Tingkat kematian akibat resistensi terhitung cukup tinggi dan hal ini disebabkan tingginya angka ketidaktepatan dalam terapi antibiotik. Penelitian Antimicrobial Resistance in Indonesia (AMRIN) menunjukkan 42% penggunaan antibiotik terindikasi tidak tepat pada pasien bedah. Penggunaan antibiotik secara bijak merupakan solusi atas masalah resistensi antibiotik. World Health Organization (WHO) dan Kementerian Kesehatan Republik Indonesia merekomendasikan penggunaan metode Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) untuk menilai kuantitas penggunaan antibiotik. Penelitian ini bertujuan untuk mengetahui nilai DDD dan Drug Utilization (DU) 90% dari antibiotik. Penelitian ini merupakan penelitian cross-sectional dengan pengambilan data secara retrospektif yang dilakukan pada November 2016-April 2017 di Rumah Sakit Universitas Airlangga dan data dianalisis menggunakan metode DDD dan DU 90%. Sampel diambil dengan cara total sampling. Sebanyak 463 pasien menjadi sampel pada penelitian ini, dengan 381 pasien mendapatkan antibiotik profilaksis dan 82 pasien mendapatkan antibiotik terapi. Sefazolin merupakan antibiotik profilaksis yang memiliki DDD tertinggi yaitu 69,08/100 operasi dengan lama pemberian sebagian besar dihentikan dalam waktu kurang dari 24 jam post-operasi (82,41%). Antibiotik profilaksis yang masuk segmen DU 90% adalah sefazolin dan seftriakson. Antibiotik terapi yang memiliki DDD tertinggi adalah seftriakson dengan 52,62/100 patient-days dan antibiotik yang masuk segmen DU 90% adalah seftriakson, metronidazol, sefazolin dan meropenem.

Background Selective serotonin reuptake inhibitors (SSRIs) have recently become potential candidates for a new therapeutic approach to ulcer and gastric bleeding. Heat shock protein 70 (Hsp70) plays an important role in cellular resistance to nonsteroidal anti-inflammatory drugs (NSAIDs). However, there is lack of evidence that fluvoxamine recruits Hsp70 to affect stress-induced gastric ulcer. Therefore, we investigated the effect of fluvoxamine on NSAID- and stress-induced gastric ulcer and the possible involvement of Hsp70. Methods ICR mice were used in the study. Stress induction was made by the water-immersion-plus-restraint method. NSAID-induced gastric ulcer was produced by oral administration of indomethacin. Fluvoxamine was given orally 30 min before stress induction and indomethacin treatment. Results Stress and indomethacin treatment significantly increased the ulcer index and intraluminal bleeding score. Stress and indomethacin treatment also significantly increased the expression of Hsp70. Fluvoxamine significantly decreased the ulcer index and intraluminal bleeding in both ulcer models. Moreover, fluvoxamine further increased the expression of Hsp70 in the gastric tissue of stress- and indomethacin-treated mice. Conclusions Our results indicate that fluvoxamine may have a protective effect against stress- as well as NSAID-induced gastric ulcer. In addition, the present study suggests the possible involvement of Hsp70 in the amelioration of gastric ulcer by fluvoxamine.

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Hydroxyapatite (HA) is a biomaterial widely used to treat bone defect, such as due to traffic accident. The HA scaffold is obtained from synthetic HA or natural sources, such as bovine hydroxyapatite (BHA). This study aims to compare the characteristics and in vivo performance of BHA-based and HA-based scaffolds. For this purpose, the scaffold was formulated with gelatin (GEL) and characterised by SEM-EDX, FTIR and mini autograph. The defect model was carried out on the femur area of Wistar rats classified into three animal groups: defect, HA-GEL and BHA-GEL. Postoperatively (7, 14 and 28 days), the bone was radiologically evaluated, and stained with haematoxylin–eosin, anti-CD80 and anti-CD163. The BHA-GEL scaffold showed a regular surface and spherical particle shape, whereas the HA-GEL scaffold exhibited irregular surface. The BHA-GEL scaffold had higher pore size and compressive strength and lower calcium-to-phosphorus ratio than the HA-GEL scaffold. In vivo study showed that the expression of CD80 in the three experimental groups was not significantly different. However, the expression of CD163 differed significantly between the groups. The BHA-GEL group showed robust expression of CD163 on day 7, which rapidly decreased over time. It also showed increased osteoclasts, osteoblasts and osteocytes cell count that contributed to the integrity of the defect area. In conclusion, the BHA-based scaffold exhibited the desired physical and chemical characteristics that benefit in vivo performance versus the HA-based scaffold. Thus, the BHA-based scaffold may be used as a bone graft.

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