2 research outputs found
OTOTOKSISITAS PADA PASIEN TUBERKULOSIS RESISTEN OBAT: SCOPING REVIEW PADA STUDI DI INDONESIA
No full textA wide variation in ototoxicity or hearing loss due to injectable anti-tubercular drugs in patients with multidrug-resistant tuberculosis (MDR-TB) has been reported globally and in Indonesia. This scoping review assesses the ototoxicity of second-line injectable anti-tubercular drugs in Indonesian patients with MDR-TB. This review was conducted under the recommended PRISMA extension for scoping review (PRISMA-ScR). The Google Scholar and PubMed database were used to search the articles on MDR-TB in the Indonesian population. Seven studies were identified based on the inclusion criteria reporting kanamycin and capreomycin in the management of MDR-TB. Ototoxicity was observed in 39.3% (116/295) MDR-TB patients. Ototoxicity was observed in kanamycin, 38.7% (105/271 patients); capreomycin, 36,8% (7/19 patients); and kanamycin plus capreomycin, 80% (4/5 patients). Only one study reported risk factors ototoxicity in MDR-TB patients. Ototoxicity was significantly associated with older age and the length of kanamycin therapy correlates with hearing loss. This review identified a high prevalence of ototoxicity in Indonesian patients with MDR-TB treated with second-line injectable drugs. Efforts were urgently needed to develop guidelines for monitoring ototoxicity, improving pharmacist and clinician awareness, and educating patients or caregivers to report hearing loss symptoms as a sign of ototoxicity.
Keywords: MDR-TB; Ototoxicity, Second-line injectable
Variasi yang luas dalam ototoksisitas atau gangguan pendengaran akibat obat antituberkulosis injeksi pada pasien dengan multidrug-resistant tuberculosis (MDR-TB) telah dilaporkan secara global dan di Indonesia. Scoping review ini mengulas ototoksisitas obat antituberkulosis injeksi lini kedua pada pasien MDR-TB di Indonesia. Tinjauan ini dilakukan menggunakan PRISMA extension for scoping review (PRISMA-ScR). Database Google Scholar dan PubMed digunakan untuk mencari artikel tentang MDR-TB pada penelitian di Indonesia. Tujuh penelitian diidentifikasi berdasarkan kriteria inklusi yang melaporkan kanamisin dan kapreomisin sebagai tatalaksana MDR-TB. Ototoksisitas ditemukan pada 39,3% (116/295) pasien TB-MDR. Ototoksisitas diamati pada kanamisin, 38,7% (105/271 pasien); kapreomisin, 36,8% (7/19 pasien); dan kanamisin ditambah kapreomisin, 80% (4/5 pasien). Hanya satu penelitian yang melaporkan faktor risiko ototoksisitas pada pasien TB-MDR. Ototoksisitas secara signifikan terkait dengan usia yang lebih tua dan lamanya terapi kanamisin berkorelasi dengan gangguan pendengaran. Review ini mengidentifikasi prevalensi tinggi ototoksisitas pada pasien MDR-TB Indonesia yang diobati dengan obat injeksi lini kedua. Upaya sangat diperlukan untuk mengembangkan pedoman untuk memantau ototoksisitas, meningkatkan kesadaran apoteker dan dokter, dan mendidik pasien untuk melaporkan gejala gangguan pendengaran sebagai tanda ototoksisitas
Evaluation of Patients with COVID-19 Followed Up in Intensive Care Units in the Second Year of the Pandemic: A Multicenter Point Prevalence Study
No full textOBJECTIVE: A 1-day point prevalence study was planned to obtain country data by determining the clinical characteristics, follow-up and treatment methods of coronavirus disease 2019 (COVID-19) cases that required intensive care unit (ICU) treatment in the second year of the pandemic. MATERIAL AND METHODS: All patients who were hospitalized in the ICUs due to COVID-19 between March 11, 2022, 08.00 am, and March 12, 2022, 08.00 am, were included in the study. Demographic characteristics, intensive care and laboratory data, radiological characteristics, and follow-up results of the patients were recorded. RESULTS: A total of 811 patients from 59 centers were included in the study, 59% of the cases were male, and the mean age was 74 ± 14 years. At least one comorbid disease was present in 94% of the cases, and hypertension was the most common. When ICU weight scores were examined, Acute Physiology and Chronic Health Evaluation-II: 19 (15-27) and Sequential Organ Failure Assessment: 7 (4-10) were seen. Sepsis was present in 37% (n = 298) of cases. PaO2 /FiO2 ratios of the patients were 190 the highest and 150 the lowest and 51% of the cases were followed via invasive mechanical ventilation. On the study day, 73% bilateral involvement was seen on chest x-ray, and ground-glass opacities (52%) were the most common on chest tomography. There was growth in culture in 40% (n = 318) of the cases, and the most common growth was in the tracheal aspirate (42%). CONCLUSION: The clinical course of COVID-19 is variable, and ICU follow-up was required due to advanced age, comorbidity, presence of respiratory symptoms, and widespread radiological involvement. The need for respiratory support and the presence of secondary infection are important issues to be considered in the follow-up. Despite the end of the second year of the pandemic and vaccination, the high severity of the disease as well as the need for follow-up in ICUs has shown that COVID-19 is an important health problem. © Author(s)
