Daftar Pemantauan Pemberian Anti Biotika Injeksi di Rawat Inap (A

Tanggal Lantai Nama Pasien No. RM Nama Obat

Julyanti Siregar SE 077096 Inj Ceftriaxone 2g/24jam
Ayu Juliana 077082 Inj Ceftriaxone 2g/24jam
Suwaji 077131 Inj Ceftriaxone 2g/24jam
Syamsul Arbi 045047 Inj Ceftriaxone 2g/24jam
Surya Andika Srg 077189 Inj Ceftriaxone 2g/24jam
5B Supiyanti 050134 Inj Ceftriaxone 2g/24jam
Nadihulwana 077191 Inj Ceftriaxone 2g/24jam
Siti Rohani 077196 Inj Ceftriaxone 2g/24jam
Gulam Rasul 077072 Inj Ceftriaxone 2g/24jam

Tamrin 069121 Drip Levofloxacin 250 mg/24jam

Misrah 076976 Inj Ceftriaxone 2g/24jam
Atisia Sarumaha 019289 Inj Ceftriaxone 2g/24jam
5/30/2024 5A
Edy Ahmad 064140 Inj Ceftriaxone 1g/12jam

Nurul Ilmi 077134 Inj Ceftriaxone 2g/24jam

Yusril Pelawi 032373 Inj Ceftriaxone 2g/24jam
Aisyah 017708 Inj Ceftriaxone 2g/24jam
Sumini 076121 Inj Ceftriaxone 2g/24jam
4B Adam Alfatih 077192 Inj Ceftriaxone 300mg/12jam
M Luffy Aqilillah 077181 Inj Cefotaxime 300mg/12jam
Mikhael Leonardo Pasaribu 017877 Inj Ceftriaxone 750mg/12jam

Jamilah 071213 Inj Meropenem 1g/8jam

ICU
Rahimah 074549 Drip Ciprofloxacin 200 mg/12jam
ika Injeksi di Rawat Inap (Automated Stop Order )

Ruang Rawatan Dokter yang Meresepkan Hari Pemberian Keterangan

523 dr. Dana, Sp.P H4
533 dr. Wanda, Sp.PD H4
541 dr. Dana, Sp.P H3
544 dr. Dana, Sp.P H3
531 dr. Wanda, Sp.PD H3
530 dr. Wanda, Sp.PD H3
537 dr. Wanda, Sp.PD H3
540 dr. Wanda, Sp.PD H3
539 dr. Mariati, Sp.PD H3

504 dr. Endah, Sp.P H3

514 dr. Endah, Sp.P H6
515 dr. Dana, Sp.P H5
508 dr. Eva, Sp.S H5

430 dr. Dana, Sp.P H3

442 dr. Dana, Sp.P H3
439 dr. Annisa, Sp.PD H4 besok PBJ (31.05.2024)
428 dr. Endah, Sp.P H4
437 dr. Anjelimery, Sp.A H3
425 dr. Anjelimery, Sp.A H3
425 dr. Dermawan, Sp.A H3

ICU dr. Asnawi, Sp.PD H1

ICU dr. Wanda, Sp.PD H5
 Daftar Pemantauan Pember

Tanggal Lantai Nama Pasien No. RM Antibiotik

Samsul Bahri 088446 Inj Ceftriaxone 1g/12jam

Inj Meropenem 1g/8jam

Afrida Nurain 045181 Inj Ceftriaxone 2g/24jam

Erma 088204 Inj Ceftriaxone 1g/24jam

Nurhidayati 055773 Inj Cefotaxime 1g/8jam

Umi Kalsum 068900 Inj Ceftriaxone 2g/24jam
Wulan Aprilia 063184 Inj Ceftriaxone 2g/24jam
Endang Dwi Ningsih 074085 Inj Ceftriaxone 2g/24jam
Mariadi 033507 Inj Ceftriaxone 1g/12jam
Dedi Irawan 020768 Inj Ceftriaxone 2g/24jam
Drip Levofloxacin 500mg/24jam
1/11/2025 5B
Fadhlan Mu'ammar Al-Habsyi 068589 Inj Ceftriaxone 1g/12jam
Muhammad Hakim Zain 089004 Inj Ceftriaxone 250mg/12jam
Arsyla Rumaisa 036399 Inj Ceftriaxone 500mg/12jam
Dessy Maida Putri 089069 Inj Ceftriaxone 1g/12jam
Mhd Rizky Syahputra 048867 Inj Ceftriaxone 2g/24jam
Tarmizi 060484 Inj Ceftriaxone 2g/24jam

