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"Latar Belakang: Induksi sputum merupakan metode alternatif untuk mendapatkan spesimen dari saluran respiratori bawah yang bersifat semi-invasif. Induksi sputum belum menjadi pemeriksaan standar pada anak, padahal sputum merupakan spesimen yang baik untuk berbagai pemeriksaan penunjang, misalnya pulasan sitologi dan biakan bakteri. Keberhasilan induksi sputum dalam mendapatkan spesimen dari saluran respiratori bawah pada anak masih diragukan. Tujuan: Mengetahui keberhasilan induksi sputum dalam mendapatkan spesimen dari saluran respiratori bawah pada anak dengan infeksi saluran respiratori bawah, toleransi induksi sputum, dan pola biakan dari spesimen sputum yang didapatkan. Metode: Penelitian potong lintang deskriptif pada subjek anak berusia 1 bulan hingga 18 tahun dengan infeksi respiratori bawah yang dipilih secara konsekutif. Subjek menjalani induksi sputum. Sputum diperiksa jumlah sel makrofag alveolar, kadar protein surfaktan A (SP-A), serta biakan bakteri aerob, atau pulasan bakteri tahan asam dan biakan M. tuberculosis. Hasil: Empat puluh orang subjek berpartisipasi dalam penelitian ini, induksi sputum berhasil dilakukan pada seluruh subjek. Usia termuda 2 bulan dan tertua 16 tahun 7 bulan. Sebagian besar subjek (27 dari 40 orang) didiagnosis dengan tuberkulosis, diikuti pneumonia dan bronkiolitis. Median durasi induksi sputum 45 menit, dan sebagian besar volume 3 atau 4 mL. Efek samping berupa perdarahan hidung (40%) dan muntah (2,5%). Jumlah sel makrofag alveolar lebih dari 5 buah ditemukan pada 97,5% subjek. Sementara, SP-A diperiksa pada 30 spesimen dan SP-A dideteksi pada seluruh spesimen dengan median 264,528 pg/mL. Pulasan bakteri tahan asam negatif pada seluruh subjek yang diperiksa, sementara biakan M. tuberculosis positif pada 1 dari 27 (3%) subjek. Biakan bakteri aerob positif pada 5 dari 13 (38,5%) orang subjek. Simpulan: Induksi sputum memiliki keberhasilan yang baik untuk mendapatkan spesimen dari saluran respiratori bawah pada anak dan aman dilakukan. Spesimen sputum yang diperoleh secara induksi memiliki hasil positif biakan bakteri aerob yang cukup baik.

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Background: Sputum induction is an alternative method to obtain specimen from lower respiratory tract. Although sputum is a good specimen for various examination such as cytology and microbiological culture, sputum induction is not a standard method in children. The efficacy of sputum induction to obtain specimen from lower respiratory tract in children is unclear. Objective: To identify the efficacy of sputum induction to obtain specimen from lower respiratory tract in children with lower respiratory tract infection. Also, to identify side effects of sputum induction and the result of microbiological culture. Design: A cross sectional study was performed in children from age 1 month old to 18 years old with lower respiratory tract infection, consecutively. Subject underwent sputum induction, and specimens were examined for number of alveolar macrophage cell, surfactant protein A (SP-A) concentration, also aerobic microbial culture, or acid-fast bacili smear and M. tuberculosis culture. Result: Forty subjects participated in this study, and sputum induction was succesfully performed in all subjects. Youngest subject was 2 months old, while the eldest was 16 years 7 months old. Most subjects (27 of 40) were diagnosed with tuberculosis, followed by pneumonia and bronchiolitis. Median duration of sputum induction was 45 minutes, and majority of volume was 3 or 4 mL. Side effects were nose bleeds (40%) and vomiting (3%). Macrophage alveolar more than 5 cells in one specimen was found in 97.5% subjects. Laboratory examination for SP-A was performed in 30 subjects? specimens, and SP-A was detected in all examined specimens with median concentration 264.528 pg/mL. Culture for M. tuberculosis was positive in 1 of 27 subjects (3%), while acid fast bacili smear was negative in all examined subjects. Aerobic microbial culture was positive in 5 of 13 subjects (38.5%), Conclusions: Sputum induction has good efficacy in obtaining lower respiratory tract specimen and it is safe to perform in children. Specimen from sputum induction yields good positive result for aerobic microbial cultures."

