Studi Pengaruh Dosis Dan Lama Penggunaan Terapi Aminoglikosida Terhadap Fungsi Ginjal
Abstract
Penelitian ini bertujuan untuk menganalisa pengaruh penggunaan aminoglikosida, yaitu streptomisin, gentamisin, dan kanamisin, terhadap fungsi ginjal pasien rawat inap di RSUP Dr. Wahidin Sudirohusodo Makassar dengan melihat parameter fungsi ginjal yaitu kadar kreatinin dan ureum serum pasien. Metode untuk penelitian ini adalah penelitian observasional non eksperimen dengan rancangan deskriptif-analitik. Pengambilan sampel dilakukan secara retrospektif, dan didapatkan 32 orang sampel yang memenuhi kriteria inklusi.
Berdasarkan uji statistik One Way ANOVA kadar kreatinin dan ureum dari ketiga kelompok obat tersebut tidak menunjukkan perbedaan yang signifikan nilai (Ur, p=0.133 > 0,05; Cr, p=0.246 > 0,05). Dalam penelitian ini terlihat bahwa pada dosis penggunaan sekali sehari pada streptomisin dan kanamisin tidak terjadi peningkatan kadar kreatinin pasien, sedangkan pada kelompok pasien gentamisin yang diterapi dengan dosis terbagi (tiap 12 jam) terjadi peningkatan kadar kreatinin. Untuk lama penggunaan terapi, pada streptomisin hanya kelompok streptomisin kategori D (penggunaan terapi >31 hari) dan semua kelompok terapi gentamisin yang menunjukkan peningkatan kreatinin. Hal ini tampaknya diakibatkan oleh sifat nefrotoksik dari aminoglikosida meningkat seiring dengan lama terapi dan penggunaan dosis terbagi. Selain itu gentamisin juga merupakan jenis aminoglikosida yang lebih toksik dibandingkan dengan streptomisin dan kanamisin karena memiliki sifat kationik yang lebih tinggi.
Kata kunci : Aminoglikosida, streptomisin, gentamisin, kanamisin, kadar kreatinin, kadar ureum, fungsi ginjal.
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