PENGARUH PENAMBAHAN PROBIOTIK TERHADAP EFEK ANTIMIKROBA TERAPI VAGINOSIS BAKTERIAL DENGAN METRONIDAZOLE TABLET (Studi Probiotik L. rhamnosus 2.5 x 109 CFU, L. reuteri 2.5 x 109 CFU pada wanita yang tidak hamil di RSIA Kendangsari Surabaya)
Abstract
ABSTRAK Vaginosis Bakterial (VB) adalah suatu kondisi perubahan ekologi vagina yang ditandai dengan pergeseran keseimbangan flora vagina yaitu dominasi Lactobacillus digantikan oleh bakteri anaerob. Penelitian ini menggunakan metode Kuasi Eksperimental Non Equivalent Control Group Design untuk mengetahui pengaruh penambahan probiotik oral terhadap efek antimikroba metronidazole pada terapi Vaginosis Bakterial (VB) pada pasien yang tidak hamil di Surabaya. Penelitian dilakukan di RSIA Kendangsari Surabaya. Outcome yang diukur adalah penilaian kriteria BV menurut kriteria Amsel, Skor Nugent, dan kondisi klinis vagina pasien. Terdapat pengaruh yang tidak signifikan (p>0,05) penambahan probiotik tehadap efek antimikroba metronidazole terapi Vaginosis Bakterial (VB) menurut kriteria Amsel dan kondisi klinis vagina antara kelompok Probiotik dan Metronidazole maupun dengan Metronidazole. Penelitian ini menunjukkan bahwa penambahan probiotik terhadap efek antimikroba metronidazole terapi BV pada pasien yang tidak hamil, berdasarkan hasil Skor Nugent berpengaruh secara signifikan (p<0,05) karena Skor Nugent merupakan gold standard pada pemeriksaan Vaginosis Bakterial (VB).
Kata Kunci: Pengaruh, Vaginosis Bakterial, Metronidazole, Probiotik
ABSTRACT Bacterial Vaginosis (BV) is a condition ecological vagina changing that indicated by flora vagina shifting balance, dominated by Lactobacillus replaced by anaerobe bacterials. This research using Quasy Experimental Non Equivalent Control Group Design method to indicate probiotic addition to antimicrobial metronidazole effect in Bacterial vaginosis therapy (BV) for impregnant woman in Surabaya. Bacterial vaginosis therapy (BV) Metronidazole tablet and Probiotic oral. The research has been doing in RSIA Kendangsari Surabaya. Measured Outcome is using BV measurement criteria according to Amsel criteria, Nugents Score, and patient’s vagina clinical condition. There are insignificantly effects (p>0,05) probiotic addition to antimicrobial metronidazole Bacterial vaginosis effect (BV) therapy according to Amsel criteria and vagina clinical condition between Probiotic group, Metronidazole, as well as Metronidazole. This research indicates probiotic antimicrobial metronidazole BV therapy effect addition to impregnant patient, according to Nugent Score significantly affected (p<0,05) because Nugent Score is the gold standard to Bacterial vaginosis (BV) checking.
Keywords: Impact, Bacterial Vaginosis, Metronidazole, Probiotic
Downloads
References
2. Kohl KS, Markowitz LE, Koumans EH. Developments in the screening for Chlamydia trachomatis: a review. Obstetrics & Gynecology Clinics of North America.2003. halaman 637-58
3. British Association for Sexual Health and HIV Clinical Effectiveness Group. National Guideline for the Management of Bacterial Vaginosis. 2006. http://www.bashh.org/documents/62/62.pdf diunduh tanggal 5 Januari 2016.
4. Koumans EH, Markowitz LE, Hogan V. Indications for therapy and treatment recommendations for bacterial vaginosis in nonpregnant and pregnant women: a synthesis of data.Clin Infect Dis. Oktober 2002
5. Goldin,B.R., danGorbach S.L. Clinical Indications for Probiotics: An Overview Clinical Infectious Diseases. 2008; 96-100.
6. Reid G. Probiotics to prevent the need for, and augment the use of, antibiotics. The Canadian Journal of Infectious Diseases & Medical Microbiology. 2006; halaman :291-292.
7. Amsel R, Totten P A, Spiegel C A, Chen K, Eschenbach D A, Holmes K K. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1994; halaman 14-22.
8. Nugent R P, Krohn M A, Hillier S L. Reliability of diagnosing bacterial vaginosis is improvedby a standardized method of gram stain interpretation. J ClinMicrobiol. 1991.29:297-301.
9. Spiegel C A, Amsel R, Holmes K K. Diagnosis of bacterial vaginosis by direct gram stain ofvaginal fluid. J ClinMicrobiol.198318:170-177.
10. Colli E, Landoni M., Parazzini F. Treatment of male partners and recurrence of bacterial vaginosis: a randomised trial. Genitourin Med
1997; 73: 267–270.
11. Bradshaw CS, Morton AN, Hocking J, Garland SM, Morris MB, Moss LM, et al. High recurrence rates of bacterial vaginosis over the course of
12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis.2006; 193: 1479–1486.
12. Senok AC, Verstaelen H, Temmerman M, Botta GA. Probiotics for the treatment of bacterial vaginosis. Cochrane Database Syst Rev.2009
13. Larrsons, P.G. et al. Bacterial vaginosis: a disturbed bacterial flora and treatment enigma. APMIS: Acta Pathologica Microbiologica et Immunologica Scandinavica, Copenhagen, v.2005; 305-316.