"Tablet moxifloxacin 400 mg telah dipasarkan di Indonesia untuk beberapa indikasi, yaitu bronkitis kronik eksaserbasi akut, pneumonia didapat di komunitas, dan sinusitis bakterial akut. Untuk menilai keamanan dan tolerabilitas moxifloxacin, dilakukan survei pasca pemasaran pada tahun 2001 yang melibatkan 589 dokter. Selain itu, dinilai pula efikasi kliniknya, baik oleh dokter maupun pasien, dengan menggunakan total skor 6 gejala yang berskala 0-12. Seluruhnya, diperoleh 1715 pasien dengan sinusitis akut, pneumonia didapat di komunitas, bronkitis kronik eksaserbasi akut dan infeksi lainnya yang diobati dengan moxifloxacin oral 400 mg sekali sehari. Sebanyak 151 (8,8%) pasien melaporkan efek samping dan 5 (0.29%) pasien mengalami efek samping serius, yang dianggap berhubungan dengan terapi moxifloxacin. Efek samping tersering adalah mual (4.96%), pusing (1.52%), muntah (0.64%), sakit kepala (0,47%), dan lemah (0,47%). Duapuluh tiga (1,34%) pasien menghentikan terapi akibat efek samping. Toleransi terhadap terapi dinilai sangat baik oleh 647 (37,7%) dan baik oleh 919 (53,6%) pasien. Berdasarkan penilaian klinis oleh dokter, 57,7% pasien dinyatakan sembuh dan 39.9% dinyatakan membaik di akhir terapi. Rerata skor gejala total, sebagaimana dinilai oleh pasien, turun dari 6,43 pada hari pertama menjadi 2,76 pada hari ketiga. Secara umum, 95.3% pasien merasa lebih baik setelah mendapat moxifloxacin dan 97,6% pasien memberikan kesan baik terhadap terapi moxifloxacin. Sebagai kesimpulan, survei pasca pemasaran ini menunjukkan bahwa pengobatan infeksi saluran napas oleh bakteri, terutama bronkitis, pneumonia komunitas dan sinusitis, dengan moxifloxacin 400 mg sekali sehari aman dan dapat ditoleransi dengan baik, dan juga bahwa moxifloxacin sangat efektif untuk pengobatan infeksi ini dengan perbaikan gejala yang cepat. (Med J Indones 2004; 14: 11-19)

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Moxifloxacin 400 mg tablet has been marketed in Indonesia for several indications, i.e. acute exacerbation of chronic bronchitis (AECB), community-acquired pneumonia (CAP), and acute bacterial sinusitis (ABS). To assess the safety and tolerability of moxifloxacin, a post-marketing surveillance study was conducted in the year 2001 involving 589 physicians. Clinical efficacy was also evaluated, both by physicians and patients, using a 6-symptom total score, which was scaled 0-12. A total of 1715 patients with acute sinusitis, CAP, AECB, and other infections were treated with oral moxifloxacin 400 mg once daily. There were 151 (8.8%) patients with adverse events (AEs) and 5 (0.29%) patients with serious adverse events (SAEs) that were considered related to moxifloxacin treatment. The most common adverse reactions were nausea (4.96%), dizziness (1.52 %), vomiting (0.64%), headache (0.47%), and weakness (0.47%). Twenty three (1.34%) patients discontinued treatment due to adverse events. Tolerance to treatment was rated very good and good by 647 (37.7%) and 919 (53.6%) of patients, respectively. Based on physicians? clinical assessment, 57.7% of patients were cured and 39.9% were improved at the end of treatment. Mean total symptom score, as assessed by the patients, decreased from 6.43 on day-1 to 2.76 on day-3. Totally, 95.3% of patients felt better after receiving moxifloxacin and 97.6% of patients had good impression on moxifloxacin treatment. In conclusion, treatment of respiratory tract infections, mainly AECB, CAP and ABS, with moxifloxacin 400 mg once daily in this post-marketing surveillance was shown to be safe and well tolerated. Moxifloxacin was also shown to be highly effective in the treatment of these infections with rapid improvement of symptoms. (Med J Indones 2004; 14: 11-19)"

