BISMILLAH LOLOS UKAI 2022 !!!!!!

RANGKUMAN JOS GANDOS O A O EEEE

FARMAKOTERAPI/KLINIK

PENYAKIT INFEKSI
RESPIRATORY TRACT INFECTIONS, UPPER
 OTITIS MEDIA AKUT
Definition: AOM is an inflammation of the middle ear that is most common in children
and infants
Patogens: Streptococcus pneumonia, Haemophillus influenza, Moraxella catarallis
Treatment:
 Pain of AOM should be addressed with oral analgesics. Acetaminophen or a
NSAID agent such as ibuprofen should be offered early to relieve pain of AOM
 Children 6 months to 12 years of age with moderate to severe ear pain or
temperature of 39 degree C or higher should receive antibotics
 Children 6 to 23 months of age with nonsevere bilateral AOM should also
received antibiotics
 Children 6 to 23 months of age with nonsevere unilateral AOM and 2-12 years
nonsevere AOM should receive initial antibiotics or initial observation.
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 Diagnosis awal: High dose amoxicillin (80-90 mg/kg/day in 2 divided dose)
Note: Children A who have received amoxicillin in last 30 days, have concurrent
purulent conjunctivitis, or have recurrent infection unresponsive to amoxicillin
should receive high dose amoxicilline-clavulanate (90 ; 6,4 mg/kg/day in 2 divide
dose)
Initial Therapy Failure at 48-72 hours
First line High dose Amoxicillin High dose Amoxicillin-
clavulanate
First line if have certain High dose Amoxicillin- Ceftriakson (1-3 days)
condition A clavulanate
Second line or Ceftriakson (1-3 days), Clindamysin
nonsevere penicillin cefdinir, cefuroxime,
alergy cefpodoksim

 Prevention for recurrent otitis media: tympanostomy tube (T-tube)

 Monitoring of AOM: after 48-72 hours. Being asymptomatic in days 7

 FARINGITIS
 Definition: an acute infection of oropharynx or nasopharynx that results in 1% to
2% of all outpatient visits
 Signs and symptoms:
Umum:
-Sakit tenggorokan yang tiba-tiba timbul dan sebagian besar sembuh sendiri
-Demam dan gejala konstitusional yang sembuh dalam waktu sekitar 3-5 hari
-Tanda dan gejala klinis serupa untuk penyebab virus dan bakteri nonstreptokokus

Tanda:
-Demam
-Eritema/radang tonsil dan faring dengan atau tanpa eksudat
-pembesaran kelenjar getah bening lunak
-pembengkakan dan kemerahan pada uvula, petekie (bintik2 kecil merah/ungu) pada
soft palate, ruam scarlatiniform

Gejala:
-sakit tenggorokan
-sakit saat menelan
-sakit kepala, mual, muntah, nyeri perut (terutama pada anak-anak)

 Treatment
Pain: PCT or NSAID
Manajemen terapi:
1. Tanda dan gejalanya konsisten apa enggak
If no: atasi gejala simptomatiknya aja (pake analgesik, antipiretik, lozenges, dll)
If yes: lakukan tes laboratorium Rapid Antigen Detection
If positive: kasih antibiotic
If negative: dewasa  atasi gejala simtomatik aja
Anak-anak <18 tahun  cek kultur tenggorokan
-negative: atasi gejala simptomatik
-positive: kasih antibiotic

THE ANTIBIOTICS
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
RESPIRATORY TRACT INFECTIONS, LOWER
 PNEUMONIA
  The patogens:
CAP: S. pneumonie, H. influenza, M. pneumoniae, Legionella, Chlamydopila
pneumonia
HAP: Gram-negative aerobic bacilli, Staphylococcus aureus, MDR

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