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Majalah Ilmu Kefarmasian

Abstract

The objectives of this study were to know (1) Patients’ characteristics (2) The most etiology of leucorrhoea (3) Association between clinical manifestations or genital symp-toms with etiology of leucorrhoea (4) Therapy management of leucorrhoea by obstet-ric-gynecologist and venereologist (5) Factors influenced the treatment of leucorrhoea (6) Compliance with hospital therapeutic guidelines. The study was cross sectional and retrospective. A total of 437 patients hospitalized from January 2006-December 2007 were included. The results showed that leucorrhoea was found in 17,6% of patients at sexually transmitted disease clinic and 82,4% of patients at obstetric-gynecology clinic. The majority of patients were in productive age, married, and housewife, with most of genital symptoms were pruritus and curd-like vaginal dis-charge. The most of etiology leucorrhoea in this study was candidiasis. Statistically, there were association between genital symptoms with candidiasis and bacterial vaginosis (p<0,05). The specific genital symptoms of candidiasis were pruritus and curd-like vaginal discharge, whereas for bacterial vaginosis were homogeneous and increased vaginal discharge. There were different treatments of vaginal discharge be-tween obstetric-gynecologist and venereologist. For candidiasis, the obstetric-gyne-cologist preferred to use fluconazole, and metronidazole+nystatin (Flagistatin®); whereas the venereologist used clotrimazole and itraconazole. For bacterial vaginosis, obstet-ric-gynecologist used clindamycin and metronidazole+nystatin (Flagistatin®), while venereologist preferred to use metronidazole. For trichomoniasis there was no different treatment between obstetric-gynecologist and venereologist. In pregnancy, antibiot-ics used to treat leucorrhoea were clindamycin, fluconazole, metronidazole+nystatin (Flagistatin®), metronidazole, and nystatin. Prescribing compliance with the hospi-tal therapeutics guidelines were 37,8%. The type of antibiotics used were azitromycin, clindamycin, clotrimazole, doxycycline, fluconazole, itraconazole, ketoconazole, and metronidazole. Statistics analysis by Logistic regression (Cl 95%) showed that factors influenced the treatment of leucorrhoea included genital symptoms (OR = 0,975), risk factors (OR = 0,917), etiology (OR = 1,103), and comorbid diseases (OR = 1,387).

Bahasa Abstract

Tujuan dari penelitian ini adalah untuk mengetahui karakteristik pasien Fluor Albus (FA) yang datang berobat ke RSCM, mengetahui etiologi yang tersering pada FA, mengetahui hubungan manifestasi klinik/keluhan dengan etiologi FA, mengetahui perbedaan pola pengobatan FA oleh dokter dari Departemen Obstetri Ginekologi dan Departemen Ilmu Penyakit Kulit kelamin, mengetahui faktor-faktor yang mempengaruhi pengobatan FA, mengetahui tingkat kesesuaian pengobatan dengan standar terapi yang ada. Penelitian ini menggunakan rancangan studi deskriptif dan analitik dengan pengambilan data secara retrospektif. Hasil menunjukkan bahwa penyakit fluor albus ditemukan pada 17,6% pasien karena tertular melalui hubungan seksual dan 82,4% pasien pada klinik obstetrik-ginekologi. Hasil penelitian didapatkan bahwa penyakit FA banyak terjadi pada penderita kelompok umur reproduktif. Pekerjaan umumnya sebagai ibu rumah tangga (IRT), dengan status marital menikah. Keluhan yang banyak diberikan adalah gatal, duh tidak berbau atau berbau asam, duh berwarna putih kuning dan kental. Penyebab FA terbanyak adalah Kandidiasis vaginalis. Terdapat hubungan bermakna antara keluhan/manifestasi klinik dengan FA. Hubungan bermakna ini terlihat pada FA yang disebabkan oleh kandidiasis vaginalis dan bakteriosis vaginalis. Terdapat perbedaan pola pengobatan FA berdasarkan etiologi (kandidiasis dan bakteriosis) antara dokter dari Departemen Obstetri Ginekologi dan Departemen Ilmu Penyakit Kulit kelamin. Faktor-faktor yang mempengaruhi pola pengobatan FA oleh dokter Departemen Obstetri Ginekologi dan Ilmu Penyakit Kulit kelamin adalah: faktor keluhan, etiologi, faktor risiko, dan penyakit penyerta. Faktor umur, pekerjaan dan status marital secara statistik, tidak memiliki hubungan yang bermakna. Tingkat kesesuaian antara pengobatan dengan standar terapi obat untuk FA di RSCM cukup rendah, dimana sebagian besar pasien diobati secara empiris.

References

1. Peipert JF. 2003. Genital Chlamy- dial Infections. http://www.nejm. com, 19 Juni 2008. 2. Lumintang H. 2007. Infeksi Geni- tal Non Spesifik dalam Buku Infeksi Menular Seksual, Ed. 3. Balai Penerbit FKUI, Jakarta. 3. Daili SF. 2007. Gonore dalam Buku Infeksi Menular Seksual, Ed. 3. Balai Penerbit FKUI, Jakarta. 4. Leitich H, dkk. 2002. Antibiotic treatment of bacterial vaginosis in pregnancy: a meta analysis. Am J Obstet Gynecol. 188(3): 752- 758. 5. Center for Disease Control & Prevention (CDC). 2006. Vaginal Infection, in Sexually Transmitted Disease, Treatment Guideline 2006. MMWR, August 4, 2006/vol 55/ No. RR-11. http://www.cdc. gov, 11 Desember 2007. 6. Sobel JD. 2008. Vulvovaginal Can- didiasis in Sexually Transmitted Disease, 4th ed. McGraw-Hill, New York. 7. Faro S, dkk. 1997. Treatment con- siderations in vulvovaginal can- didiasis. The female patient, vol 22, March 1997. http://www. google.com, 10 Maret 2008. 8. Smith MC and AL Wertheimer. 1996. Social and Behavioral aspect of Pharmaceutical care. Pharma- ceutical Products Press, New York. 9. Soedarmadi. 2007. Kandidosis vul-vovaginal dalam Buku Infeksi Menular Seksual, Ed. 3. Balai Penerbit FKUI, Jakarta. 10. Paavonen JP, dkk. 2000. Vaginal Clindamisin and Oral Metronidazol for Bakterial Vaginosis : A Random- ized Trial. http://www.yahoo. com, 11 Desember 2007. 11. Judanarso J. 2007. Vaginosis Bakterial dalam Buku Ilmu Penyakit Kulit dan Kelamin, Ed.5. Balai Penerbit FKUI, Jakarta. 12. Luthra R. Diagnosis of Vaginitis and Pelvic Inflamation Disease. Women’s Health & Education Center, United States of Ame- rica. 13. Chandeying V, dkk. 1998. Evaluation of two clinical protocol for the management women with vaginal discharge in Southern Thailand. Sex Transm Infect.

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