k16 - penggunaan antibiotik pada sistem respirasi-1.pdf

8/20/2019 K16 - PENGGUNAAN ANTIBIOTIK PADA SISTEM RESPIRASI-1.pdf

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Bagian FarmakologiBagian FarmakologiBagian FarmakologiBagian Farmakologi

Since 1992-the antibiotics IS the magic drugfor infectious diseases.

MISUSE

IrrationalPrescribing


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Antibiotics for prophylaxis Fifty percent of patients receive antibiotics

needlessly In an analysis of prescribing practices in

teaching hospitals worldwide, more than 40percent of all antimicrobials prescribedwere considered inappropriate

Continuation of empiric therapy despitenegative culture in a stable patient,

Lack of awareness of susceptibility patternsof common pathogens

Habits and expectations hard to change “cultural factors

Lack of knowledge re risks

Self medication and non

Lack of control over aggressive marketing.


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But he is coughing really bad for a wholeweek

But the school wont let him back until he getsan antibiotic for his running nose

But I need to return to work as early aspossible

But if I didn’t prescribe an antibiotic I mayloose my patients


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Case

2 years old male, brought with history of fever andcough with rhinorrhea of two days. Red eyes,Diarrhea, cough ++.History of similar case in family.Throat congested.Clinically diagnosed : Viral Upper RespiratoryViral Upper RespiratoryViral Upper RespiratoryViral Upper RespiratoryTract InfectionTract InfectionTract InfectionTract Infection – seasonal( Pharyngotonsillitis ).Management :

- General and symptomatic therapy.

ANTIBIOTICS : Not NeededNot NeededNot NeededNot Needed

Case ::::

40 years old otherwise healthy, non smokermale.

Present C/O :

-dry cough for 2 weeks.

-clear sputum production & fatigueDenies : pharyngitis, fever, chills.

Vital signs : normal temperature , respiratoryrate & pulse.


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Diagnosis : Acute Bronchitis.

* Over 90% are viral.

* Approximately 60% of patientsseeking medical care are givenantibiotics !!!

* One of the most common causes ofantibiotic abuse.

•Viruses cause most commonrespiratory illnesses

•Viral illness needs time to

heal, antibiotic can not helpantibiotic can not helpantibiotic can not helpantibiotic can not help


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Coronavirus.

Rhinovirus.

Influenza A and B.

Parainfluenza. respiratory syncitial virus.

Human metapneumovirus

Taking antibiotics for viral illnesses willnot :

cure the infection.

keep others from getting the illness.

makes the patient feel better.But it will make it more likely to bacterialresistance.


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Viral infection is disseminated throughoutthe system (URT/LRT). Fever is usually highat onset, settles by day 3-4

Bacterial infection is localized to one partof the system ( acute tonsillitis does not

present with running nose or chest signs ).Fever is generally moderate at the onsetand peaks by day 3peaks by day 3peaks by day 3peaks by day 3----4.4.4.4.


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Thank you

k16 - penggunaan antibiotik pada sistem respirasi-1.pdf

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