Selasa, 17 Mei 2011


SUPERVISION AS AN EFFORT TO INCREASE THE HEAD LCS civil WORK LEARNING ACHIEVEMENT


Abstract: Globalization and modernization can not be avoided, the product of modernization is the technological sophistication. All agencies, offices and government agencies and private, like it or not affected by modernization. Activities office, the agency to achieve the desired goals much better utilize modern technology in the form of hardware and software. However, it should be understood that the activities of institutions and agencies in achieving the goal is not only determined by technological sophistication, but there is another factor that is human resources. Talking about human resource issues in educational institutions, one of which is the Civil Learning. The civil work performance study will also determine the success will be the achievement of educational goals, even Pamong Learning (PB) is a very peting factor in the learning process at school. Because it is necessary that the existence of efforts to improve work performance Pamong Learning. There are factors that can affect work performance Pamong Learning, including the supervision performed by the principal, as stated by Sir James Robert Marks (1985) states that all Civil Learning requires supervision, and services. Stop Similarly Johnson (1967) menatakan that supervision becomes an important job for the principal. The successful achievement of the goals of education in schools is closely related to the role played by the school as educational supervision.

Key words: supervision, job performance

There are various concepts of supervision.Historically mulau first applied to the traditional concept of supervision, namely the work of inspection, monitoring and fault finding in the sense of finding fault with the aim to improve.Behavior of traditional supervision is called snooper vision, namely the task of spying to find fault. Concepts such as these cause educators to be scared and they work with are not good for fear of being blamed. Then developing the scientific supervision, are:
a. Systematic, meaning that is regular, planned and continuous
b. Objective in the sense data is obtained based on real observation is not based on personal interpretation.
c. Using recording devices that can provide information as feedback to mengdakan assessment of the learning process in class.
The more advanced hasli-results research-field of education has helped change the various approaches in educational supervision. Adam Dickey (1959) in his book Basic Principles of supervision states that supervision is a program that plans to improve teaching. This program essentially is a matter of learning and teaching improvement.
According to Kimball Wiles (1961) a supervisor who both have five basic skills namely:
a. Skills in human relations
b. Skills in group process
c. Skills in leadership
d. Skill in managing personnel
e. Skills in evaluation
Opinions Alfonso (1981) that supervision is the assistance provided to improve teaching and learning situation lebh good. While Hendyat Sutopo (1984) argues that supervision is an attempt to stimulate, coordinate, and guide the growth of the Civil-Civil Education Learning at school either individually or in groups, with tolerance and paedagogis measures are effective, so that they could stimulate and guide students so that better able to participate in a democratic society, while according to Alfonso RJ et all in Oliva (1984) teaching supervision is a behavior that was designed by agency officials that directly affect the behavior of the Civil Education (PB) in various ways to assist student learning and ways to achieve the objectives undertaken by the institution.
Many diagnostic opinion in general from above when associated with the implementation of supervision in the Studio Learning Activities, it can be formulated that supervision is the efforts undertaken by the supervision in this case the head of the LCS to provide assistance and services to educators in this case is whether the civil learning individual or group in an effort to improve teaching.
The purpose of Supervision
According to Piet A. Sahertian (2000) objective of supervision is to develop learning and teaching situation better. Effort towards the improvement of learning and teaching aimed at achieving the ultimate goal of education is child's personal correction to the fullest.
The situation of learning and teaching in schools now describe a very complex situation. Confusion that exists is the result of objective factors which hamper each other resulting in reduced learning outcomes. Because it is necessary to create situations that allow citizens to learn to learn well and can guide the creative atmosphere where they feel they grow in their learning environment.

Head LCS For Supervisor
Sergiovani (1983) explained that the principal not only as leaders, administrators and managers, but serves as supervisor. The headmaster was the first person responsible for the implementation of the education process at school. Duties and responsibilities of the head of the LCS if more work with humans in order to achieve LCS goals, then this task tend to be associated with supervision.
LCS Malang as an institution that carries out educational programs, is identical to the LCS, so automatic that acts as the head of the LCS is the LCS head.
Head of the LCS was the person most worthy to be given the responsibility in the field of supervision, because almost every day knowing that faced Civil problematic Learning (PB), then he can quickly together with the Civil Learning (PB) to solve these probematika. Another advantage, is no stranger to the head of the LCS in the LCS, but he dalah friend Pamong Learning (PB) alone, thus making Pamong Learning (PB) tend to not feel afraid to supervisor. The situation is prasarat supervisor for supervision in the LCS.

