DAYA GUNA SINBIOTIK DALAM TATA LAKSANA DIARE AKUT ROTAVIRUS PADA ANAK

Made Ratna Dewi, Prof. dr. Srisuparyati Soenarto, Ph.D, Sp.A(K)

2013 | Tesis | S2 Ked.Klinik/MS-PPDS

Diare merupakan salah satu penyebab utama kesakitan dan kematian pada anak di dunia, dimana rotavirus merupakan penyebab utamanya. Tata laksana diare akut saat ini adalah lima lintas diare. Terapi tambahan sinbiotik dikatakan dapat memperpendek lama diare. Tujuan penelitian ini adalah membandingkan lama diare akut rotavirus antara kelompok sinbiotik dan plasebo. Penelitian ini merupakan penelitian uji klinis acak terkontrol dan pembutaan ganda pada anak umur ≥6 bulan- ≤59 bulan dengan diare akut rotavirus di Divisi Gastrohepatologi Bagian/SMF Ilmu Kesehatan Anak RSUP Sanglah Denpasar. Rotavirus dideteksi dengan immunochromatography assay. Analisis kesintasan Kaplan-Meier digunakan untuk melihat pengaruh perlakuan terhadap lama diare. Analisis kovarian (general linear model) digunakan untuk menentukan faktor-faktor lain yang berpengaruh terhadap lama diare disamping perlakuan yang diberikan. Tingkat kemaknaan adalah 0,05. Pada penelitian ini didapatkan median lama diare pada kelompok sinbiotik yaitu 50,0 jam (SE 1,1) (IK 95% 47,9 sampai 52,1) dan kelompok plasebo 63,0 jam (SE 5,9) (IK 95% 51,4 sampai 74,6). Berdasarkan kesintasan Kaplan Meier, lama diare pada kelompok sinbiotik lebih pendek daripada plasebo (log-rank test P<0,0001). Berdasarkan analisis kovarian (general regresi linear) terbukti bahwa perlakuan mempunyai pengaruh yang kuat terhadap lama diare.

Diarrhea is one of major causes of morbidity and mortality in children throughout the world and rotavirus is the main cause. Management of acute diarrhea that is use in daily practice currently is the WHO five steps diarrhea management. Synbiotic therapy is reckon to shorten the duration of diarrhea. Aim of this study was to compare the duration of acute rotavirus diarrhea between synbiotic compared to placebo group. This study was a double blind randomized controlled trials in children aged ≥6 months-≤59 months infected with rotavirus in Pediatric Gastrohepatology Division in Denpasar. Rotavirus was detected through immunochromatography assay. Kaplan-Meier survival analysis was used to predict the effect on the duration of diarrhea. Analysis of covariance (general linear model) was used to determine other factors that affect the duration of diarrhea in addition to the treatment given. Significance level was 0.05. The median duration of diarrhea among the synbiotic group was 50.0 hours (SE 1.1) (95% CI 47.9 to 52.1) and the placebo group was 63.0 (SE 5.9) (CI 95% 51.4 to 74.6). Based on Kaplan-Meier survival rate, duration of diarrhea among the synbiotic group was shorter than placebo group (log-rank test P <0.0001). Based on the analysis of covariance (general linear regression) proved that the treatment had a strong influence on the duration of diarrhea.

Kata Kunci : diare akut rotavirus, sinbiotik, RCT