Sri Adi Sumiwi

Assessment of Risk Factors of Hepatotoxicity among Tuberculosis Patients

Tuberculosis is a devastating disease caused by Mycobacterium tuberculosis. If left untreated or not properly treated, it could lead to progressive tissue damage and even death. Short-term chemotherapy containing isoniazid, rifampicin. and pyrazinamide were proven to be very effective in the treatment of TB. However, the concern regarding its potential hepatotoxicity might hinder the completion of treatment. Information regarding risk factor of hepatotoxicity among Indonesian tuberculosis patients were limited. This study aimed to investigate risk factors of hepatotoxicity among Indonesian tuberculosis patients. This was a case-control study with retrospective approach conducted at one of the public hospital in Lampung, Indonesia. We included 320 tuberculosis patients who were classified as case (64 patients who were diagnosed with hepatotoxicity during hospitalization) and control (256 patients). Results of multivariate logistic regression analysis showed that age was significant risk factor of hepatotoxicity (adjusted odds ratio (OR) 1.056, 95% CI 1.0121, 1.091), while longer duration of hospitalization had a 1.4 lower odds of hepatotoxicity compared to control (adjusted OR 0.757, 95% CI 0.682, 0.839) (p<0.005). The results indicated that older patients were more likely to have hepatotoxicity, while patients with shorter duration of hospitalization tend to have higher risk of hepatotoxicity. In conclusion, age was the risk factor associated with hepatotoxicity among tuberculosis patients. Keywords: tuberculosis, hepatotoxicity, age, hospitalization

Evaluation of Prescription Pattern for Internal Medicines Outpatients using World Health Organization Indicators

Rational use of drugs plays an important role in efficacy and safety. World Health Organization (WHO) developed a set of indicators to assess medicines precribing pattern. The aim of this study was to evaluate the rational use of drugs among internal medicines outpatients at a hospital in Papua, Indonesia, using WHO prescribing indicators. This study was a retrospective observational study conducted during January-March 2014. The data were obtained from patients medical prescriptions. From each prescriptions, data regarding the the total number of drugs, generic, antibiotics, parenteral, and essential drugs were extracted. A total of 2025 medical precriptions were included in this study. We found out that the average number of drugs per prescription was 2.3. Majority of the prescribed drugs were generic (84.14%). The use of antibiotics, parenteral drugs, and essential drugs were 33.43%, 3.40%, and 60.13%, respectively. Polypharmacy was relatively low among the subjects. The medicines prescribing patterns among internal medicines outpatients were in accordance with WHO recommendation. Keywords: prescribing indicator, polypharmacy, essential drugs