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"Latar belakang: Ventilator-associated pneumonia VAP merupakan jenis infeksi nosokomial terbanyak pada pasien pediatric intensive care unit PICU. VAP menyebabkan pemanjangan durasi ventilasi mekanik, durasi hospitalisasi, dan kematian. Omeprazole direkomendasikan sebagai profilaksis dan pengobatan stress ulcer pada pasien PICU dengan ventilator. Omeprazole diduga dapat meningkatkan kejadian VAP melalui peningkatan kolonisasi bakteri lambung. Namun, belum banyak studi yang meneliti pengaruh ini pada populasi pasien PICU. Tujuan: Mengetahui pengaruh pemberian omeprazole terhadap kejadian VAP pada Pasien PICU di RSUPN Dr. Ciptomangunkusumo. Metode: Studi ini dilaksanakan dengan metode cross-sectional dengan 58 subjek. Sampel diambil dari rekam medis pasien PICU tahun 2014 hingga 2016. Subjek terdiri dari dua kelompok, yaitu pasien PICU dengan ventilator yang diberi omeprazole dan tidak diberi omeprazole. Hasil: Karakteristik subjek meliputi jenis kelamin, usia, status gizi, faktor risiko potensial, dan keluaran berupa durasi hospitalisasi, durasi intubasi, dan kematian. Sejumlah 9 dari 29-31 subjek yang diberi omeprazole mengalami VAP dan 3 dari 29-10 subjek yang tidak diberi omeprazole mengalami VAP. Uji Chi-square menunjukkan hubungan tidak bermakna antara omeprazole dan kejadian VAP dengan nilai p=0.105 dan prevalence ratio PR 3.00-95 CI 0.903-9.970. Diskusi: Hasil penelitian ini menyatakan bahwa pemberian omeprazole tidak berpengaruh terhadap kejadian VAP pada pasien PICU.

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Background: Ventilator associated pneumonia VAP is the most common nosocomial infection among pediatric intensive care unit PICU patients. VAP prolongs duration of intubation and hospitalization and increases mortality. Omeprazole is often used as prophylaxis and therapy for stress ulcer, a common disease in PICU patients. Omeprazole is suspected to increase VAP incidence through gastric colonization.

Aim: To determine the effect of omeprazole on incidence of ventilator associated pneumonia among RSUPN Dr. Ciptomangunkusumo PICU Patients.

Methods: This is a cross sectional study with 58 subjects obtained from PICU medical records from 2014 to 2016. Subjects were put into two categories 1 PICU patients who received omeprazole, and 2 PICU patients who did not receive omeprazole.

Results: Subject characteristics include sex, age, nutritional status, potential risk factors, and outcome duration of hospitalization, duration of intubation and mortality. A number of 9 of 29 31 patients who received omeprazole developed VAP and 3 of 29 10 patients who did not receive omeprazole developed VAP. Chi square test showed no significant difference in the incidence of VAP in the two categories p 0.105 and prevalence ratio PR 3.00 95 CI 0.903 9.970.

Discussion: Omeprazole does not affect the incidence of VAP on PICU patients in this study."

"Ventilator-associated pneumonia VAP punya prevalensi yang tinggi pada pasien pediatric intensive care unit PICU . Gizi lebih overweight dan obesitas dicurigai sebagai salah satu faktor risiko VAP namun hubungannya kurang diteliti. Penelitian ini bertujuan untuk menyelidiki hubungan antara gizi lebih dan kejadian VAP pada pasien PICU RSCM. Desain studi ini adalah cross-sectional analitik dengan data rekam medis pasien PICU RSCM yang mendapat ventilasi mekanik pada periode 2014 ndash;2016. Pasien dikatakan menderita gizi lebih berdasarkan assessment gizi pada rekam medis atau berdasarkan data antropometri dengan rujukan kriteria WHO atau CDC jika assessment gizi tidak ada. VAP ditentukan berdasarkan diagnosis tertulis pada rekam medis atau adanya gejala dan tanda yang memenuhi kriteria NNIS/CDC. Data tambahan yang diambil antara lain ada tidaknya kondisi immunocompromised, reintubasi, enteral feeding, penggunaan imunosupresan, antibiotik atau profilaksis stress ulcer. Sebanyak 64 pasien diikutsertakan sebagai subjek. Gizi lebih ditemukan pada 12 pasien 18.8 dan VAP pada 12 pasien 18.8 . Hanya satu pasien dengan gizi lebih mengalami VAP. Penelitian ini tidak menemukan hubungan antara gizi lebih dan kejadian VAP pada pasien PICU RSCM two-sided p = 0.436 dengan uji Fisher , mungkin karena sampel terlalu kecil. Penelitian prospektif dengan sampel yang cukup dibutuhkan untuk mengetahui hubungan antara gizi lebih dan VAP.

