Robert Sinto
Birth place, date : Jakarta, 21 Juni
E-mail : [email protected]
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