"ABSTRACTBackground: urinary tract infection (UTI) is often treated in daily practice as overactive bladder (OAB) by giving anticholinergic, the recommended treatment options of OAB. However, anticholinergic application for UTI symptoms relief has never been investigated. To our knowledge, this study was the first randomized trial which investigate anticholinergic use for UTI treatment. This study aimed to evaluate whether additional anticholinergic is beneficial alongside an empiric antibiotic therapy in reducing symptoms and tolerable for females with uncomplicated UTI. Methods: this was a randomized double-blind controlled trial that included female aged >18 y.o with uncomplicated lower UTI. Patients were randomly assigned to either solifenacin succinate 5 mg (group 1) or placebo (group 2) in addition to empiric levofloxacin 500 mg treatment for 3 days. Those with structural and/or functional abnormalities of the urinary tract and allergic reaction history were excluded. We observed changes in overactive bladder symptom score (OABSS), patient perception of bladder condition (PPBC) score, patient-reported symptoms and adverse events. Results: a total of 126 patients, 63 for each group, initiated the trial with median age of 44 (19-67) y.o. There were no differences of age, OABSS, and PPBC score between the 2 groups at baseline. We found significant (p<0.05) reduction of OABSS and PPBC score in both groups at the end of therapy; however the amount of reduction were not different between groups. In group 1 we found 22.2% of patients complained of dry mouth and 25.4%, 4.7%, 3.2% of patients complained of nausea, somnolence and constipation respectively. In group 2 we found 20.0%, 21.7% and 3.3% patients who complained of dry mouth, nausea, and somnolence respectively. One patient in group 2 experienced allergic reaction and was dropped out. Conclusion: we found no significant difference in OABSS and PPBC score reduction by adding anticholinergic to antibiotic therapy for females with uncomplicated UTI. There was no serious adverse event recorded."

"Pneumonia merupakan penyakit infeksi pernafasan akut yang menyebabkan kematian tinggi di dunia khususnya pada anak-anak dan lansia. Pneumonia dapat disebabkan oleh berbagai jenis infeksi yang mayoritas disebabkan oleh kelompok virus dan bakteri. Selama pandemi COVID-19, prevalensi pneumonia meningkat akibat sirkulasi SARS-CoV-2 yang juga dapat menyebabkan pneumonia. Penelitian ini mengidentifikasi etiologi virus dan bakteri pada kasus-kasus positif dan negatif COVID-19 di Jakarta, Indonesia. Penelitian ini menganalisis 245 kasus pneumonia yang terdiri atas 173 sampel negatif SARS-CoV-2 dan 72 sampel positif SARS-CoV-2. Sampel tersebut diperiksa menggunakan delapan panel virus menggunakan konvensional PCR dan dua panel bakteri menggunakan RT-PCR. Penelitian ini berhasil mengidentifikasi etiologi dari 109 (44.5%) sampel yang mayoritas adalah SARS-CoV-2 (n=41, 16.7%), paramyxovirus (n=18, 7.3%), herpesvirus (n=16, 6.5%) dan influenza (n=12, 4.9%). Sedangkan, dari kelompok bakteri sebanyak H.influenzae (n=21, 8.6%) dan S. pneumoniae (n=14, 5.7%). Prevalensi koinfeksi pada kasus pneumonia di Indonesia selama pandemik COVID-19 adalah 6.1%, dimana pada kasus positif SARS-CoV-2 (18.8%) lebih tinggi daripada pada kasus negatif (5.8%). Penelitian ini menggambarkan prevalensi patogen pada masa awal pandemik COVID-19 di Indonesia dan pengaruhnya dalam menyebabkan pneumonia pada pasien.

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Pneumonia is an acute respiratory infection that causes high mortality in the world, especially in children and the elderly. Pneumonia can be caused by various types of infections, the majority of which are caused by groups of viruses and bacteria. During the COVID-19 pandemic, the prevalence of pneumonia increased due to circulating SARS-CoV-2 which can also cause pneumonia. This study identifies viral and bacterial etiology in positive and negative cases of COVID-19 in Jakarta, Indonesia. We analyzed 245 pneumonia cases consisting of 173 SARS-CoV-2 negative samples and 72 SARS-CoV-2 positive samples. We were able to identify the etiology of 109 (44.5%) samples, the majority of which were SARS-CoV-2 (n=41, 16.7%), paramyxovirus (n=18, 7.3%), herpesvirus (n=16, 6.5%) and influenza (n=12, 4.9%). Meanwhile, from the group of bacteria H. influenzae (n=21, 8.6%) and S. pneumoniae (n=14, 5.7%) were detected in this study. The prevalence of coinfection in pneumonia cases in Indonesia during the COVID-19 pandemic was 6.1%, whereas positive cases of SARS-CoV-2 (18.8%) were higher than in negative cases (5.8%). This study describes the prevalence of the pathogen in the early days of the COVID-19 pandemic in Indonesia and its influence in causing pneumonia in patients."