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Ventilator associated pneumonia VAP is prevalent among pediatric intensive care unit PICU patients. Overnutrition overweight and obesity is a candidate for VAP risk factor but research into the link is wanting. This study aimed to investigate the association between overnutrition and VAP among PICU patients in RSCM. Medical records of RSCM PICU patients undergoing mechanical ventilation between 2014 and 2016 were used in this analytic cross sectional study. Overnutrition was established based on the nutritional assessment on the patient rsquo s medical record or anthropometric data using WHO or CDC criteria if the former was not available. VAP was established based on recorded diagnosis or the presence of signs and symptoms meeting the NNIS CDC criteria. Additional data include whether the patient was immunocompromised, reintubation, enteral feeding, use of immunosuppressants, antibiotics and stress ulcer prophylaxis. A total of 64 patients was included as subjects. Overnutrition was identified in 12 patients 18.8 and VAP in 12 patients 18.8 . Only one overnourished patient had VAP. This study found no association between overnutrition and VAP two sided p 0.436 by Fisher rsquo s test , probably because the sample was too small. Prospective studies with adequate sample sizes are needed to understand the link between overnutrition and VAP."

"Obat golongan proton pump inhibitor (PPI) digunakan secara luas dalam berbagai gangguan pada saluran gastrointestinal terkait asam lambung dan sering digunakan bersama dengan obat lain sehingga meningkatkan risiko terjadinya interaksi obat. Tujuan dilakukannya penelitian ini adalah untuk menganalisis potensi interaksi obat golongan PPI pada pasien rawat jalan di RSPAD Gatot Soebroto periode Juli-Desember 2015. Penelitian ini menggunakan metode deskriptif analitik-retrospektif pada data resep dan rekam medis pasien rawat jalan periode Juli-Desember 2015 yang menerima obat golongan PPI dan satu atau lebih item obat lain yang dipilih dengan metode pursposive sampling. Analisis dilakukan terhadap 400 lembar resep yang berasal dari 192 pasien. Berdasarkan penelitian ini dapat disimpulkan bahwa terapi obat golongan PPI pada pasien rawat jalan di RSPAD Gatot Soebroto periode Juli-Desember 2015 memiliki potensi interaksi obat pada 324 lembar resep (81,00%) dengan total kasus sebanyak 475 kasus yang terdiri dari 42 kasus interaksi mayor, 138 kasus interaksi moderat dan 295 kasus interaksi minor. Terdapat 14 obat yang memiliki potensi interaksi dengan obat golongan PPI antara lain mikofenolat mofetil, klopidogrel, kilostazol, warfarin, besi, levotiroksin, propranolol, siklosporin, simvastatin, atorvastatin, sianokobalamin, sukralfat, teofilin dan antasida.

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Proton pump inhibitor (PPI) drugs are widely used for the treatment of gastrointestinal tract with gastric-acid disorder and usually used concomitant with other drugs so that increase the risk of drug interaction. This study aimed to analyse the potential of PPI drug interaction in outpatients at Gatot Soebroto Army Centre Hospital period of July-December 2015. This study use analytical descriptive-retrospective method on prescriptions and medical records of outpatients who get PPI drugs with one or more other drugs in the period of July-December 2015, which were selected by purposive sampling method. This analysis study was conducted on 400 prescriptions from 192 patients.

This study concluded that PPI therapy in outpatients at RSPAD Gatot Soebroto period of July-December 2015 had potential drug interaction on 324 prescriptions (81,00%) with total of 475 cases, which are consisted of 42 cases of major interactions, 138 cases of moderate interactions, and 295 cases of minor interactions. There are 14 drugs that can potentially interact with PPI drugs, such as: mycophenolate mofetil, clopidogrel, cilostazol, warfarin, iron, levothyroxine, propranolol, cyclosporine, simvastatin, atorvastatin, cyanocobalamin, sucralfate, theophylline and antacid."