Understanding Job Performance
Work performance according to the Dharma (1985) is: something that is done or the products and services produced by a person or diebrikan employees can be viewed as work performance.With these results may be held at assessing the results of that and also will know how far the tasks assigned to him to finish. In addition to separating prestsi kerj penegrtian between individual and group performance.
According Siagian (1988), that "performance is everything in terms of behavior, and personality of someone who often shows itself in various forms of attitudes, ways of thinking, and acting". Various things affect a human personality in organizational behavior terecermin which in turn will affect the work performance boss / leader, who also acknowledged that many of the difficulties experienced in adequately handle. It is not always easy to assess the performance of a subordinate employee accurately, and anyway is difficult to convey the results of these assessments to the relevant subordinates without creating a sense of disappointment for those concerned.

Assessment Method
In general practice to assess or measure performance provided the form or scale that can help guide the assessors of the special characteristics of employees and job. It is trying to employees and their work. It is trying to overcome the tendency to generalize. Usually the director or the supervisor to choose procedures that will minimize conflicts with the person being assessed, giving relevant feedback to the person being assessed. Basically the boss trying to discover, develop, and implement employee performance evaluation program that can benefit employees, managers, and working groups and agencies.
Performance assessment procedures, there is no generally accepted method, which is considered suitable for every purpose agencies and organizations.

1. Graphic scale
Assessment procedures in the form of a format that contains a number of properties and performance characteristics that should be assessed. Rating scale (rating scales) are distinguished by:
1) to how far apart people who interpret the assessment that can tell whether the response is meant by the Assessor.
2) to what extent people who interpret the assessment that can tell whether the response is meant by the Assessor.
3) to what extent the level of dimensional accuracy is defined only for the appraisal results.

2. Rating
Leaders use the rank order procedure to evaluate all subordinates. Subordinates are ranked according to relative value for the company or work unit.

3. Check a list of weighted
Assessment based on weighted list of checks that consists of a number of statements that describe various kinds and levels of behavior for a particular job.

4. Descriptive Treatise
This assessment by requiring outlining the main points of strengths and weaknesses of the person being assessed.
According to Dharma 91,985) vahwa how pengukruan work performance involves three things:
a. Quantity, ie the amount that must be resolved.
Quantity measurement involves the calculation of output or outcome, the process of implementation of activities. This is related to the amount of output or results produced.
b. Quality; the quality produced. Measurement of quality of output or results reflect the level of satisfaction of how well the solution.
c. Timeliness, which is in accordance or not with the planned time. Measurement of punctuality is a type of quantitative measurement that determines the timeliness of completion of an activity.
From urian above can be deduced that a person is said to perform or not perform can be measured by the quantity, quality and timeliness in completing the work. Work performance can also be shown with creativity Pamong Learning (PB) tried to get the job done faster.

 
Conclusion
1. Supervision is the efforts to provide a stimulant, assistance, guidance to educators in the LCS, both individually and jointly with paedagogis action to improve teaching.
2. LCS head not only as leadaer, administrators and managers, but he was as a supervisor in the LCS, because the head of the LCS as the people who deal directly with the Civil Learning every day, and have a close emotional relationship, so the proximity to more quickly to provide aid to the Civil Learn if he has a problem in teaching, so that the process worked well in teaching and ultimately job performance Pamong Learning to increase.
 
REFERENCES

Robert Alfonso, J., Firth Geral, R. 1981.Instructional Supervision: A Behavior System.Boston: Allyn and Bacon, Inc..

Dharma, A. 1985. Job Performance Management, A Practical Guide For The Supervisor To Improve Job Performance. Jakarta: CV Rajawali.

Sergiovani, T.J., and Carverr F. D. 1980. The New School Execuitve; A Theory of Administration. New York: Harper and Row Publishers.

Sahertian, Peat. A. 2000. Basic Concepts and Techniques of Education Supervision. Surabaya: Bina Space.

Siagian, S. P. 1988. Organizational Behavior Leadership and Administration. Jakarta: CV Haji Mas Agung.