"Pneumonia merupakan penyakit penyebab kematian kedua tertinggi setelah diare diantara balita. Hal ini menunjukkan bahwa pneumonia merupakan penyakit yang menjadi masalah kesehatan masyarakat utama yang berkontribusi terhadap tingginya angka kematian balita di Indonesia. Intervensi yang dapat dilakukan untuk menurunkan angka mortalitas neonatal antara lain promosi menyusui dini dan diikuti dengan pemberian ASI eksklusif. ASI merupakan minuman alami bagi bayi baru lahir pada bulan pertama kehidupannya yang bermanfaat untuk kesehatannya. Namun sayang, cakupan ASI eksklusif di Indonesia masih sangat rendah. tingginya angka pneumonia dan rendahnya cakupan ASI eksklusif ini perlu mendapatkan perhatian. Penelitian ini menggunakan disain kasus kontrol. Kasus adalah anak usia 1-5 tahun yang didiagnosa pneumonia oleh dokter/bidan/perawat yang berkunjung ke puskesmas terpilih. Kontrol adalah anak usia 1-5 tahun yang didiagnosa tidak pneumonia dan penyakit berat yang berkunjung ke puskesmas terpilih. Analisis yang dilakukan adalah analisis univariat, bivariat, stratifikasi, dan multivariat dengan logistik regresi. Dan hasil penelitian diperoleh bahwa anak yang diberi ASI tidak eksklusif memiliki Rasio Odds 6,699 kali (95% CI: 3.204-14.007) untuk mengalami kejadian pneumonia dibandingkan anak yang diberi ASI eksklusif setelah dikontrol dengan variabel adanya perokok, adanya asap pembakaran, pendidikan ibu, riwayat imunisasi DPT lengkap dan status gizi. Hasil penelitian ini membuktikan hipotesis penelitian yaitu pemberian ASI tidak eksklusif meningkatkan risiko kejadian Pneumonia dibandingkan yang diberi ASI eksklusif pada anak usia 1-5 tahun di Kabupaten Bogor. Intervensi melalui promosi ASI eksklusif selama enam bulan, program anti rokok, penggunaan bahan bakar untuk masak yang sempurna pembakarannya, pemberdayaan ibu rumah tangga, imunisasi DPT dan perbaikan gizi, perlu dilakukan secara terintegritas untuk menurunkan morbiditas dan mortalitas penyakit Pneumonia.

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Pneumonia is one of main cause after diarrhea among under-five year children. It was showed that Pneumonia had become a major public health problem which contributed toward the high of mortality among under-five year children. The intervention action we can do is breastfeeding initiation promotion and giving exclusive breastfeeding. Breastfeeding is a natural food for newborn particularly in the first month of life, that very important for their health in the future. Unfortunately, the practice of exclusive breastfeeding in Indonesia was not really good. The high prevalence of Pneumonia and the low of exclusive breastfeeding practice, so we should give more attention for this problem. The objective of study was to identify the role of exclusive breastfeeding practice with lower respiratory tract infection in under-five children in Bogor District. This study used case control design. Sample was selected by purposive (for cases) and random sampling (for control). Each group consist 107 cases and 107 controls. Case definition is children suffered Pneumonia whom diagnosed by doctor/midwives/nurse seeking for treatment at selected health center. Control definition is children without Pneumonia whom diagnosed by doctor/midwives/nurse seeking for treatment at selected health center. Data analysis used univariate, bivariate, stratification, and multivariate using logistic regression. And the result of study showed that children whom not given exclusive breastfeeding had the risk Rasio Odds 6,699 kali (95% CI: 3.204-14.007) greater to Pneumonia than children whom given exclusive breastfeeding in under-five year children after controlled by smoker at home, air pollution from cooking at home, level education of mother, immunization status and nutrition status. This result succeed to prove the hypothesis that not giving exclusive breastfeeding practice increasing the risk to Pneumonia than whom given exclusive breastfeeding in under-five year children. Intervention through exclusive breastfeeding promotion, anti-cigarette program, use of stove with perfect burst, mother empowerment, immunization, improving nutrition status should applied at each family for decreasing morbidity and mortality caused by lower respiratory tract infection in under-five year children."