Robert Sinto

Birth place, date : Jakarta, 21 Juni

E-mail : rsinto@yahoo.com

Formal education2006 : Bachelor of Medicine, Universitas Indonesia, Jakarta2008 : Medical Doctor, Universitas Indonesia, Jakarta2014 : Internal Medicine Specialist, Universitas Indonesia, Jakarta2016-now : Tropical and Infectious Diseases Consultant, Universitas Indonesia, Jakarta

Informal education2015 : Clinical training on Transplant-Oncology-Immunocompromised Host

Infectious Diseases, Singapore General Hospital, Singapore2016 : Transplant Infectious Diseases Course, The Transplant Society, HongKong2017 : Singapore Antimicrobial Stewardship Training Course, Institute of Infectious

Diseases and Epidemiology

Workplace2016-now : Medical staff, Division of Tropical and Infectious Diseases

Department of Internal Medicine, FM Universitas Indonesia-RSCM

Robert SintoDivision of Tropical and Infectious Diseases, Department of Internal Medicine

Faculty of Medicine Universitas Indonesia, RS Cipto Mangunkusumo

Rumah Sakit Pelni

Rumah Sakit Pantai Indah Kapuk

2017

Clinical Approach on Infectious Diseases

Management: Rational Antibiotic Usage

UN meeting on antibiotic resistance. 2016.

Trends of antibiotic use and carbapenem

resistance in Enterobacteriaceae

Plüss-Suard C et al. Antimicrob Agents Chemother 2013;57:1709-13.

Post-Antibiotic Era

Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill…

Dr. Keiji FukudaWHO Assistant Director General for Health Security, 2014

Balancing the Needs of the Patient and Society

Source: Richards GA. Clin Microbiol Infect. 2005;11(suppl 6):18-22.

Indiscriminate Use of Broad-Spectrum

Antibiotics DrivingResistance

Inadequate Antibiotic Therapy Associated with Higher Mortality

Serious infection suspected

Begin empirical antibacterial treatment targeting the most common pathogen based on local data

De-escalating antibacterial based on results of clinical microbiology data

Significant clinical improvement after 48-96 hours

Discontinue antibacterial after 7-14 days course basedon site of infection and clinical response

Obtain appropriate microbial sample for culture and special stain

Follow up: temp, WBC, CXR, PaO2/FiO2, haemodynamic, organ function

Search for superinfection,

abscess formation, non-

infectious caused of fever

Kollef, Drugs 2003;63 (20): 2157

Yes

No

De-escalation Approach to Antimicrobial Utilization