"Terapi kardiovaskular merupakan aspek penting dalam pengobatan penyakit kardiovaskular yang umumnya kompleks dan memerlukan perhatian khusus dalam peresepan obat. Penelitian ini bertujuan untuk menganalisis terapi kardiovaskular berdasarkan resep yang diterima di Apotek Roxy serta mengidentifikasi pengaruh peresepan proton pump inhibitor (PPI) terhadap terapi kardiovaskular. Analisis dilakukan untuk menilai pola peresepan obat kardiovaskular, proporsi pasien yang menerima PPI sebagai bagian dari terapi, dan hubungan antara peresepan PPI dengan jenis dan dosis obat kardiovaskular yang digunakan. Selain itu, diperhatikan pula aspek administrasi, farmasetik, dan klinis dari resep yang diambil. Metode penelitian ini menggunakan pendekatan retrospektif dengan mengumpulkan data resep dari pasien yang mengambil obat kardiovaskular di Apotek Roxy selama periode tertentu. Data yang dikumpulkan mencakup jenis obat kardiovaskular yang diresepkan, dosis, frekuensi, serta apakah PPI juga diresepkan bersamaan dengan obat kardiovaskular. Hasil analisis diketahui bahwa resep telah memenuhi aspek farmasetik dan aspek klinis. Namun, pada aspek administrasi terdapat data seperti berat badan pasien, nomor telepon, dan tanggal penulisan resep yang tidak tercantum di dalam resep. Kemudian, diketahui pula bahwa penggunaan obat golongan proton pump inhibitor dan antiplatelet perlu dilakukan monitoring dan perlu disesuaikan dengan kebutuhan pasien. Temuan ini dapat berguna bagi profesional kesehatan dalam meningkatkan pemahaman tentang interaksi obat dan potensi efek samping yang perlu diperhatikan saat meresepkan kombinasi obat kardiovaskular dan PPI. Untuk itu, dari penelitian ini diharapkan dapat memberikan rekomendasi bagi Apotek Roxy dan profesional kesehatan dalam meningkatkan kualitas peresepan obat kardiovaskular dan memastikan terapi yang optimal bagi pasien dengan kondisi kardiovaskular.

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disease which is generally complex and requires special attention in drug prescribing. This study aims to analyze cardiovascular therapy based on prescriptions received at Roxy Pharmacy and to identify the effect of proton pump inhibitor (PPI) prescriptions on cardiovascular therapy. Analyzes were performed to assess patterns of cardiovascular drug prescribing, the proportion of patients receiving PPIs as part of their therapy, and the relationship between PPI prescriptions and the type and dose of cardiovascular drugs used. In addition, administrative, pharmaceutical, and clinical aspects of the prescriptions taken were also considered. This research method used a retrospective approach by collecting prescription data from patients who took cardiovascular drugs at the Roxy Pharmacy during a certain period. The data collected included the type of cardiovascular drug prescribed, dosage, frequency, and whether PPIs were also prescribed concomitantly with cardiovascular drugs. The results of the analysis revealed that the prescription met the pharmaceutical and clinical aspects. However, in the administrative aspect there are data such as the patient's weight, telephone number, and the date of writing the prescription that is not included in the prescription. Then, it is also known that the use of proton pump inhibitor and antiplatelet class drugs needs to be monitored and needs to be adjusted to the needs of the patient. These findings could be useful to healthcare professionals in increasing understanding of drug interactions and potential side effects to watch for when prescribing combinations of cardiovascular drugs and PPIs. For this reason, this research is expected to provide recommendations for Roxy Pharmacy and health professionals in improving the quality of cardiovascular drug prescribing and ensuring optimal therapy for patients with cardiovascular conditions."

