Evaluasi Bukti dari Uji Klinis tentang Interaksi Antibiotik dan Antasida: Suatu Tinjauan Sistematis Literatur
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Interaksi antara antibiotik dan antasida merupakan permasalahan klinis yang penting karena dapat mempengaruhi efektivitas terapi serta meningkatkan risiko kegagalan pengobatan. Penggunaan kedua golongan obat ini secara bersamaan sering terjadi dalam praktik klinis, khususnya pada pasien dengan keluhan saluran cerna yang juga menjalani terapi antibiotik. Penelitian ini bertujuan untuk mengevaluasi bukti dari uji klinis terkait interaksi antibiotik–antasida melalui pendekatan tinjauan sistematis literatur. Proses pencarian artikel dilakukan melalui database PubMed, Google Scholar, dan sumber ilmiah terpercaya lainnya menggunakan kata kunci terstandar. Seleksi literatur mengikuti panduan PRISMA untuk memastikan relevansi dan kualitas studi. Hasil analisis menunjukkan bahwa antasida dan proton pump inhibitors (PPI) dapat menurunkan bioavailabilitas antibiotik, terutama golongan kuinolon dan tetrasiklin, melalui mekanisme pembentukan khelat dengan ion logam dan peningkatan pH lambung yang mengganggu absorpsi obat. Kombinasi penggunaan antibiotik dan PPI juga terbukti meningkatkan risiko Clostridioides difficile infection (CDI), terutama pada pasien usia lanjut atau dengan komorbiditas. Sebaliknya, agen penekan asam baru seperti vonoprazan menunjukkan efektivitas yang baik dalam mendukung terapi eradikasi Helicobacter pylori tanpa menurunkan daya kerja antibiotik. Meskipun terdapat bukti klinis yang signifikan, sebagian besar studi masih bersifat retrospektif dengan keterbatasan ukuran sampel dan populasi. Oleh karena itu, dibutuhkan uji klinis prospektif berskala besar untuk memperkuat dasar ilmiah interaksi ini. Pemahaman mendalam terhadap interaksi antibiotik–antasida sangat penting untuk menunjang praktik peresepan yang rasional, aman, dan efektif.
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