Pedoman Ringkas Implementasi Penatagunaan Antimikroba di ICU
Keywords:
antimicrobial stewardship, ICU, intensive care, critical careSynopsis
Selama dekade terakhir, antibiotik telah diresepkan secara luas dan terus-menerus di seluruh dunia. Penggunaannya mempunyai risiko ganda; risiko individu terhadap efek samping, serta risiko kolektif resistensi antibiotik. Angka efek samping meningkat seiring dengan peresepan antibiotik, sedangkan resistensi berkorelasi dengan konsumsi antibiotik. Resistensi antibiotik merupakan ancaman kesehatan masyarakat yang muncul.
Pada pasien intensive care unit (ICU), infeksi oleh bakteri dengan resistensi merupakan faktor risiko yang penting terhadap mortalitas. Untuk mengatasi atau mengurangi masalah resistensi antibiotik, konsumsi antibiotik harus dikurangi, terutama karena sepertiga resep rumah sakit masih diperdebatkan atau tidak diperlukan. Banyak dari faktor risiko munculnya resistensi berdampingan dengan operasional di ICU, sehingga menjadikannya tempat dimana penggunaan antibiotik harus dilakukan sebijak mungkin. Dalam konteks ini, implementasi penatagunaan antimikroba harus menjadi upaya terdepan untuk mengendalikan konsumsi di ICU.
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References
Anggraini D, et al. Surveilans Resistansi Antibiotik Rumah Sakit Kelas A dan B di Indonesia Tahun 2020. Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia; 2021.
Arulkumaran N, Routledge M, Schlebusch S, Lipman J, Conway Morris A. Antimicrobial-associated harm in critical care: a narrative review. Intensive Care Med. 2020 Feb;46(2):225-235.
Berg G, Rybakova D, Fischer D, Cernava T, Vergès MC, Charles T, et al. Microbiome definition re-visited: old concepts and new challenges. Microbiome. 2020 Jun 30;8(1):103. doi: 10.1186/s40168-020-00875-0. Erratum in: Microbiome. 2020 Aug 20;8(1):119.
Blot S, Ruppé E, Harbarth S, Asehnoune K, Poulakou G, Luyt CE, Rello J, Klompas M, Depuydt P, Eckmann C, Martin-Loeches I, Povoa P, Bouadma L, Timsit JF, Zahar JR. Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive Crit Care Nurs. 2022 Jun;70:103227.
Cao Z, Sugimura N, Burgermeister E, Ebert MP, Zuo T, Lan P. The gut virome: A new microbiome component in health and disease. EBioMedicine. 2022 Jul;81:104113.
Cortegiani A, Antonelli M, Falcone M, Giarratano A, Girardis M, Leone M, Pea F, Stefani S, Viaggi B, Viale P. Rationale and clinical application of antimicrobial stewardship principles in the intensive care unit: a multidisciplinary statement. J Anesth Analg Crit Care. 2023 May 1;3(1):11.
Fabre V, Davis A, Diekema DJ, et al. Principles of diagnostic stewardship: A practical guide from the Society for Healthcare Epidemiology of America Diagnostic Stewardship Task Force. Infection Control & Hospital Epidemiology. 2023;44(2):178-185.
Gajic I, Kabic J, Kekic D, Jovicevic M, Milenkovic M, Mitic Culafic D, Trudic A, Ranin L, Opavski N. Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods. Antibiotics (Basel). 2022 Mar 23;11(4):427.
Hoffmann C, Dollive S, Grunberg S, Chen J, Li H, Wu GD, Lewis JD, Bushman FD. Archaea and fungi of the human gut microbiome: correlations with diet and bacterial residents. PLoS One. 2013 Jun 17;8(6):e66019.
Hou K, Wu ZX, Chen XY, Wang JQ, Zhang D, Xiao C, Zhu D, Koya JB, Wei L, Li J, Chen ZS. Microbiota in health and diseases. Signal Transduct Target Ther. 2022 Apr 23;7(1):135.
Huong VT, Ha N, Huy NT, Horby P, Nghia HD, Thiem VD, Zhu X, Hoa NT, Hien TT, Zamora J, Schultsz C, Wertheim HF, Hirayama K. Epidemiology, clinical manifestations, and outcomes of Streptococcus suis infection in humans. Emerg Infect Dis. 2014 Jul;20(7):1105-14.
Jeffrey M, Denny KJ, Lipman J, Conway Morris A. Differentiating infection, colonisation, and sterile inflammation in critical illness: the emerging role of host-response profiling. Intensive Care Med. 2023 Jul;49(7):760-771.
Kim JY, Whon TW, Lim MY, et al. The human gut archaeome: identification of diverse haloarchaea in Korean subjects. Microbiome. 2020;8:114.
Klinker KP, Hidayat LK, Wenzler E, Balada-Llasat J, Motyl M, DeRyke CA, et al. Use of Novel Antibiograms to Determine the Need for Earlier Susceptibility Testing and Administration for New β-Lactam/β-Lactamase Inhibitors in the United States. Antibiotics. 2022;11(5):660.
Kowalska-Krochmal B, Dudek-Wicher R. The Minimum Inhibitory Concentration of Antibiotics: Methods, Interpretation, Clinical Relevance. Pathogens. 2021 Feb 4;10(2):165.