SENSITIVITY TO Salmonella typhi chloramphenicol
AND IN ceftriaxone Dr. SOETOMO SURABAYA AND
DI Dr. Saiful Anwar Malang PERIOD 2008-2009

Abstract: The sensitivity of Salmonella typhi bacteria to several antibiotics for the treatment of typhoid fever particularly chloramphenicol and Ceftriaxone constantly changing. For patients with typhoid fever at Dr. Soetomo chloramphenicol could be an option for the treatment of typhoid fever in the Ceftriaxone. As for patients with typhoid fever in RSSA Malang use of chloramphenicol and Ceftriaxone need consideration because of the high resistance rate against Salmonella typhi.

Key words: salmonella typhi, chloramphenicol, ceftriaxone

     Typhoid fever is an acute infectious disease in the small intestine with symptoms of fever a week or more with disorders of the digestive tract (Widodo, 2007). Typhoid fever is an endemic disease in countries that are developing, including Indonesia (Widodo, 2007). In Indonesia the incidence of typhoid fever ranges from 350-810 cases per 100,000 population per year with a death rate of 2%. Typhoid fever is found almost throughout the year especially in the summer (Rampengan, 2008).
In East Java incidence of typhoid fever at the health center and several hospitals respectively 4000 and 1000 cases per month, with a mortality rate of 0.8%. Results of previous studies in Surabaya showed that typhoid fever is estimated from year to year tend to increase. At Dr. Soetomo during the period 1991-1995 has treated 586 patients with typhoid fever death rate 1.4%, and during the period 1996-2000 has treated 1563 patients with typhoid fever death rate 1.09% (Soewandojo, 2007), while the prevalence of typhoid fever in Malang Regency as much as 1.2% of 10,966 samples in 2007 (Dinkesjatim, 2008)
Typhoid fever caused by Salmonella typhi, which is a Gram-negative bacteria that is transmitted is almost always occur through contaminated food and beverages. Multiplication of bacteria entered the bloodstream, then the absorption into the digestive tract and excreted along with feces such patients (Rampengan, 2008).
The most widely used drug in the treatment of typhoid fever is chloramphenicol, a drug used since 1948 and is still used as a drug of choice in Indonesia, especially at Dr. Soetomo General Hospital and Dr. Saiful Anwar Malang because efektvitasnya against Salmonella typhi was still high in addition to the price of drugs is relatively cheap (Musnelina, 2004). From the molecular level studies suggested that the Salmonella typhi bacteria become resistant to chloramphenicol due to the plasmid that produces the enzyme Chloramphenicol Acetyltransferase (CAT), which activates chloramphenicol (Balbi, 2004). This makes the experts look for another alternative is the best medicine for typhoid fever, among others, Ceftriaxone (Musnelina, 2004).
Ceftriaxone is an antibiotic effective in the treatment of typhoid fever caused by Salmonella typhi. Lucrative nature of this drug is having a network with good penetrating power and can penetrate into the inflammation that makes Ceftriaxone be one second choice drug for the treatment of typhoid fever particularly in hospitals and Dr Dr.Soetomo Surabaya. Saiful Anwar Malang (Darmowandowo, 2002). Ivanoff, 2002 showed that since 1990 more and more resistant Salmonella typhi Ceftriaxone.
The nature of the bacteria that often change change can affect the success of first-line treatment of infectious diseases and the effect on the cost of treatment of patients at the hospital. The absence of regular monitoring of data, especially Salmonella typhi bacteria sensitivity to the drug's first choice for typhoid fever, namely chloramphenicol and one second choice drugs are widely used namely Ceftriaxone in East Java, especially at Dr. Soetomo General Hospital and Dr. Saiful Anwar Malang makes researchers want to know the description of the sensitivity of Salmonella typhi to chloramphenicol and Ceftriaxone at Dr. Soetomo and in Dr. Saiful Anwar Malang period 2008-2009. Describing the sensitivity of Salmonella typhi to chloramphenicol and Ceftriaxone at Dr. Soetomo and in Dr. Saiful Anwar Malang period 2008-2009?

RESEARCH METHOD
- The research design used in this study is an observational descriptive cross sectional approach.
- The research instrument used is the record of the medical records of typhoid fever patients who do inpatient at Dr. Soetomo General Hospital and Dr.Saiful Anwar Malang Period from 2008 to 2009.
- Data were obtained from secondary data that the medical records of patients who did typhoid fever hospitalized at Dr. Soetomo General Hospital and Dr. Saiful Anwar Malang Period from 2008 to 2009.
- Data obtained from the medical records were analyzed descriptively and are presented in tables and graphs (bar chart) in the form of percentages.