Asmah 085960 Inj Ceftriaxone 1g/12jam

Rosmanidar 087283 Inj Ceftriaxone 2g/24jam
Mustari 066877 Inj Ceftriaxone 2g/24jam

02.01.2024 Mayety br Sirait 055144 Inj Ceftriaxone 2g/24jam

Winda Ivani 086514 Inj Ceftriaxone 1g/12jam

Asmah 085960 Inj Ceftriaxone 1g/12jam

Sarwan 054217 Drip Levofloxacin 750mg/24jam

Puji Astuti 085789 Inj Ceftriaxone 1g/12jam

Benneria Siregar 031274 Inj Ceftriaxone 2g/24jam
Ajeliah 064473 Inj Ceftriaxone 1g/12jam
Daftar Pemantauan Pemberian Antibiotika Injeksi di Rawat Inap

Ruang
Dokter yang Meresepkan Hari Pemberian Keterangan
Rawatan

526 dr. Annisa, Sp.PD H7, diaff Kolik abdomen + AKI stg 2 + GEA + C
dr. Dana, Sp.P H7, diaff

539 dr. Dana, Sp.P H5 CHF E.C MR MODERATE + AR MODER

541 dr. Annisa, Sp.PD H5 Dispepsia + GEA dengan dehidrasi r-s + susp e

534 dr. Mariati, Sp.PD H4 Anemia hemolitik + Dengue fever +

539 dr. Mariati, Sp.PD H4 Febris ec bacterial infection + se
518 dr. Endah, Sp.P H4 TB paru
540 dr. Dana, Sp.P H4 PPOK Eksaserbasi + DM tipe
540 dr. Annisa, Sp.PD H4 thypoid fever + Bronkitis + Cholesistitis + BPH
536 dr. Mariati, Sp.PD H1, diaff, pasien alergi PSMBB + Anemia
H3 stomatitis

528 dr. Dermawan, Sp.A H3 Obs. Febris ec Bacterial infection dd/V

528 dr. Dermawan, Sp.A H3 BP + KDS
525 dr. Dermawan, Sp.A H3 bp + susp. Morbili
cholelithiasis + NAFLD + Cystitis + nefrolithiasis bilater
542 dr. Annisa, Sp.PD H3
s
538 dr. Wanda, Sp.PD H3 obs febris ec suspek bacterial dd vira
532 dr. Dana, Sp.P H3 PPOK eksaserbasi + CHF ec C

537 dr. Annisa, Sp.PD H2 CHolesistitis + NAFLD + Nefrolithiasis bilater

530 dr. Mariati, Sp.PD H2 Hematokezia ec PSMBB
535 dr. Endah, Sp.P H2 PPOK Eksaserbasi Akut + Post TB dd TB

Penurunan kesadaran + susp Electrolite imbalance +

530-->ICU dr. Asnawi, Sp.PD H2
susp. sespsis + anemia ec ?
540 -->ICU dr. Annisa, Sp.PD H4 Anemia ec perdarahan + GEA + post part

537 dr. Annisa, Sp.PD H1 CHolesistitis + NAFLD + Nefrolithiasis bilater

526-->ICU dr. Johannes, Sp.P H1 Suspect Stroke Iskemik + Parkinson Disease + Low B