"Latar Belakang: Ventilator-associated pneumonia (VAP) merupakan infeksi yang sering terjadi di intensive care unit (ICU) dan memiliki angka mortalitas yang tinggi. Pengetahuan tentang prediktor mortalitas dapat membantu pengambilan keputusan klinis untuk tatalaksana pasien. Studi-studi tentang faktor prediktor mortalitas VAP menunjukkan hasil yang berbeda-beda dan tidak ada penelitian yang komprehensif di Indonesia.Tujuan: Mengetahui faktor-faktor prediktor mortalitas pasien VAP di RSCM.Metode: Penelitian ini merupakan studi kohort retrospektif pada pasien ICU RSCM yang didiagnosis VAP selama tahun 2003-2012. Data klinis dan laboratorium beserta status luaran (hidup atau meninggal) selama perawatan diperoleh dari rekam medis. Analisis bivariat dilakukan pada variabel kelompok usia, infeksi kuman risiko tinggi, komorbiditas, renjatan sepsis, kultur darah, prokalsitonin, ketepatan antibiotik empiris, acute lung injury, skor APACHE-II, dan hipoalbuminemia. Variabel yang memenuhi syarat akan disertakan pada analisis multivariat regresi logistik.Hasil: Sebanyak 201 pasien diikutsertakan pada penelitian ini. Didapatkan angka mortalitas selama perawatan sebesar 57,2%. Kelompok usia, komorbiditas, renjatan sepsis, prokalsitonin, ketepatan antibiotik empiris, dan skor APACHE II merupakan variabel yang berpengaruh terhadap mortalitas pada analisis bivariat. Prediktor mortalitas pada analisis multivariat adalah antibiotik empiris yang tidak tepat (OR 4,70; IK 95% 2,25 sampai 9,82; p < 0,001), prokalsitonin > 1,1 ng/mL (OR 4,09; IK 95% 1,45 sampai 11,54; p = 0,01), usia ≥ 60 tahun (OR 3,71; IK 95% 1,35 sampai 10,20; p = 0,011), dan adanya renjatan sepsis (OR 3,53; IK 95% 1,68 sampai 7,38; p = 0,001).Kesimpulan: Pemberian antibiotik empiris yang tidak tepat, prokalsitonin yang tinggi, usia 60 tahun atau lebih, dan adanya renjatan sepsis merupakan pediktor independen mortalitas pada pasien VAP.

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Background: Ventilator-associated pneumonia (VAP) is a frequent infection with high mortality rates in intensive care unit (ICU). The prediction of outcome is important in decision-making process. Studies exploring predictors of mortality in patients with VAP produced conflicting results and there are no comprehensive reports in Indonesia.

Objective: To determine predictors of mortality in patients with VAP in Cipto Mangunkusumo Hospital.

Methods: We performed a retrospective cohort study on patients admitted to the ICU who developed VAP between 2003?2012. Clinical and laboratory data along with outcome status (survive or non-survive) were obtained for analysis. We compared age, presence of high risk pathogens infection, presence of comorbidity, septic shock status, blood culture result, procalcitonin, appropriateness of initial antibiotics therapy, presence of acute lung injury, APACHE II score, and serum albumin between the two outcome group. Logistic regression analysis performed to identify independent predictors of mortality.

Results: A total of 201 patients were evaluated in this study. In-hospital mortality rate was 57.2%. Age, comorbidity, septic shock status, procalcitonin, appropriateness of initial antibiotics therapy, and APACHE II score were significantly different between outcome groups. The independent predictors of mortality in multivariate logistic regression analysis were inappropriate initial antibiotics therapy (OR: 4.70; 95% CI 2.25 to 9.82; p < 0.001), procalcitonin > 1.1 ng/mL (OR: 4.09; 95% CI 1.45 to 11.54; p = 0.01), age ≥ 60 years old (OR: 3.71; 95% CI 1.35 to 10.20; p = 0.011), and presence of septic shock (OR: 3.53; 95% CI 1.68 to 7.38; p = 0.001).

Conclusion: Inappropriate initial antibiotic therapy, high serum procalcitonin level, age 60 years or older, and presence of septic shock were independent predictors of mortality in patients with VAP."

