasi praktis, dan kesehatan masyarakat. Total terdapat 84 apoteker terlibat dalam penelitian ini; response rate 38,71%. Pemberian rekomendasi produk obat baik dengan maupun tanpa rujukan ke dokter atau saran non-farmakologi diberikan oleh 75 (89,29%) partisipan dan jenis obat yang paling sering direkomendasikan adalah probiotik, kaolin-pektin, domperidon, attapulgit. Sebanyak 26 apoteker (30,95%) memberikan rekomendasi yang tepat, yaitu: rujuk dokter segera dengan atau tanpa disertai rekomendasi lain. Hasil penelitian ini mengindikasikan perlunya intervensi untuk mengoptimalkan pemberian rekomendasi apoteker komunitas pada kasus AAD anak.

Kata Kunci

Apoteker Komunitas; Diare Anak akibat antibiotik; Pemberian Rekomendasi; Survei Berbasis Kasus

Teks Lengkap:

PDF

Referensi

Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385(9966):430–40. doi: 10.1016/S0140-6736(14)61698-6.

Levine MM, Nasrin D, Acácio S, Bassat Q, Powell H, Tennant SM, et al. Diarrhoeal disease and subsequent risk of death in infants and children residing in low-income and middle-income countries : analysis of the GEMS case-control study and 12-month GEMS-1A follow-on study. Lancet Glob Heal 2019. 2019;(19):1–11. doi: 10.1016/S2214-109X(19)30541-8.

Alebel A, Tesema C, Temesgen B, Gebrie A, Petrucka P, Kibret GD. Prevalence and determinants of diarrhea among under-five children in Ethiopia : A systematic review and meta-analysis. PLoS One. 2018;1–20. doi: 10.1371/journal.pone.0199684.

Gibson MK, Crofts TS, Dantas G. Antibiotics and the developing infant gut microbiota and resistome. Curr Opin Microbiol. 2015;27:51–6. doi: 10.1016/j.mib.2015.07.007.

Mcfarland L V, Goh S. Preventing pediatric antibiotic-associated diarrhea and Clostridium difficile infections with probiotics: a meta-analysis. World J Meta-Analysis. 2013;1(3):102–20. doi: 10.13105/wjma.v1.i3.102.

Youngster I, Avorn J, Belleudi V, Cantarutti A, Díez-domingo J, Kirchmayer U, et al. Antibiotic Use in Children – A Cross-National Analysis of 6 Countries. J Pediatr. 2016;1–7. doi: 10.1016/j.jpeds.2016.11.027.

Holstiege J, Schink T, Molokhia M, Mazzaglia G, Innocenti F, Oteri A, et al. Systemic antibiotic prescribing to paediatric outpatients in 5 European countries: a population-based cohort study. BMC Pediatr. 2014;14:1–10. doi: 10.1186/1471-2431-14-174.

Rogawski ET, Platts-mills JA, Seidman JC, John S, Mahfuz M, Ulak M, et al. Use of antibiotics in children younger than two years in eight countries: a prospective cohort study. Bull World Health Organ. 2017;95:49–61. doi: 10.2471/BLT.16.176123.

Mantegazza C, Molinari P, Auria ED, Sonnino M, Morelli L, Zuccotti G. Probiotics and antibiotic-associated diarrhea in children : A review and new evidence on Lactobacillus rhamnosus GG during and after antibiotic treatment. Pharmacol Res. 2018;128:63–72. doi: 10.1016/j.phrs.2017.08.001.

Kuehn J, Ismael Z, Long PF, Barker CIS, Sharland M. Reported rates of diarrhea following oral penicillin therapy in pediatric clinical trials. J Pediatr Pharmacol Ther. 2015;20(2):90–104. doi: 10.5863/1551-6776-20.2.90.

Giannelli FR. Antibiotic-associated diarrhea. J Am Acad Physician Assist. 2017;30(10):46–7. doi: 10.1097/01.JAA.0000524721.01579.c9.

Patel S, Abrahamson E, Goldring S, Green H, Wickens H, Laundy M. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy ( p-OPAT) in the UK: a consensus statement. J Antimicrob Chemother. 2015;70:360–73. doi: 10.1093/jac/dku401.