526 dr. Annisa, Sp.PD H1 NAFLD + Cholesistitis + Cystitis + nefroli

febris ec suspek demam dengue + DM Tipe 2 + LBP dd
525 dr. Wanda, Sp.PD H1
kemoterapi ca mammae
538 dr. Annisa, Sp.PD H1 Hipertensi + NAFLD + cholesistitis +
 Keterangan

domen + AKI stg 2 + GEA + CHF ec HHD

MR MODERATE + AR MODERATE + PPOK

dengan dehidrasi r-s + susp elektrolit imbalance

hemolitik + Dengue fever + DM tipe 2

bris ec bacterial infection + sefalgia
TB paru
PPOK Eksaserbasi + DM tipe II
ronkitis + Cholesistitis + BPH + PPOK eksaserbasi
PSMBB + Anemia
stomatitis

s ec Bacterial infection dd/Viral infection

BP + KDS
bp + susp. Morbili
ystitis + nefrolithiasis bilateral + GEA dengan dehidrasi r-
s
ris ec suspek bacterial dd viral infection
PPOK eksaserbasi + CHF ec CAD

NAFLD + Nefrolithiasis bilateral + Cystitis + GEA

Hematokezia ec PSMBB
aserbasi Akut + Post TB dd TB Paru Relaps

+ susp Electrolite imbalance + dehirasi ringan sedang +

susp. sespsis + anemia ec ?
erdarahan + GEA + post partum hemoragik

NAFLD + Nefrolithiasis bilateral + Cystitis + GEA

+ Parkinson Disease + Low Back Pain ec HNP Lumbalis

holesistitis + Cystitis + nefrolithiasis Dextra

engue + DM Tipe 2 + LBP dd HNP +TB Paru Relaps + Post
kemoterapi ca mammae
tensi + NAFLD + cholesistitis + Cystitis
 Daftar Pemantauan Pemberian Antibiotika

Ruang
Tanggal Lantai Nama Pasien No. RM Antibiotik
Rawatan

Syahrial 088315 Drip Levofloxacin 750mg/24jam 514

Zainuddin Ismail 057857 Inj Ceftriaxone 2g/24jam 515

Elyska Devi 088887 Drip Levofloxacin 750mg/24jam 513

Indah Susanti 059046 Inj Ceftriaxone 2g/24jam 502
Nurjannah 050631 Inj Ceftriaxone 2g/24jam 510
Suwarni 088012 Inj Ceftriaxone 1g/12jam 505

1/11/2025 5A M. Hidayat 071824 Inj Ceftriaxone 2g/24jam 511

Suyatno 038264 Inj Ceftriaxone 2g/24jam 515

Sakdiah 088079 Inj Ceftriaxone 2g/24jam 510
Hamdiah 081022 Inj Ceftriaxone 2g/24jam 507
Ginem 065795 Inj Ceftriaxone 2g/24jam 509
Abdul Jalil 089097 Inj Cefotaxime 1g/8jam 516
Maju Lumbantobing 025705 Inj Ceftriaxone 2g/24jam 514

cc

Wagiman 048441 Drip Levofloxacin 500mg/24jam 510

Azithromycin 1x500mg tablet
 Kasmuin 088109 Inj Ceftriaxone 2g/24jam 510-->ICU

11/22/2024 Maimunah 052985 Inj Ceftriaxone 2g/24jam 506-->ICU

Masliana Lubis 086705 Drip Levofloxacin 750mg/24jam 508-->ICU

Drip Levofloxacin 750mg/24jam ###

Drip Levofloxacin 750mg/24jam
ntauan Pemberian Antibiotika Injeksi di Rawat Inap

Dokter yang Meresepkan Hari Pemberian Keterangan

dr. Johannes, Sp.P H5 pneumonia + ppok eksaserbasi + CAD post UAP + HT

dr. Dana, Sp.P H5 PPOK Eksaserbasi Akut + HT Emergency

dr. Johannes, Sp.P H4 pneumonia + dyspepsia

dr. Dana, Sp.P H4 mastitis tb
dr. Dana, Sp.P H4 PPOK Eksaserbasi Akut + CPC + APS
dr. Annisa, Sp.PD H4 cholelithiasis + NAFLD + obs jaundice ec cholelithiasis