DISCUSSION
Preview sensitivity of Salmonella typhi to chloramphenicol and Ceftriaxone at Dr. Soetomo and in Dr. Saiful Anwar Malang.
Salmonella typhi is a Gram-negative bacteria is the cause of typhoid fever infections (Darmowandowo, 2006). Until now, the trilogy still embraced the management of typhoid fever that is rest and treatment, diet and therapy support, as well as giving antibiotics (Widodo, 2007). The drugs most commonly used antibiotics to treat typhoid fever, among others, chloramphenicol, Tiamfenikol, Cotrimoxazole, Ampisillin and Amoxicillin, a third generation cephalosporin, and Florokuinolon (Widodo, 2007). Some antibiotic sensitivity test results against Salmonella typhi at Dr. Soetomo as shown in table 1:
 
Table 1 Table Frequency and Percentage of Each Antibiotics in Response Sensitivity Dr. Soetomo in 2008-2009
Jenis Antibiotik
Frekuensi Sensitivitas Antibiotik untuk S.typhi
Jumlah
Prosentase Sensitivitas Antibiotik untuk S.typhi
Jumlah
Sensitif
Intermediet
Resisten
Sensitif
Intermediet
Resisten
Amikasin
13
2
4
19
68.4
10.5
21.1
100
Amoksisilin
6
0
13
19
31.6
0
68.4
100
Amoksisilin-Asam Klavulanat
9
7
3
19
47.4
36.8
15.8
100
Seftriakson
6
0
13
19
31.6
0
68.4
100
Sefotaksim
6
0
13
19
31.6
0
68.4
100
Siprofloksasin
19
0
0
19
100
0
0
100
Meropenem
19
0
0
19
100
0
0
100
Kloramfenikol
12
1
6
19
63.2
5.3
31.6
100
(Primary Data, 2010)
Figure 1 Percentage Response SensitivityDiagram Each antibiotics at Dr. Soetomo in 2008-2009

Table 1 shows the antibiotics that are still sensitiveto Salmonella typhi that is amikacin, Ciprofloxacin,Meropenem, and chloramphenicol. Whileconducted in Dr. Saiful Anwar Malang as in table2:

Table 2 Table and Percentage FrequencyResponse Sensitivity Each Antibiotics in Dr Saiful Anwar Malang in 2008-2009

Jenis Antibiotik
Frekuensi Sensitivitas Antibiotik untuk S.typhi
Jumlah
Prosentase Sensitivitas Antibiotik untuk S.typhi
Jumlah
Sensitif
Intermediet
Resisten
Sensitif
Intermediet
Resisten
Amikasin
3
3
7
13
23.1
23.1
53.8
100
Amoksisilin
2
0
11
13
15.4
0
84.6
100
Amoksisilin-Asam Klavulanat
5
2
6
13
38.5
15.4
46.2
100
Seftriakson
3
3
7
13
23.1
23.1
53.8
100
Sefotaksim
3
1
9
13
23.1
7.7
69.2
100
Siprofloksasin
9
1
3
13
69.2
7.7
23.1
100
Meropenem
12
0
1
13
92.3
0
7.7
100
Kloramfenikol
3
0
10
13
23.1
0
76.9
100
(Primary Data, 2010)
Figure 2 Percentage Response Sensitivity GraphEach Antibiotics in Hospital
Dr. Saiful Anwar Malang in 2008-2009

Table 2 shows that are still sensitive to antibioticsof Salmonella typhi that is tto Ciprofloxacin andMeropenem. Preview sensitivity of Salmonellatyphi to several antibiotics in East Java, which was represented by Dr. Soetomo General Hospital andDr. Saiful Anwar Malang as in table 3

Table 3. Table Frequency Response SensitivityAnd the percentage of each antibiotic in theSecond Hospital in 2008-2009
Jenis Antibiotik
Frekuensi Sensitivitas Antibiotik untuk S.typhi
Jumlah
Prosentase Sensitivitas Antibiotik untuk S.typhi
Jumlah
Sensitif
Intermediet
Resisten
Sensitif
Intermediet
Resisten
Amikasin
16
5
11
32
50
15.6
34.4
100
Amoksisilin
8
0
24
32
25
0
75
100
Amoksisilin-Asam Klavulanat
14
9
9
32
43.8
28.1
28.1
100
Seftriakson
9
3
20
32
28.1
9.4
62.5
100
Sefotaksim
9
1
22
32
28.1
3.1
68.8
100
Siprofloksasin
28
1
3
32
87.5
3.1
9.4
100
Meropenem
31
0
1
32
96.9
0
3.1
100
Kloramfenikol
15
1
16
32
46.9
3.1
50
100