"Latar Belakang: Pneumonia berat adalah infeksi saluran napas yang masih memiliki angka mortalitas yang tinggi. Pasien pneumonia berat sering kali memerlukan intubasi untuk mencapai ventilasi yang adekuat. Terjadinya kegagalan ekstubasi dapat meningkatkan komplikasi dan mortalitas pada pasien, sehingga pasien dengan risiko gagal ekstubasi perlu dikenali sedini mungkin.Tujuan: Mengetahui faktor yang dapat memprediksi kegagalan ekstubasi pada pasien pneumonia beratMetode: Studi ini merupakan studi kohort retrospektif yang melibatkan pasien dengan pneumonia berat yang terintubasi dan dirawat di ICU/HCU RSCM pada tahun 2015-2019. Data pasien dan hasil pemeriksaan laboratorium diambil dari rekam medis. Analisis bivariat dilakukan dengan uji Chi-square atau uji Fischer, sementara analisis multivariat dilakukan dengan uji regresi cox.Hasil: Sebanyak 192 subjek pasien pneumonia berat dilibatkan dalam penelitian ini. Insidensi kegagalan ekstubasi pada pasien pneumonia berat di RSCM adalah 70,3%, dengan angka mortalitas pada pasien yang mengalami gagal ekstubasi adalah sebesar 85,2%. Dari analisis bivariat, didapatkan usia >60 tahun, merokok, Charlson Comorbidity Index sedang-berat, tidak adanya penyakit neuromuskular, terapi pengganti ginjal, prokalsitonin > 2 ng/mL, dan skor APACHE II ≥25 sebagai variabel yang berhubungan signifikan dengan kegagalan ekstubasi. Selanjutnya, analisis multivariat menemukan bahwa Charlson Comorbidity Index sedang-berat (p=0,002, HR 2,254, IK95% 1,353-3,755), dan prokalsitonin > 2 ng/mL (p<0,001, HR 1,859, IK95% 1,037-3,333) merupakan prediktor independen terhadap kegagalan ekstubasi pada pasien pneumonia berat.Kesimpulan: Faktor-faktor yang secara independen merupakan prediktor kegagalan ekstubasi pada pasien pneumonia berat adalah Charlson Comorbidity Index sedang-berat, dan kadar prokalsitonin > 2 ng/mL.

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Background: Severe pneumonia is a lower respiratory tract infection still presenting with a high a mortality rate. Patients with severe pneumonia often require intubation in order to achieve adequate ventilation. Extubation failure, however, is associated with increased complications and mortality. Therefore, it is crucial to recognize risk factors associated with extubation failure as soon as possible.

Objective: To determine the predictors associated with extubation failure in patients with severe pneumonia

Methods: A retrospective cohort study was conducted, which included patients with severe pneumonia who were intubated in ICU/HCU of Ciptomangunkusumo General Hospital over the period of 2015-2019. Patient characteristics and laboratory values were obtained from medical records. Bivariate analysis was performed with Chi-square or Fischer test, whereas multivariate analysis was performed with cox regression model.

Results: A total of 192 subjects with severe pneumonia was included in this study. Incidence of extubation failure among patients with severe pneumonia was 70,3%, with a mortality rate of 85,2%. Bivariate analyses found that age of >60 years, smoking history, moderate-to-severe Charlson Comorbidity Index, procalcitonin > 2 ng/mL, not having neuromuscular disease, renal replacement therapy, and APACHE II score of ≥25 were significantly associated with extubation failure. In multivariate analysis, moderate-to-severe Charlson Comorbidity Index (p=0,002, HR 2,254, 95% CI 1,353-3,755) and procalcitonin > 2 ng/mL (p<0,001, HR 1,859, 95% CI 1,037-3,333) were found to be independent predictors of extubation failure in patients with severe pneumonia.

Conclusion: Moderate-to-severe Charlson Comorbidity Index and procalcitonin level of > 2 ng/mL were independent predictors of extubation failure in patients with severe pneumonia."