PPOK Eksaserbasi Akut + Bronkitis + DM Tipe 2 + Hiponatremia (125) +

dr. Endah, Sp.P H3
CHF e.c HHD + MR Moderate ec AML Prolapse
Anemia + PSMBA EC varises esophagus + post Ligasi varises esophagus
dr. Dana, Sp.P H2
+ DM tipe 2 + Pneumonia + Post TB
dr. Wanda, Sp.PD H2 Kolik Abdomen + Asites + Susp Tumor Abdomen
dr. Mariati, Sp.PD H2 Cholelitiasis+Abses o/t regio abdominal
dr. Dana, Sp.P H2 PPOK Eksaserbasi akut
dr. Mariati, Sp.PD H2 Hepatis viral dd non viral + Anemia + AKI dd CKD
dr. Dana, Sp.P H2 PPOK eksaserbasi

GE kronik dengan dehidrasi ec suspek Inflamatory bowel disease + DM

dr. Mariati, Sp.PD H1
tipe 2
H1
dr. Johannes, Sp.P H4 pneumonia + ppok ekasaserbasi + dyspepsia + chf ec CAD

gagal napas tipe 2 + PPOK eksaserbasi + CHF e.c HHD (HFpEF) + dm

dr. Dana, Sp.P H6
dr. Johannes, Sp.P H3 23.11.2024 07:26, diaff pneumonia dd ppok eksaserbasi + CHF e.C CAD

H4 27.11.2024 07:10, diaff

H5 24.11.2024 07:11, diaff
 Keterangan

umonia + ppok eksaserbasi + CAD post UAP + HT

PPOK Eksaserbasi Akut + HT Emergency

pneumonia + dyspepsia
mastitis tb
PPOK Eksaserbasi Akut + CPC + APS
elithiasis + NAFLD + obs jaundice ec cholelithiasis

basi Akut + Bronkitis + DM Tipe 2 + Hiponatremia (125) +

HF e.c HHD + MR Moderate ec AML Prolapse
MBA EC varises esophagus + post Ligasi varises esophagus
+ DM tipe 2 + Pneumonia + Post TB
olik Abdomen + Asites + Susp Tumor Abdomen
Cholelitiasis+Abses o/t regio abdominal
PPOK Eksaserbasi akut
epatis viral dd non viral + Anemia + AKI dd CKD
PPOK eksaserbasi

ngan dehidrasi ec suspek Inflamatory bowel disease + DM

tipe 2
onia + ppok ekasaserbasi + dyspepsia + chf ec CAD

tipe 2 + PPOK eksaserbasi + CHF e.c HHD (HFpEF) + dm

tipe 2 + hipokalemia
neumonia dd ppok eksaserbasi + CHF e.C CAD
 Daftar Pemantauan Pembe

Tanggal Lantai Nama Pasien No. RM Antibiotik

Sholihati 032974 Inj Ceftriaxone 1g/12jam

Cefixime 2x200mg kapsul

Yuni 088905 Inj Ceftriaxone 2g/24jam

Cantika Kirana 088952 Inj Ceftriaxone 250mg/12jam

Siti Habibah 088930 Inj Cefotaxime 1g/8jam
Annasya Zea Almahyra 088906 Inj Ceftriaxone 400mg/12jam
M Fachrezi Al Fiqraa 088993 Inj Ceftriaxone 2g/24jam
Subandi Damanik 088909 Inj Ceftriaxone 2g/24jam
1/11/2025 4B Rosita br Tompul 63469 Inj Ceftriaxone 3g/24jam

Nazla Aishwa Khawtar Marbun 033559 Inj Ceftriaxone 300mg/12jam

Adeeva Hanin Arta Husaini 083559 Inj Ceftriaxone 400mg/12jam
Inaya Humairah 076183 Inj Ceftriaxone 200mg/12jam
Tania Aprillia Syafitri 028574 Inj Ceftriaxone 1g/12jam
Nur Afni 089089 Drip Levofloxacin 750mg/24jam
Mirza Gusti Achmad 089102 Inj Ceftriaxone 350mg/12jam

M. V. Sirait 068898 Drip Levofloxacin 750mg/24jam

Muliansyah Putra 089117 Inj Ceftriaxone 3g/24jam
Siti Hajar 089127 Inj Ceftriaxone 2g/24jam

