| Summary: | Selection of antibiotics should be based on culture results, resistance
patterns and guidelines since microorganisms and their sensitivity to antibiotics
always changing. Infections that occur in patients with febrile neutropenia treated
with broad-spectrum antibiotics when the infection first occur. This research aims
to evaluate the use of antibiotics in pediatric patients with hematologic
malignancy with febrile neutropenia during cancer chemotherapy in RSUP Dr.
Sardjito.
This study is a non-experimental studies with prospective data collection on
the ward Estella2, Instalasi Kesehatan Anak RSUP Dr. Sardjito Yogyakarta, the
period from April to June 2011. Data of all pediatric patients meeting the
inclusion criteria taken from the patient's medical record includes a physical
examination, laboratory results, antibiotic regimen, the resulting clinical outcome
and drug related problems (DRPs) which occurs due to antibiotics, then the data
were analyzed descriptively evaluative.
In this study there were 27 episodes in pediatric patients with febrile
neutropenia according to inclusion criteria. Patterns the use of antibiotic as
prophylactic antibiotics is 3.7% (1 patient) and 100 % (27 patients) for
therapeutic antibiotic. Prophylactic antibiotic used ciprofloxacin, and the most
used therapeutic antibiotic is combination of ceftazidim with gentamicin (44.6%).
There was 92.6% of the selection therapeutic antibiotic which is in accordance
with the Standard Pelayanan Medik RS Dr.Sardjito 2005, the initial therapy
regimen using a combination of β-lactam with an aminoglycoside. Therapeutic
efficacy is 51.85% (14 patients) and has not been adequate antibiotic therapy or
therapeutic failure by 48.15% (13 patients). Clinical outcome the use of empiric
antibiotics for febrile neutropenia use combination regimen of ceftazidime with
gentamycin, which amounted to 45.83 %. DRPs that occured related with the
administration of antibiotics are contraindication, inappropriate dosing, adverse
drug reaction and drug interactions. Selection of antibiotic therapy in pediatric
hematologic malignancy with febrile neutropenia is in accordance with Standard
Pelayanan Medik RS Dr. Sardjito 2005, but achieving success of therapy depends
on the patient's clinical condition.
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