Kuntaman, et al. Surveilans Resistansi Antibiotik Rumah Sakit di Indonesia Tahun 2021. Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia; 2022. Diakses Januari 03, 2024. https://pamki.or.id/download/buku-surveilans-resistansi-antibiotik-rumah-di-indonesia-tahun-2021/.
Kuntaman, et al. Pola Patogen dan Antibiogram di Indonesia Tahun 2022. Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia; 2023. Diakses Januari 03, 2024. https://pamki.or.id/download/buku-pola-patogen-dan-antibiogram-2022/.
Lloyd-Price J, Abu-Ali G, Huttenhower C. The healthy human microbiome. Genome Med. 2016 Apr 27;8(1):51.
Mokrani D, Chommeloux J, Pineton de Chambrun M, Hékimian G, Luyt CE. Antibiotic stewardship in the ICU: time to shift into overdrive. Ann Intensive Care. 2023 May 6;13(1):39.
Moniz P, Coelho L, Póvoa P. Antimicrobial Stewardship in the Intensive Care Unit: The Role of Biomarkers, Pharmacokinetics, and Pharmacodynamics. Adv Ther. 2021 Jan;38(1):164-179.
Morgan DJ, Malani P, Diekema DJ. Diagnostic Stewardship-Leveraging the Laboratory to Improve Antimicrobial Use. JAMA. 2017;318(7):607–608.
Mulani MS, Kamble EE, Kumkar SN, Tawre MS, Pardesi KR. Emerging Strategies to Combat ESKAPE Pathogens in the Era of Antimicrobial Resistance: A Review. Front Microbiol. 2019 Apr 1;10:539.
Normal Human Microbiota. In: Riedel S, Hobden JA, Miller S, Morse SA, Mietzner TA, Detrick B, Mitchell TG, Sakanari JA, Hotez P, Mejia R. eds. Jawetz, Melnick, & Adelberg's Medical Microbiology, 28e. McGraw Hill; 2019. Accessed January 01, 2024. https://accessmedicine.mhmedical.com/content.aspx?bookid=2629§ionid=217770393.
Normally Sterile Sites: Invasive Bacterial Diseases. Department of Health of Minnesota, Infectious Disease Epidemiology, Prevention and Control Division. Updated October 20, 2022. Accessed January 2, 2024. https://www.health.state.mn.us/diseases/invbacterial/sterile.html.
Princess I, Vadala R. Clinical Microbiology in the Intensive Care Unit: Time for Intensivists to Rejuvenate this Lost Art. Indian J Crit Care Med. 2021 May;25(5):566-574.
Saharman YR, Karuniawati A, Severin JA, Verbrugh HA. Infections and antimicrobial resistance in intensive care units in lower-middle income countries: a scoping review. Antimicrob Resist Infect Control. 2021 Jan 29;10(1):22.
van Samkar A, Brouwer MC, Schultsz C, van der Ende A, van de Beek D. Streptococcus suis Meningitis: A Systematic Review and Meta-analysis. PLoS Negl Trop Dis. 2015 Oct 27;9(10):e0004191.
Tascini C, Sozio E, Viaggi B, Meini S. Reading and understanding an antibiogram. Italian Journal of Medicine. 2016;10:289-300.
The European Committee on Antimicrobial Susceptibility Testing Clinical Breakpoints (v 14.0); 2021. Diakses 14 January 2021. https://www.eucast.org/clinical_breakpoints.
Truong WR, Hidayat L, Bolaris MA, Nguyen L, Yamaki J. The antibiogram: key considerations for its development and utilization. JAC Antimicrob Resist. 2021 May 25;3(2):dlab060.
Ture Z, Güner R, Alp E. Antimicrobial stewardship in the intensive care unit. J Intensive Med. 2022 Nov 15;3(3):244-253.
Umpleby H, Dushianthan A, Catton T, Saeed K. Antimicrobial stewardship programmes focused on de-escalation: a narrative review of efficacy and risks. JECCM. 2022;6:23.
Ursell LK, Clemente JC, Rideout JR, Gevers D, Caporaso JG, Knight R. The interpersonal and intrapersonal diversity of human-associated microbiota in key body sites. J Allergy Clin Immunol. 2012 May;129(5):1204-8.
Ursell LK, Haiser HJ, Van Treuren W, Garg N, Reddivari L, Vanamala J, Dorrestein PC, Turnbaugh PJ, Knight R. The intestinal metabolome: an intersection between microbiota and host. Gastroenterology. 2014 May;146(6):1470-6.
World Health Organization. Diagnostic stewardship: a guide to implementation in antimicrobial resistance surveillance sites; 2016. Diakses 06 Januari 2024. https://www.who.int/glass/resources/publications/diagnostic-stewardship-guide/en/.
Wunderink RG, Srinivasan A, Barie PS, Chastre J, Dela Cruz CS, Douglas IS, et al. Antibiotic Stewardship in the Intensive Care Unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM. Ann Am Thorac Soc. 2020 May;17(5):531-540.
Yao Y, Cai X, Ye Y, Wang F, Chen F, Zheng C. The Role of Microbiota in Infant Health: From Early Life to Adulthood. Front Immunol. 2021 Oct 7;12:708472.
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