Syafrida 026860 Inj Ceftriaxone 2g/24jam

Drip Levofloxacin 750mg/24jam
12.12.2024
Ponisah 087726 Inj Ceftriaxone 1g/12jam

Sufiah 056274 Inj Ceftriaxone 1g/12jam

ftar Pemantauan Pemberian Antibiotika Injeksi di Rawat Inap

Ruang
Dokter yang Meresepkan Hari Pemberian Keterangan
Rawatan

431 dr. Annisa, Sp.PD H5, diaff Hipoalbumin + DM Tipe 2 + ascites + post debrideme
H2 Anemia

obs febris ec suspek bacterial dd viral infection + pos

434 dr. Wanda, Sp.PD H5
+ HEG + MG Multipara IUP 29 minggu + LK PUK

420 dr. Dermawan, Sp.A H4 Demam Typoid + ISPA

432 dr. Wanda, Sp.PD H4 hepatitis viral dd non viral + chole
430 dr. Anjelimery, Sp.A H4 Febris ec viral infection + Vomitus + DRS +
426 dr. Mariati, Sp.PD H4 obs febris dd infection bacterial dd viral in
427 dr. Fauzan, Sp.JP H4 UAP + Post ADHF + DM Tipe 2 + Dy
419 dr. Mariati, Sp.PD H4 Demam tifoid

421 dr. Dermawan, Sp.A H3 Fever H3 + GEA

430 dr. Dermawan, Sp.A H3 obs febris e.c susp viral dd/ bacterial
428 dr. Dermawan, Sp.A H3 Obs. Febris ec Bacterial infection dd/Vi
425 dr. Dermawan, Sp.A H3 obs febris e.c susp viral dd/ bacterial infection d
432 dr. Johannes, Sp.P H3 pneumonia + asma eksaserbasi ringan seda
437 dr. Dermawan, Sp.A H3 Obs. Febris ec Bacterial infection dd/Vi

427 dr. Johannes, Sp.P H2 pneumonia + ppok stabil + vertigo

424 dr. Mariati, Sp.PD H2 Obs. Febris ec Typhoid Feve
439 dr. Wanda, Sp.PD H2 colic abdomen ec suspek ISK

PPOK Eksaserbasi Akut + Pneumonia (PSI Score : 75

435 dr. Endah, Sp.P H5
Post Stroke + CHF ec HHD + LB
H1 06.12.2024
427-->ICU dr. Annisa, Sp.PD H1 DHF grade 3 + bacterial infecti

441 dr. Annisa, Sp.PD H1 Cholesistitis + NAFLD + konstip

 Keterangan

+ DM Tipe 2 + ascites + post debridement + bacterial infection +

Anemia

uspek bacterial dd viral infection + post Hipoglikemia + Anemia

MG Multipara IUP 29 minggu + LK PUKI + AH Tachycardia

Demam Typoid + ISPA

hepatitis viral dd non viral + cholesistitis
ris ec viral infection + Vomitus + DRS + Lymphadenitis
febris dd infection bacterial dd viral infection + ISPA
UAP + Post ADHF + DM Tipe 2 + Dyspepsia
Demam tifoid

Fever H3 + GEA
obs febris e.c susp viral dd/ bacterial infection
Obs. Febris ec Bacterial infection dd/Viral infection
e.c susp viral dd/ bacterial infection dd BP dd typoid fever
umonia + asma eksaserbasi ringan sedang + dyspepsia
Obs. Febris ec Bacterial infection dd/Viral infection