"Obat penghambat pompa proton merupakan salah satu obat pengontrol asam lambung yang paling banyak diresepkan. Pemakaian jangka panjang obat penghambat pompa proton berisiko menurunkan kadar magnesium darah hipomagnesemia. Penelitian ini bertujuan untuk menilai hubungan antara penggunaan obat golongan penghambat pompa proton terhadap dan penurunan kadar magnesium darah pada pasien di RSUPN Dr. Cipto Mangunkusumo Jakarta. Desain penelitian adalah cross sectional studi komparatif dengan teknik pengambilan sampel consecutive sampling pada bulan Juni sampai Oktober 2016. Penelitian ini membandingkan kadar magnesium darah antara pasien yang menggunakan obat penghambat pompa proton lansoprazole dan omeprazole dengan pasien yang tidak menggunakan penghambat pompa proton. Jumlah sampel dalam penelitian ini adalah 184 pasien. Pengumpulan data menggunakan kuesioner dan rekam medis. Analisis statistik dilakukan dengan uji t tidak berpasangan, Mann-Whitney, dan one way ANOVA. Rata-rata kadar magnesium pasien yang menggunakan penghambat pompa proton adalah 2.08 0.21 mg/dL lebih rendah dari yang tidak menggunakan penghambat pompa proton 2.27 0.38 mg/dL dengan nilai p < 0.001 signifikan. Kadar magnesium lebih rendah secara bermakna terjadi pada pasien yang menggunakan penghambat pompa proton lebih dari satu tahun dan yang menggunakan omeprazole p < 0.05.

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Proton pump inhibitors is one of the controller gastric acid medication controllers most widely prescribed. The long term use of proton pump inhibitors has a risks decrease of blood magnesium levels hypomagnesemia. The purpose of this study was to determine whether and to what degree PPI use affects blood magnesium levels. The study design was a cross sectional comparative study with consecutive sampling technique on June to October 2016.

This study compared blood magnesium levels among patients using proton pump inhibitors lansoprazole and omeprazole with patients not taking proton pump inhibitor. The total sample was 184 patients. Collecting data using questionnaires and medical records. Statistical analysis was performed with the unpaired t test, Mann Whitney, and one way ANOVA. The average level of magnesium patient using proton pump inhibitors is 2.08 0.21 mg dL whereas who not taking proton pump inhibitors is 2.27 0.38 mg dL with p 0.001 significant. Levels of magnesium were significantly lower in patients using proton pump inhibitors more than one year and using omeprazole p."

"Latar Belakang : Sindrom frailty berkaitan dengan angka morbiditas dan kematian yang lebih tinggi, sehingga dipakai sebagai prediktor kesehatan pada orang usia lanjut (usila). Polifarmasi sebagai salah satu faktor risiko sindrom frailty, dapat berkaitan dengan obat PPI yang sering diberikan pada usila, atas indikasi adanya keluhan gangguan saluran cerna bagian atas. Sampai saat ini belum ada penelitian yang mempelajari hubungan PPI jangka panjang dan sindrom frailty pada usila. Penelitian ini diharapkan dapat memberikan data mengenai penggunaan PPI jangka panjang (≥ 6 bulan) terhadap risiko sindrom frailty pada usila. Metode : Desain studi kasus kontrol dengan kriteria inklusi subjek penelitian 60 tahun ke atas dan berstatus kognitif baik. Kriteria ekslusi adalah data yg tidak lengkap atau terdapat kontraindikasi PPI. Kasus adalah usila terdiagnosis Frailty menurut FI-40 item dan kontrol adalah usila yang tidak frailty berdasarkan instrumen yang sama. Pengambilan data primer termasuk status frailty telah dilakukan bulan Maret-Juni 2013 oleh Seto E dan Sumantri S. Pengambilan data sekunder yang digunakan pada penelitian ini dilakukan pada bulan Oktober-November 2014 dari data primer tersebut, ditambah dengan data dari rekam medis poliklinik Geriatri dan poliklinik diabetes RS Cipto Mangunkusumo. Hasil : Didapatkan 225 subjek (75 kasus:150 kontrol), 59,6% berjenis kelamin perempuan (rerata usia 72,14 tahun; simpang baku ± 6,4 tathun) dan 47,1% berpendidikan tinggi. Subjek yang berpendidikan rendah, berstatus cerai mati, berstatus nutrisi lebih buruk, tidak mandiri, memerlukan caregiver, hidup tidak berkecukupan dan kondisi kesehatan yang lebih buruk lebih banyak didapatkan pada kelompok frailty dibandingkan kelompok yang tidak frail. Proporsi pengguna PPI Jangka Panjang sebesar 40,9%. Penggunaan PPI jangka panjang meningkatkan risiko sindrom frailty (Crude OR 2,15; IK 95% 1,22-3,78; p<0,007) dengan adjusted OR 1,83 (IK 1,0-3,36) terhadap variabel nutrisi dan merokok. Kesimpulan : Penggunaan PPI jangka panjang (≥ 6 bulan) secara independen meningkatkan salah satu risiko sindrom frailty pada usila.

