Farmakoepidemiologi Penggunaan Proton Pump Inhibitor sebagai Profilaksis Stress Ulcer pada Pasien Bedah Digestif RSUD KHZ Musthafa
Keywords:
bedah digestif, pantoprazole,, PPI, stress ulcer prophylaxisAbstract
Penggunaan Proton Pump Inhibitor (PPI) sebagai profilaksis stress ulcer perlu dievaluasi untuk meng-gambarkan praktik penggunaannya pada pasien bedah digestif. Penelitian ini bertujuan menggam-barkan karakteristik pasien dan pola penggunaan PPI di RSUD KHZ Musthafa. Penelitian menggunakan desain observasional deskriptif retrospektif terhadap rekam medis periode Januari 2024–Desember 2025. Sebanyak 41 rekam medis yang memenuhi kriteria dianalisis secara deskriptif meliputi jenis kelamin, usia, diagnosis, jenis tindakan, lama rawat, jenis PPI, dosis, frekuensi, rute, dan lama pemberian. Pasien perempuan berjumlah 22 orang (53,7%), kelompok usia terbanyak 18–29 ta-hun (53,7%), diagnosis terbanyak apendisitis (75,6%), dan tindakan terbanyak emergensi (90,2%). Re-rata lama rawat adalah 4,7 ± 1,6 hari. Seluruh pasien menerima pantoprazole intravena 40 mg satu kali sehari dengan lama pemberian 1–7 hari dan rerata 2,1 ± 1,4 hari. Regimen tersebut sesuai dengan kategori PPI dosis rendah dalam pedoman SCCM–ASHP 2024 dari aspek dosis dan frekuensi. Ketepatan indikasi, rute, dan durasi belum dapat dinilai karena data faktor risiko klinis tidak terdoku-mentasi secara sistematis.
References
Achmad, R. et al. 2022. The Relationship Between Age , Gender And The Incidence Of Acute Appendicitis In Naval Hospital dr . Oetojo Sorong Period January 2021, 13(02), 1013–1017.
Ann, K. G. et al. 2018. Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs : risks versus benefits, 361–374.
Awaluddin 2020 Faktor Risiko Terjadinya Apendisitis pada Penderita Apendisitis di RSUD Batara Guru Belopa Kabupaten Luwu Tahun 2020, 67–72.
Barletta, J. F. et al. 2016. Stress ulcer prophylaxis, Critical Care Medicine, 44(7), 1395–1405.
Bhangu, A. et al. 2015. Acute appendicitis: Modern understanding of pathogenesis, diagnosis, and management, The Lancet, 386(1000), 1278–1287.
Billah, T. H., Alifiar, I. and Salasanti, C. D. 2024. Evaluasi Penggunaan Antibiotik Profilaksis Pada Pasien Bedah, 2(1).
Cook, D. J. and Guyatt, G. H. 2018. Prophylaxis against upper gastrointestinal bleeding in hospitalized patients’, New England Journal of Medicine, 378(26), 2506–2516
Dinata, F. S., Anik, I. and Sapti, A. 2024 Penerapan Mobilisasi Dini terhadap Skala Nyeri Pasien Post Operasi Apendiktomi di Ruang Bedah Umum RSUD Jend. Ahmad Yani Metro, 4, 1–87.
Elamin, M. M. et al. 2025. Insights into stress ulcer prophylaxis among non-critically ill patients : a tertiary hospital perspective from Sudan, 1–7.
Eom, C. S. et al. 2011. Use of acid-suppressive drugs and risk of pneumonia: A systematic review and meta-analysis, Canadian Medical Association Journal, 183(7), 310–319.
Ferris, M. et al. 2017. The global incidence of appendicitis: A systematic review of population-based studies, Annals of Surgery, 266(2), 237–241
Freedberg, D. E., Kim, L. S. and Yang, Y. X. 2017. The risks and benefits of long-term use of proton pump inhibitors: Expert review and best practice advice from the American Gastroenterological Association, Gastroenterology, 152(4), 706–715
Heidelbaugh, J. J., Goldberg, K. L. and Inadomi, J. M. 201.0 Overutilization of proton pump inhibitors: A review of cost-effectiveness and risk in PPI therapy, American Journal of Gastroenterology, 105(Suppl. 2), S27–S32.
Kasim, N. A., Harahap, H. and Prihantono, P. 2018. Factors related with length of stay ( LOS ) on digestive surgical patient in Dr . Wahidin Sudirohusodo hospital , Makassar , Indonesia’, 6(8), 2587–2591.
Krag, M., Perner, A. and Møller, M. H. 2014. Stress ulcer prophylaxis in the intensive care unit, Current Opinion in Critical Care, 20(2), 186–190.
Laine, L. et al. 2021 ‘Trends for incidence of hospitalization and death due to gastrointestinal bleeding in the United States from 2001 to 2018, The American Journal of Gastroenterology, 116(5), 899–906.
Li, H. et al. 2022 Appropriateness and Associated Factors of Stress Ulcer Prophylaxis for Surgical Inpatients of Orthopedics Department in a Tertiary Hospital : A Cross-Sectional Study, 13(June), 1–13.
MacLaren, R. et al. 2024 Society of Critical Care Medicine and American Society of Health-System Pharmacists guideline for the prevention of stress-related upper gastrointestinal bleeding in critically ill adults’, Critical Care Medicine, 52(9), e395–e414.
Octavia, M., Nurul, M. and Rima, N. F. 2024. Appropriateness and Cost of Prophylaxis Stress Ulcer for Inpatient in the Internal Medicine Department in a Government Hospital : A Cross- Sectional Study’, 7(1).
Rauch, S. et al. 2021. Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital, European Journal of Clinical Pharmacology, 77(8), 1171–1179.
Rensburg, C. J. Van and Susan, C. 2012 Pantoprazole for the Treatment of Peptic Ulcer Bleeding and Prevention of Rebleeding, 51–60.
Rosdiana, N., Ahmad, R. and Lannasari 2024. Hubungan Keterlambatan Waktu Mulai Operasi Elektif terhadap Kecemasan Pasien Pra Operasi di Kamar Operasi RS Islam Bogor, 03(06), 257–263.
Setyani, E. T. A., Asri, W. M. and Ira, P. 2024. Proton Pump Inhibitor Sebagai Profilaksis Stress Ulcer Pada Pasien Bedah Digestif Di RSUD R . T . Notopuro, 5, 12179–12184.
Shin, J. M. and Kim, N. 2013. Pharmacokinetics and Pharmacodynamics of the Proton Pump Inhibitors, 19(1), 25–35.
Strom, B. L., Kimmel, S. E. and Hennessy, S. 2019 Textbook of pharmacoepidemiology. 3rd edn. Wiley-Blackwell.
Wettermark, B. et al. 2016 Drug utilization research: Methods and applications. Introducti. Edited by M. Elseviers. Wiley-Blackwell.
World Health Organization. 2003 Introduction to drug utilization research. World Health Organization.
Zhao, J. L. et al. 2024 An updated review and a case report: Stress ulcer prophylaxis and its clinical implications. Cureus, 16(5), e62034.