pneumonia + ppok stabil + vertigo perifer

Obs. Febris ec Typhoid Fever
colic abdomen ec suspek ISK

rbasi Akut + Pneumonia (PSI Score : 75) + UAP DD/ NSTEMI +

Post Stroke + CHF ec HHD + LBP
DHF grade 3 + bacterial infection

Cholesistitis + NAFLD + konstipasi

 Daftar Pemantauan Pemberian Antibiotik

Tanggal Lantai Nama Pasien No. RM Antibiotik Ruang Rawatan

Inj Ceftriaxone 2g/24jam ICU

Naimah 055223
Inj Meropenem 1g/8jam ICU

Nuraini S 059291 Drip Levofloxacin 750mg/24jam ICU ---> 338

Inj Ceftriaxone 2g/24jam

Fatmawati 073047 ICU
Azithromycin 1x500mg tab

M Wahyudi 078790 Inj Ceftriaxone 2g/24jam ICU

7/1/2024 ICU Mhd Nasir 055342 Drip Levofloxacin 750mg/24jam ICU

Sabto 078868 Inj Ceftriaxone 2g/24jam ICU

Maulidah 078890 Inj Ceftriaxone 2g/24jam ICU

Kasmin 078799 Inj Ceftriaxone 2g/24jam 533 ---> ICU

Arumi Fadheela 054085 Inj Ceftriaxone 300mg/12jam ICU

Muhammad
078906 Inj Ceftriaxone 300mg/12jam ICU
Fahrizyk Hidayat
antauan Pemberian Antibiotika Injeksi di Rawat Inap

Dokter yang Meresepkan Hari Pemberian Keterangan

dr. Fauzan, Sp.JP (H1 25 Jun 19.08) Aff 26 Jun CHF e.c CAD, HHD+Emergency HT+Stroke Iskemik+
dr. Taufik, Sp.N H4 (H1 26 Jun 15.19) Hipokalemia+Sepsis ec ???

TB Paru Putus Obat+CHF e.c CAD (HFrEF)+Hipokalemia+

dr. Endah, Sp.P H3 (H1 27 Jun 07.05)
PSMBB+Anemia

dr. Endah, Sp.P H2 (H1 28 Jun 07.03) Pneumonia CAP dd Pneumonia HAP + DM tipe 2 +
dr. Asnawi, Sp.PD H2 (H1 28 Jun 07.02) Stroke iskemik

GEA Dehidrasi Ringan Sedang +urticaria +Asidosis metabolik+

dr. Mariati, Sp.PD H2 (H1 28 Jun 06.27)
Cushing syndrome+Takikardi + APS+susp abses submandibula

PPOK Eksaserbasi Berat+Pneumonia CAP+

dr. Endah, Sp.P H2 (H1 28 Jun 07.09)
CHF e.c HHD + AR Mild + Stroke Iskemik

Hipoglikemi+Hiponatemia (125)+Penurunan kesadaran ec stroke

dr. Eva, Sp.S H2 (H1 29 Jun 19.15)
iskemik dd stroke hemoragik+Obs konvulsi

dr. Mariati, Sp.PD H1 30 Jun 18.25

Efusi Pleura Sinistra ec Susp sistemik+Pneumonia dd TB Paru

dr. Endah, Sp.P H3 (29 Jun 16.21)
+Susp Sirosis Hepatis

dr. Edy Irawan, Sp.A H1 30 Jun 19.25

H1 1 Juli 07.22
dr. Edy Irawan, Sp.A
 Keterangan

HF e.c CAD, HHD+Emergency HT+Stroke Iskemik+

Hipokalemia+Sepsis ec ???

aru Putus Obat+CHF e.c CAD (HFrEF)+Hipokalemia+

PSMBB+Anemia

neumonia CAP dd Pneumonia HAP + DM tipe 2 +

Stroke iskemik

ehidrasi Ringan Sedang +urticaria +Asidosis metabolik+

g syndrome+Takikardi + APS+susp abses submandibula

PPOK Eksaserbasi Berat+Pneumonia CAP+

CHF e.c HHD + AR Mild + Stroke Iskemik

emi+Hiponatemia (125)+Penurunan kesadaran ec stroke

iskemik dd stroke hemoragik+Obs konvulsi

Pleura Sinistra ec Susp sistemik+Pneumonia dd TB Paru

+Susp Sirosis Hepatis
 Daftar Pemantauan Pemberian Antibiotika Inje

Tanggal Lantai Nama Pasien No. RM Antibiotik

6/10/2024 ICU

Miswati 056437 Inj Ceftriaxone 2g/24jam

emantauan Pemberian Antibiotika Injeksi di Rawat Inap

Ruang Rawatan Dokter yang Meresepkan Hari Pemberian Keterangan

stroke iskemik+konvulsi+ht+
ICU dr. Eva, Sp.S H2
hiponatremia
 Keterangan

stroke iskemik+konvulsi+ht+
hiponatremia