Tesfamariam S, Anand IS, Kaleab G, Berhane S, Woldai B, Habte E. Self-medication with over the counter drugs , prevalence of risky practice and its associated factors in pharmacy outlets of Asmara, Eritrea. BMC Public Health. 2019;1–9. doi: 10.1186/s12889-019-6470-5.

Hou F, Wang Y, Li J, Wang G, Liu Y. Management of acute diarrhea in adults in China: a cross-sectional survey. BMC. 2013;13:41. doi: 10.1186/1471-2458-13-41.

Collins JC, Schneider R, Faraj R, Wilson F, Cesar A, et al. Management of common ailments requiring referral in the pharmacy: a mystery shopping intervention study. Int J Clin Pharm. 2017;39(4):697–703. doi: 10.1007/s11096-017-0505-8.

Mukattash TL, Alkhatatbeh MJ, Andrawos S, Jarab AS, Abufarha RK, Nusair MB. Parental self-medication of antibiotics for children in Jordan. J Pharm Heal Serv Res. 2019;11. doi: 10.1111/jphs.12331.

Westerlund T, Barzi S, Bernsten C. Consumer views on safety of over-the-counter drugs , preferred retailers and information sources in Sweden: after re-regulation of the pharmacy market. Pharm Pr. 2017;15(1):1–8. doi: 10.18549/PharmPract.2017.01.894.

Eickhoff C, Hammerlein A, Griese N, Schulz M. Nature and frequency of drug-related problems in self-medication ( over-the-counter drugs ) in daily community pharmacy practice in Germany. Pharmacoepidemiol Drug Saf. 2012;21:254–60. doi: 10.1002/pds.2241.

Villako P, Volmer D, Raal AIN. Factors influencing purchase of and counselling about prescription and OTC medicines at community pharmacies in Tallinn, Estonia. Acta Pol Pharm. 2012;69(2):335–40.

Djawaria DPA, Setiadi AP, Setiawan E. Analisis Perilaku dan Faktor Penyebab Perilaku Penggunaan Antibiotik Tanpa Resep di Surabaya. J MKMI. 2018;14(4):406–17. doi: 10.30597/mkmi.v14i4.5080.

Halim SV, S AAP, Wibowo YI. Profil Swamedikasi Analgesik di Masyarakat Surabaya, Jawa Timur. J Ilmu Kefarmasian Indones. 2018;16(1):86–93.

Chan V, Tran H. Purchasing Over-the-counter medicines from Australian pharmacy : What do the pharmacy customers value and expect ? Pharm Pr. 2016;14(3):1–8. doi: 10.18549/PharmPract.2016.03.782.

Hermansyah A, Sukorini AI, Setiawan CD, Priyandani Y. The Conflicts Between Professional and Non-Professional Work of Community Pharmacists in Indonesia. 2012;10(1):33–9. doi: 10.4321/S1886-36552012000100006.

Komite Farmasi Nasional RI. Pedoman Re-Sertifikasi Apoteker Dan Penentuan Nilai Satuan Kredit Partitispasi ( SKP ). 2014;

Barbut F, Meynard JL. Managing antibiotic associated diarrhoea. Bmj. 2002;324(7350):1345–6.

Stein R, Dogan HS, Hoebeke P, Kocvara R, Nijman RJM, Radmayr C, et al. Urinary Tract Infections in Children : EAU / ESPU Guidelines. Eur Urol. 2015;67:546–58. doi: 10.1016/j.eururo.2014.11.007.

Langer B, Kunow C. Do north-eastern German pharmacies recommend a necessary medical consultation for acute diarrhoea? Magnitude and determinants using a simulated patient approach [version 1; peer review: 1 approved, 2 approved with reservations]. F1000 Res. 2020;1–16. doi: 10.12688/f1000research.21045.2.

Hanna L, Hughes C. The influence of evidence-based medicine training on decision-making in relation to over-the-counter medicines: a qualitative study. Int J Pharm Pract. 2012;20:358–66. doi: 10.1111/j.2042-7174.2012.00220.x.

