Program Pengendalian Resistensi Antimikroba: (PPRA) Di Rumah Sakit
Program Pengendalian Resistensi Antimikroba: (PPRA) Di Rumah Sakit
Program Pengendalian Resistensi Antimikroba: (PPRA) Di Rumah Sakit
RESISTENSI ANTIMIKROBA
(PPRA)
DI RUMAH SAKIT
Hari Paraton. dr. SpOGK
1. AMR Mechanism
2. Global Problem
3. Global Action Plan
4. Situasi Nasional
5. Tugas KPRA Rumah Sakit
6. Key Performance Indicator
Rp
AMR
PERILAKU
Rp Rp PROBLEM
WHO 2013
10.000.000/tahun
2050
USD. 100 TRILLIUN
(Jim O Neill 2015)
KOMITE PENGENDALIAN RESISTENSI ANTIMIKROBA
KEMENTERIAN KESEHATAN
WHO; Global Action Plan
40 40 WHO/
35 PPRA
30 26- ESBL
28 RSD 56%
20 RSD S
S
10 9 AMRI
0 N
2000 2005 2010 2013 2016
PENDAHULUAN
BAGAIMANA INDONESIA
The prevalence of ESBL producing E.coli and RSUD.Dr. Soetomo 204 sample kasus
Klebsiella pneumoniae among hospitals in Jan-Juli 2010
Indonesia six hospitals 2013
N= 554
60 56,39% 56,8% 100.00%
51,69% 52,23% 90.00%
50 45,33% 80.00%
40,83% 70.00%
40 37,82% 60.00%
Persentase
34,31% 32,16% 32,7% 35,02
50.00% %(194)
30 27,94% 26,71% 40.00%
30.00%
20 20.00% 6,50%(36) 4,51%(25)
10.00%
10 0.00%
Jumlah Isolat Jumlah ESBL Jumlah PAN Jumlah
RESISTEN MRSA
0
Macam Isolat
Hasil
Kategori Sby Semg
(%) (%)
Tidak ada
indikasi 76 53
terapi
Tidak ada
indikasi 55 81
profilaksis
Food Kurikul
Knowled Residu AB Insent um
ge if
(+)
Training
R AB / R /Semina
OTC/Apat self AMR AB/ Knowle r
ek medikas dge
i RS DR Worksh
op
Farma TOP
si MGT
klinik
PPI Klinis
i
HEALTH RESOURCES IN INDONESIA 2016
community education
STRATEGI UTAMA
CEGAH
SELECTIVE CEGAH KENDALI
ANTIBIOTIK KEWASPADAAN
DEKOLONISASI
BIJAK UNIVERSAL
PPI FARMASI
KPRA
MIKROBI
KFT OLOGI
KLINIK
FULL
INITIAL PILOT IMPLEME SUSTAIN
NT
Metronidazol 37.95
Meropenem 11.61
Lefofloxacin 5.80
Ciprofloxacin 29.11
Ceftriaxone 23.66
Ceftazidime 0.89
Cefotaxime 5.25
Cefo-sulbactam 1.00
Cefixime 0.67
Ampicillin 29.46
Amoxicillin 3.35
Amoxiclav 58.93
Amikacin 1.12
40.00
37.10
35.00
30.00
25.81
25.00
20.00
16.13
15.00
9.68
10.00
6.45
4.84
5.00
0.00
VI V IVa IIIa IIIb 0
% RATIO 16.13 25.81 6.45 4.84 9.68 37.10
31
Survellans Penggunaan Antibiotik
IRNA Anak
60 54.35 IRNA Medik-SMF Peny.Dalam
50 37.10
40.00
40
30.00 25.81
30 21.74
20.00 16.13
20 9.68
10.87 6.45
6.52 10.00 4.84
10 2.17 2.17 2.17
0.00
0 VI V IVa IIIa IIIb 0
VI V IVa IIIa IIIb IIb 0
% RATIO 16.13 25.81 6.45 4.84 9.68 37.10
% RATIO 6.52 10.87 2.17 21.74 2.17 2.17 54.35