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Background: Frailty syndrome as being used as the newest elderly health predictor, associated with higher morbidity and mortality. PPI are often used in elderly due to presence of upper gastrointestinal complaints, and related with polypharmacy as one of the risk factor for frailty syndrome. No study has studied the relationship of long term PPI and frailty syndrome in elderly. The objective of the study is to find whether long term use of PPI (≥ 6 months) would increase the risk of frailty syndrome in the elderly.

Methods: A case control study includes subjects 60 years and above with good cognitive status. All subject with history of hypersensitivity of PPI is excluded. Elderly diagnosed as frailty based in FI-40 item is defined as cases, while individuals that are not frailty are classified as the control. Primary data (included frailty status) was collected on March-June 2013 by Seto E and Sumantri S, et al. Secondary data used in the current study was gathered on October-November 2014, from the primary data above and from the medical record taken from geriatric and diabetic outpatient clinics Cipto Mangunkusumo Hospital.

Result: There were 225 subjects collected (75 cases : 150 controls), 59,6% were female (mean age 72,14 years old, SD ± 6,4 years) and 47,1% with higher education. Lower education, divorced, poor nutrition, dependent, needed caregiver, economicaly insufficient, more comorbidity and poor health condition are seen in frailty group.The proportion of long term PPI use were 40,9%. Long term PPI medication increase the risk of frailty syndrome (Crude OR 2,154; CI 95% 1,225-3,778; p<0,007) with adjusted OR 1,83 (CI 95% 1,02-3,37) after adjusting to nutrition and smoking variables.

Conclusion: Long term use of PPI significantly increase the risk of frailty syndrome compared to the non-users."

"[ABSTRAKPenghambat pompa proton (PPP) adalah salah satu contoh obat yang digunakan secara luas di dunia. Efikasi dan profil keamanan yang baik dari PPP berperan dalam terjadinya peresepan berlebihan di fasilitas pelayanan kesehatan. Data terkini menunjukan bahwa PPP berhubungan dengan peningkatan risiko pneumonia nosokomial. Penggunaan PPP intravena yang tidak tepat telah berkontribusi dalam meningkatkan total biaya kesehatan serta mengurangi ketersediaan obat. Penelitian retrospektif observasional ini bertujuan untuk menganalisa total konsumsi PPP, total penggunaan sediaan PPP intravena, ketepatan penggunaan sediaan PPP intravena, ketepatan frekuensi penggunaan PPP, dan kejadian pneumonia nosokomial yang berhubungan dengan obat ini. Data diambil dari rekam medik pasien yang masuk ruang rawat inap Ilmu Penyakit Dalam RSCM selama periode Oktober hingga Desember 2014. Pada penelitian ini, dari 210 pasien yang dievaluasi, terdapat 166 pasien (79%) menggunakan PPP, frekuensi ini lebih tinggi dari yang ditemukan pada rumah sakit di US (40-70%) dan di China (42%). Total konsumsi tercatat sebesar 194.31 defined daily dose (DDD)/ 100 bed-days, jauh lebih tinggi dibandingkan yang ditemukan di Irlandia dan India (56.73 dan 128 DDD/ 100 bed-days). Sediaan intravena diberikan pada 87.35% pasien dan hanya 34.48% pasien memiliki indikasi yang tepat. Frekuensi penggunaan diberikan tanpa diturunkan pada beberapa pasien. Persentase pneumonia nosokomial tujuh hingga delapan kali lipat lebih tinggi pada kelompok PPP dibandingkan kelompok non-PPP. Namun, peranan beberapa faktor risiko terhadap terjadinya pneumonia nosokomial tidak dapat disingkirkan.

