Epidemiologi OMA

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JURNAL READING Diagnosis, Microbial Epidemiology, andAntibiotic Treatment of Acute Otitis Media in Children A Systematic Review Disusun Oleh: Selvi Sulistia Ningsih (H1A010041) Suluh Bayu Waskito (H1A010027) Pembimbing: dr. Afif Rahmawan, Sp.THT M.Kes

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Epidemiologi OMA

Transcript of Epidemiologi OMA

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JURNAL READING 

Diagnosis, Microbial Epidemiology, andAntibioticTreatment of Acute Otitis Media in Children

A Systematic Review

Disusun Oleh:• Selvi Sulistia Ningsih (H1A010041)• Suluh Bayu Waskito (H1A010027)

Pembimbing:dr. Afif Rahmawan, Sp.THT M.Kes

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PENDAHULUANTahun 2006 pengeluaran sebesar $350 per anak dengan diagnosis OMA

Diagnosis dan manajemen yang tepat memiliki konsekuensi yang signifikan dalam pelayanan kesehatan dan anggaran belanja

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TUJUAN

Untuk melakukan tinjauan sistematis pada diagnosis OMA, pengobatan, dan asosiasi penggunaan vaksin pneumococcal conjugate

heptavalent (PCV7) dengan OMA mikrobiologi.

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METODE• SELEKSI

Data diambil dari

•Pubmed•Cochrane Controlled Clinical Trials Register Database•Review efektivitas Cochrane Database•Web Sains dari artikel yang dipublikasikan Januari 1999 sampai Juli 2010 pada diagnosis OMA•Hasil pengobatan•Asosiasi penggunaan PCV7 dengan perubahan mikrobiologi

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Inklusi•Anak berusia 4 minggu sampai 18 tahun•Studi observasional untuk PCV7 dan pertanyaan diagnostik •OMA mikrobiologi sebelum dan setelah implementasi PCV7

Eksklusi•Anak dengan imunodefisiensi dan anomali kraniofasial•Percobaan terkontrol secara acak (RCT), uji klinis terkontrol, dan studi observasional dimasukkan dalam pencarian awal; laporan kasus, ikhtisar klinis, editorial, dan pedoman praktek•Dokter dalam pelatihan

Kriteria Restriksi

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Data Abstraksi

Dua peneliti (T.R.C. , M.A.L.) ditinjau dari judul independen dan abstrak untuk artikel yang berpotensi dan relevan.

Ketidaksepakatan diselesaikan dengan konsensus, peneliti utama (P.G.S. , G.S.T.) memutuskan jika ada perselisihan.

Penyajian biostatistika data untuk analisis data terkait pengobatan-efek samping

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PENILAIAN KUALITAS•Untuk meninjau kualitas RCT

Kriteria JADAD

•Untuk menilai kualitas sistematis

Kriteria AMSTAR

•Untuk menilai kualitas studi diagnostik

Kriteria QUADAS

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SINTESIS DATA

studi diagnostik dan studi tentang penggunaan PCV7 dan perubahan epidemiologi mikroba OMA Ringkasan data ANALISIS

Studi pengobatan artikel diidentifikasi dianalisis perbandingan berdasarkan jenis antibiotik bukan kelas antibiotik kecuali kelompok amoxsisilin dan ampisilin

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HASIL

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HASIL

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OMA Diagnosis

• gejala infeksi akut

• bukti radang telinga tengah

• adanya efusi dari telinga tengah

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EPIDEMIOLOGI mikrobakteri OMA dan

PCV 7

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Ampisilin atau Amoksisilin vs Placebo

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Antibiotik Segera vs Antibiotik Terlambat2

melaporkan

tingkat

keberhasilan

yang lebih tingg

i deng

an pengobatan

segera

menggunakan Antibiotik

2 tidak menemukan

perbedaannya

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 Efek berbahaya jangka pendek dari terapi Antibiotik

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Efek merugikan dari Pengobatan Antibiotik jangka

panjangTidak satu pun dari studi yang mengevaluasi

tingkat efek samping jangka panjang pengobatan antibiotik, termasuk resistensi

antibiotik

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Perbandingan Efektivitas Antibiotik

Amoxicillin clavulanate lebih unggul dari cefaclor

10 hari amoxicillinclavulanate lebih unggul dari 5 hari azitromisin

5 hari amoksisilin-klavulanat tidak seefektif 7 sampai 10 hari

5 hari ceftibuten tidak seefektif dibanding 10 hari ceftibuten

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Antibiotik Terkait Efek Samping

Efek samping yang sering terjadi pada pengobatan ini adalah DIARE

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KESIMPULAN

Temuan otoskopik sangat

penting untuk diagnosis OMA yang akurat.

OMA mikrobiologi

telah berubah dengan

penggunaan PCV7.

Antibiotik sederhana lebih efektif

daripada tidak ada pengobatan tetapi menyebabkan efek

buruk di 4-10 % dari anak-anak.

Kebanyakan antibiotik memiliki

keberhasilan klinis yang sebanding.

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TERIMAKASIH