Hanna L, Hughes CM. ‘First, Do No Harm’: Factors that Influence Pharmacists Making Decisions about Over-the-Counter Medication. Drug Saf. 2010;33(3):245–55.

Keeney KM, Yurist-doutsch S, Arrieta MC, Finlay BB. Effects of Antibiotics on Human Microbiota and Subsequent Disease. Annu Rev Microbiol. 2014;68(May):217–35. doi: 10.1146/annurev-micro-091313-103456.

Francino MP. Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances Increased Susceptibility to Infections. Front Microbiol. 2016;6(January):1–11. doi: 10.3389/fmicb.2015.01543.

Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11:506–14. doi: 10.1038/nrgastro.2014.66.

Chu W, Lu F, Zhu W, Kang C. Isolation and characterization of new potential probiotic bacteria based on quorum-sensing system. J Appl Microbiol. 2010;202–8. doi: 10.1111/j.1365-2672.2010.04872.x.

Ossowski I Von, Reunanen J, Satokari R, Vesterlund S, Kankainen M, Huhtinen H, et al. Mucosal Adhesion Properties of the Probiotic Lactobacillus rhamnosus GG SpaCBA and SpaFED Pilin Subunits. Appl Environ Microbiol. 2010;76(7):2049–57. doi: 10.1128/AEM.01958-09.

Guo Q, Jz G, Humphrey C, R ED, Bc J, Guo Q, et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea (Review). Cochrane Database Syst Rev 2019. 2019;(4). doi: 10.1002/14651858.CD004827.pub5.

Hempel S, Newberry SJ, Maher AR, Wang Z, Miles JN., Shanman R, et al. Probiotics for The Prevention and Treatment of Antibiotic-Associated Diarrhea. Am Med Assoc. 2012;307(18):1959–69. doi: 10.1001/jama.2012.3507.

Probiotics for antibiotic-associated diarrhea in pediatrics: a review of clinical effectiveness and guidelines . Ottawa: CADTH; 2019 Mar. (CADTH rapid response report: summary with critical appraisal

Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59(1):132‐152. doi:10.1097/MPG.0000000000000375

Reddymasu SC, Soykan I, McCallum RW. Domperidone: review of pharmacology and clinical applications in gastroenterology. Am J Gastroenterol. 2007;102(9):2036‐2045. doi:10.1111/j.1572-0241.2007.01255.x

O. I, Bakri A, Bahar E, Ismail R. Benefits of domperidone in ambulatory acute diarrhea with severe vomiting. PI [Internet]. 31Oct.2007 [cited 19May2020];47(5):207-. Available from: https://paediatricaindonesiana.org/ index.php/paediatrica-indonesiana/article/view/415

Miller R, Goodman C. Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review. Health Policy Plan. 2016 Sep; 31(7): 940–953. doi: 10.1093/heapol/czw007

De Tran V, Dorofeeva VV, Loskutova EE, Lagutkina TP, Kosova IV. Factors influencing community pharmacists' recommendation of over-the-counter medications in four VIetnam cities. Tropical Journal of Pharmaceutical Research. 2019;18(2):421-427. doi: 10.4314/tjpr.v18i2.29.

Djawaria DPA, Setiadi AP, Setiawan E. Pengembangan kuesioner dan identifikasi faktor penyebab penjualan antibiotik tanpa resep dokter di komunitas kota Surabaya. Jurnal Manajemen dan Pelayanan Farmasi. 2018;8(3):105-118.

Mahendradhata Y, Trisnantoro L, Listyadewi S, Soewindo P, Marthias T, et al. The Republic of Indonesia Health System Review. Health Systems in Transition. 2017;7(1):1-292.

Brata C, Schneider CR, Marjadi B, Clifford RM. The provision of advice by pharmacy staff in eastern Indonesian community pharmacies. Pharmacy Practice 2019 Apr-Jun;17(2):1452. doi: 10.18549/PharmPract.2019.2.1452.

DOI: https://doi.org/10.25077/jsfk.7.3.218-228.2020