Figure 3 Percentage Response Sensitivity Graph Each antibiotics In Second  Hospital in 2008-2009 

Table 3 shows Siproloksasin and Meropenem has the highest sensitivity. The shift of the sensitivity of Salmonella typhi in the two places, namely at Dr.Soetomo and in Dr. Saiful Anwar Malang as written in his book Widodo, 2007. The big difference in the sensitivity pattern of Salmonella typhi at Dr. Soetomo and in Dr. Saiful Anwar Malang, shows the sensitivity pattern of Salmonella typhi to antibiotics the same can be varied.Because each region has a different sensitivity pattern and vary at different times and places.Sensitivity of bacteria is basically a natural ability of bacteria to survive (Ryan & Ray, 2004).According Dzen, 2004 the factors that affect it such as overuse and missuse antibiotics by doctors, free use of antibiotics by the public, a long treatment with low doses, where the resistance mechanism is by way of accumulation through the impermeability barrier to antibiotics, change ofantibiotic target so that antibiotics have no effects, antibiotic inactivation by the production of enzymes from bacteria, the bacteria form an enzyme which has undergone a change, the bacteria pump out (export), antibiotics (Ryan & Ray, 2004). 
Since 1948 chloramphenicol is the drug of choice for typhoid fever in Indonesia because of its effectiveness against Salmonella typhi was still high in addition to drug prices are relatively cheap (Musnelina, 2004). Results of sensitivity tests against Salmonella typhi chloramphenicol at Dr.Soetomo as shown in Table 1 shows the chloramphenicol is still sensitive to Salmonella typhi that is equal to 63.2%, this indicates chloramphenicol is still effective for the treatment of typhoid fever at Dr. Soetomo. But from the results of sensitivity tests as in table 2 shows that the sensitivity of chloramphenicol against Salmonella typhi in Dr. Saiful Anwar Malang, there is quite low at 76.9% of 13 isolates were already resistant.Wandana, 2008 stating that the price is relatively inexpensive antibiotics such as Ampisillin, Amoxicillin, and chloramphenicol sensitivity values
​​are higher in Jakarta than in Malang. And conversely, the price is relatively expensive antibiotic sensitivity value in Malang better than in Jakarta, this shows the purchasing power of influence to the increasing resistance rates.Moreover, chloramphenicol is often prescribed by doctors so that was ranked the 6th most common used in Dr. Saiful Anwar Malang (Budi, 2000).From the molecular level studies suggested that bacteria can become resistant Salmonella typhi as a result of enzyme-producing plasmid Chloramphenicol acetyltransferase (CAT), which inactivates chloramphenicol (Balbi, 2004). 
Second choice drug most widely used at Dr Soetomo and in Dr. Saiful Anwar Malang is Ceftriaxone (Darmowandowo, 2006). Sensitivity pattern of Salmonella typhi in typhoid fever cases performed at the General Hospital, Dr. Cipto Mangunkusomo Jakarta during 2000-2004 showed the sensitivity of Salmonella typhi Ceftriaxone is as high as 91.9%, but in contrast with the results conducted at Dr. Soetomo and in Dr Saiful Anwar poor as in table 1 to table 2 shows the numbers of Salmonella typhi Seftriakon sensitivity is quite low, at Dr Soetomo sensitive isolates of Salmonella typhi which only 31.6% and 68.4% resistant , the same thing also occurs in isolates of Salmonella typhi in Dr. Saiful Anwar Malang, there were 23.1% sensitive and 53.8% of 13 isolates of Salmonella typhi conducted sensitivity tests already experiencing resistance.Ceftriaxone is a high level of resistance against Salmonella typhi probably because the old treatment for MRS that is too short ie 3-6 days (Hussein, 2007) while the duration of treatment according to WHO 2003 guidelines typhoid fever duration of treatment with Ceftriaxone is 10-14 days, duration of treatment too short to induce resistance. