Sciences of Pharmacy

Venni Melinda, Yusi Anggriani, Sondang Khairani, Fitri Nurhayati

Platinum-based chemotherapy remains an important treatment option for patients with advanced non-small cell lung cancer (NSCLC), particularly in settings where reimbursement and resource allocation are major considerations. A retrospective observational cost-effectiveness study was conducted using medical records and billing data from adult patients with NSCLC who received carboplatin–paclitaxel, cisplatin–pemetrexed, or carboplatin–gemcitabine in 2023. Effectiveness outcomes included the one-year survival rate (%) and median progression-free survival (PFS). Costs were calculated based on direct medical expenses over six chemotherapy cycles. Cost-effectiveness was assessed using ACER, ICER, and dominance analysis. A total of 101 patients were included: 81 received carboplatin and paclitaxel, 14 received cisplatin and pemetrexed, and 6 received carboplatin and gemcitabine. Mean direct medical costs were IDR 27, 588, 547, IDR 41, 214, 281, and IDR 47, 471, 752, respectively. No statistically significant differences were observed in one-year survival rate or median PFS among the regimens, although interpretation should consider the unequal sample sizes (81 vs. 14 vs. 6), which limit statistical power. Based on one-year survival, carboplatin–paclitaxel had the lowest ACER and dominated the other regimens by providing higher observed survival at lower cost. Based on median PFS, cisplatin–pemetrexed provided longer PFS than carboplatin–paclitaxel but at a higher cost, requiring ICER-based interpretation. Carboplatin–paclitaxel was associated with the lowest direct medical cost and the most favorable cost-effectiveness profile based on one-year survival among the evaluated regimens. However, conclusions should be interpreted cautiously because of the retrospective design, small and unequal group sizes, and potential confounding by baseline clinical characteristics.

Sciences of Pharmacy

ED. Yunisa Mega Pasha, Lutfiani Az-Zahro, Siti Saidah, Mia Nisrina Anbar Fatin

Type 2 diabetes mellitus is a metabolic disease that commonly occurs in geriatric patients and is generally accompanied by comorbidities. This condition can increase medication use and potentially lead to drug interactions that may affect therapeutic effectiveness and cause adverse effects. This study aimed to identify potential antidiabetic drug interactions and analyze the association between length of hospitalization, number of medications used, and potential drug interactions. This was an analytical observational study with a cross-sectional approach and retrospective data collection using a total sampling technique on 41 medical records of geriatric patients with type 2 diabetes mellitus in the inpatient unit from January to December 2024. Potential drug interactions were identified using Medscape and Drugs. com. with severity levels classified as minor, moderate, and major. The results showed 95 potential antidiabetic drug interactions. Moderate interactions were the most common category, accounting for 88 cases (92.6%), while pharmacodynamic interactions were the most dominant mechanism, with 84 cases (88.4%). Of the 41 patients, 73.2% experienced potential drug interactions. Bivariate analysis using Fisher’s exact test showed a significant association between length of hospitalization, number of medications used, and potential drug interactions (p< 0.05). Potential antidiabetic drug interactions in geriatric patients with type 2 diabetes mellitus may be considered in monitoring medication use, especially in patients with polypharmacy and longer hospital stays. However, this study only evaluated potential drug interactions based on a drug interaction database therefore, further studies are needed to assess the clinical manifestations of drug interactions.

Sciences of Pharmacy

Nindita Sari Nastiti, Dayyana Rizkya Hanum, Shelomita Risti Oktavia, Rissa Maharani Dewi

Bronchopneumonia is a respiratory tract infection affecting the bronchi and lungs and remains one of the leading causes of mortality among children worldwide. Antibiotics are the mainstay of therapy; however, their high utilization necessitates evaluation to ensure rational use. At K. R. M. T. Wongsonegoro Hospital, Semarang, bronchopneumonia was the leading infectious disease among pediatric patients in 2023, highlighting the need for a comprehensive assessment of antibiotic prescribing practices. This study aimed to determine the profile of antibiotic use and evaluate both qualitative and quantitative appropriateness of antibiotic therapy among pediatric inpatients with bronchopneumonia. A descriptive, retrospective, cross-sectional study was conducted involving 281 pediatric inpatients aged 0–18 years hospitalized with bronchopneumonia throughout 2023. Qualitative antibiotic appropriateness was evaluated using the Gyssens method, while quantitative utilization was analyzed via the Defined Daily Dose (DDD)/100 inpatient-days system. Ceftriaxone was the predominant therapy, both as monotherapy and in combination with azithromycin. Qualitative analysis revealed notable irrationalities, characterized primarily by incorrect dosing intervals and inappropriate dosages, alongside truncated treatment durations. Quantitatively, ceftriaxone exhibited the highest consumption rate, dominating the Drug Utilization 90% (DU90%) segment. These findings reveal suboptimal antibiotic utilization patterns, underscoring an urgent need for institutional prescription audits and targeted educational interventions to mitigate the risk of localized antimicrobial resistance.

Sciences of Pharmacy

Nurul Kamilah Sadli, Santi Perawati, Vina Neldi, Novia Tri Astuti, Marizki Pondawinata, Syaza Putri Humaira

Digoxin has a narrow therapeutic index, requiring close monitoring to prevent toxicity, particularly in patients with heart failure, polypharmacy, and impaired renal function. Due to limitations in therapeutic drug monitoring (TDM), we estimated digoxin serum levels using pharmacokinetic formulas based on creatinine clearance. This retrospective observational study aimed to conduct an initial risk screening by estimating digoxin concentrations, evaluating drug interactions, and assessing heart rate in 17 heart failure patients at a regional general hospital in Jambi (January–August 2025). Descriptive analysis revealed that 76% of patients were within the therapeutic range, while 24% exceeded it, with elevated levels correlating with higher creatinine serum and lower creatinine clearance. Common drug interactions involved furosemide, bisoprolol, and proton pump inhibitors, with spironolactone posing a severe risk. Clinically, bisoprolol combined with hypokalemia appeared associated with lower heart rates in patients with predicted toxic concentrations. While the formula-based pharmacokinetic approach serves as a useful exploratory initial screening tool, these findings require further validation through laboratory-based TDM and larger studies.

Sciences of Pharmacy

Norhidayah Norhidayah, Safira Maza, Novita Anggraeni, Taufik Qurrahman, Rizki Rahmadi Pratama, Yulistia Budianti Soemarie

Traditionally, menginang (a mixture of betel leaf, areca nut, gambir, and lime) has been used as a natural antibacterial agent. This study aimed to compare the antibacterial activity of single betel leaf extract and menginang extract against four oral pathogenic bacteria in vitro. This study compared the antibacterial activity of traditional menginang extract and single betel leaf extract against multiple oral pathogenic bacteria to evaluate their potential synergistic antibacterial effects. The experimental method used a disk diffusion technique at three concentrations (12.5%, 25%, and 50%), and the data were analyzed using one-way ANOVA and Bonferroni post hoc tests. Chlorhexidine 0.2% was used as the positive control, while distilled water was used as the negative control. The 50% menginang extract showed the strongest antibacterial activity against all tested bacteria, with inhibition zones ranging from 22.76 ± 1.38 mm to 28.22 ± 0.14 mm, and the differences were statistically significant (p < 0.05). The inhibition zones produced by the 50% menginang extract were close to those of 0.2% chlorhexidine. The superiority antibacterial activity of menginang extract may be associated with synergistic interactions among alkaloids, phenolics, flavonoids, tannins, saponins, triterpenoids, and steroids identified during phytochemical screening. The menginang extract has high potential to be developed as an innovative natural product for oral health.

Sciences of Pharmacy

Stefani Alya Swasa Wuryanto, Ida Ayu Manik Damayanti, Putu Indrayoni

Cutibacterium acnes is a cause of acne. Conventional treatments often lead to side effects and bacterial resistance, necessitating natural alternatives. Globe Amaranth (Gomphrena globosa L. ) shows potential as an anti-acne agent. This study employed an in vitro experimental laboratory design to evaluate the anti-acne activity of G. globosa L. flower extract formulated cream against C. acnes using the well diffusion method. Antibacterial activity was tested using KN (base cream), KP (1% clindamycin cream), F1 (10%), F2 (15%), and F3 (20%), and the data were analyzed using SPSS statistical analysis. Results indicated that the ethanolic extract of GA flowers has an IC₅₀ of 85.483 ppm, TPC of 60.456 ± 0.589 mg GAE/g, and TFC of 34.390 ± 0.989 mg QE/g. It exhibited antibacterial activity against C. acnes, with inhibition zone diameters of 6.693 ± 0.2 mm for the 15% formula and 7.382 ± 0.22 mm for the 20% formula. The antibacterial activity is believed to be driven by the presence of secondary metabolites, particularly phenols and flavonoids identified in the extract.

Sciences of Pharmacy