14. Siswandono dan B Soekardjo. Kimia Medisinal, edisi 2. Airlangga University Press. 2000; Surabaya.
15. Katzung, B.G. Farmakologi Dasar dan Klinik. Terjemahan: Petrus Andrianto. Edisi III. Jakarta: PenerbitBukuKedokteran EGC. 1989; Halaman 771.
16. Anukam K, Osazuwa E, Ahonkhai I, Ngwu M, Osemene G, Bruce AW, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes and Infection. 2006;8[6]:1450-4.
17. Aziz Alimul Hidayat. Metode Penelitian Kesehatan. Paradigma Kuantitatif. CetakanPertama. Surabaya. 2011.
18. Sobel J, Chaim W. Vaginal microbiology of women with acute recurrent vulvovaginal candidiasis. J ClinMicrobiol. 1996; 34 : 2497–9
19. Reid G, Beuerman D, Heinemann C, Bruce AW. Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunology and Medical Microbiology. 2001.
20. Alvarez-Olmos MI, Barousse MM, Rajan L, Van Der Pol BJ, Fortenberry D, Orr D, et al. Vaginal lactobacilli in adolescents: presence and relationship to local and systemic immunity, and to bacterial vaginosis. Sexually Transmited Diseases. 2004
21. Endang SL, Juliette AS. Antimicrobial Resistance in Indonesia: Prevalence, Determinants and Genetic Basis; 2009
22. Pedoman Pelayanan Kefarmasian Untuk Terapi Antibiotik. Kementrian Kesehatan Republik Indonesia. 2011
23. Carl Erik Nord. The Infectious Diseases Society of America. Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. 2009.
24. Thomason JL. Gelbart SM, Anderson RJ, Wait AK, Osypowski PJ, Broekhuizen FF. Statistivalevaluation of diagnosis critrtia for bacterial vaginosis Am J Obstet Gynecol. 1990;162:155-60
25. Holmes KK, Sparling PF, Stamm WE, et. al., editors. Sexually Transmitted Diseases. 4th ed. New York: Mc Graw-Hill. 2008.
26. Morb Mortal Wkly Rep; 2010; p.56-8. diakses: www.cdc.gov/std/treatment/2010/stdtreatment-2010-rr5912.pdf tanggal 10 Jnauari 20167.
27. Murtiastutik,Dwi. Buku Ajar Infeksi Menular Seksual. Surabaya : FK Unair. 2008.
28. Rauh VA, Culhane JF, Hogan VK. Bacterial vaginosis: a public health problem for women. JAMWA2000; 5:220-4.
29. Center for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. MMWR Morb Mortal Wkly Rep; 2010; p.56-8. Available from: www.cdc.gov/std/treatment/2010/stdtreatment 2010-rr5912.pdf diakses tanggal 2 Januari 2017.
30. Agarwal, K., Sharma, U. and Acharya, V. (2004) Microbial and Cytopathological Study of Intrauterine Contraceptive Device Users. Indian Journal of Medical Sciences, 58, 394-399.
31. Ferraz do Lago, R., Simões, J.A., Bahamondes, L., Camargo, R.P., Perrotti, M. and Monterio, I. (2003) Follow-Up of Users of Intrauterine Device with and without Bacterial Vaginosis and Other Cervicovaginal Infections Contraception, 68, 105-109. http://dx.doi.org/10.1016/S0010-7824(03)00109-4
32. Avonts D, Sercu M, Heyerick P, Vandermeeren I, Meheus A, Piot P. (1990) Incidence of uncomplicated genital infections in women using oral contraception or an intrauterine device: a prospective study. Sex Transm Dis. Jan–Mar;17(1):23–29
33. Bradshaw CS, Morton AN, Hocking J, Garland SM, Morris MB, et al. (2006) High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. Journal of Infectious Diseases 193: 1478–1489.
34. Joan M. Mastrobattista, Mark A. Klebanoff, J. Christopher Carey , John C. Hauth , Cora A. Mac Pherson, et al (2008) The Effect of Body Mass Index on Therapeutic Response to Bacterial Vaginosis in Pregnancy.
35.Huang H, Song L, Zhao W. Effects of probiotics for the treatment of bacterial vaginosis in adult women: a meta-analysis of randomized clinical trials. Arch Gynecol Obstet. 2013
36. Ya W, Reifer C, Miller LE. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebocontrolled study. Am J Obstet Gynecol. 2010
- Articles published in CALYPTRA are licensed under a Creative Commons Attribution-ShareAlike 4.0 International license. You are free to copy, transform, or redistribute articles for any lawful purpose in any medium, provided you give appropriate credit to the original author(s) and the journal, link to the license, indicate if changes were made, and redistribute any derivative work under the same license.
- Copyright on articles is retained by the respective author(s), without restrictions. A non-exclusive license is granted to CALYPTRA to publish the article and identify itself as its original publisher, along with the commercial right to include the article in a hardcopy issue for sale to libraries and individuals.
- By publishing in CALYPTRA, authors grant any third party the right to use their article to the extent provided by the Creative Commons Attribution-ShareAlike 4.0 International license.