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ABSTRACTProton pump inhibitors (PPIs) are among the most widely used drugs in the world. The favorable efficacy and safety profile of these drugs has led to their over prescriptions in health care facilities. Recent data, however, has shown that the use of PPIs was associated with the increased risk of nosocomial pneumonia. Inappropriate use of intravenous PPIs has contributed to the increasing of total health cost and also decreasing the source of drugs. This retrospective, observational study was aimed to analyze the total consumption of PPIs, the total use of intravenous PPIs preparations, the appropriateness use of intravenous PPIs preparations, the appropriateness of the frequency of PPIs adminstration, and the occurance of nosocomial pneumonia related to PPIs use. Data were obtained from medical records of patients who came to Internal Medicine Ward RSCM during the period of October to Desember 2014. In this study, out of 210 patients evaluated, 166 patients (79%) used PPIs, the frequency is higher than those in hospitals in the US (40 to 70%) and in China (42%). The total consumption of PPIs was 194.31 defined daily dose (DDD)/ 100 bed-days, which is much higher compared to those in Ireland and India (56.73 and 128 DDD/ 100 bed-days). Intravenous preparations were admistered to 87.35% of patients, among which only 34.48% had been given for appropriate indications. There are no reduced of frequent used in some patients. The frequency of nosocomial pneumonia was seven to eight times higher among patients treated with PPIs compared to those without PPIs. However, the role of some risk factors that may contribute the occurance of nosocomial pneumonia cannot be ruled out.;Proton pump inhibitors (PPIs) are among the most widely used drugs in the world. The favorable efficacy and safety profile of these drugs has led to their over prescriptions in health care facilities. Recent data, however, has shown that the use of PPIs was associated with the increased risk of nosocomial pneumonia. Inappropriate use of intravenous PPIs has contributed to the increasing of total health cost and also decreasing the source of drugs. This retrospective, observational study was aimed to analyze the total consumption of PPIs, the total use of intravenous PPIs preparations, the appropriateness use of intravenous PPIs preparations, the appropriateness of the frequency of PPIs adminstration, and the occurance of nosocomial pneumonia related to PPIs use. Data were obtained from medical records of patients who came to Internal Medicine Ward RSCM during the period of October to Desember 2014. In this study, out of 210 patients evaluated, 166 patients (79%) used PPIs, the frequency is higher than those in hospitals in the US (40 to 70%) and in China (42%). The total consumption of PPIs was 194.31 defined daily dose (DDD)/ 100 bed-days, which is much higher compared to those in Ireland and India (56.73 and 128 DDD/ 100 bed-days). Intravenous preparations were admistered to 87.35% of patients, among which only 34.48% had been given for appropriate indications. There are no reduced of frequent used in some patients. The frequency of nosocomial pneumonia was seven to eight times higher among patients treated with PPIs compared to those without PPIs. However, the role of some risk factors that may contribute the occurance of nosocomial pneumonia cannot be ruled out., Proton pump inhibitors (PPIs) are among the most widely used drugs in the world. The favorable efficacy and safety profile of these drugs has led to their over prescriptions in health care facilities. Recent data, however, has shown that the use of PPIs was associated with the increased risk of nosocomial pneumonia. Inappropriate use of intravenous PPIs has contributed to the increasing of total health cost and also decreasing the source of drugs. This retrospective, observational study was aimed to analyze the total consumption of PPIs, the total use of intravenous PPIs preparations, the appropriateness use of intravenous PPIs preparations, the appropriateness of the frequency of PPIs adminstration, and the occurance of nosocomial pneumonia related to PPIs use. Data were obtained from medical records of patients who came to Internal Medicine Ward RSCM during the period of October to Desember 2014. In this study, out of 210 patients evaluated, 166 patients (79%) used PPIs, the frequency is higher than those in hospitals in the US (40 to 70%) and in China (42%). The total consumption of PPIs was 194.31 defined daily dose (DDD)/ 100 bed-days, which is much higher compared to those in Ireland and India (56.73 and 128 DDD/ 100 bed-days). Intravenous preparations were admistered to 87.35% of patients, among which only 34.48% had been given for appropriate indications. There are no reduced of frequent used in some patients. The frequency of nosocomial pneumonia was seven to eight times higher among patients treated with PPIs compared to those without PPIs. However, the role of some risk factors that may contribute the occurance of nosocomial pneumonia cannot be ruled out.]"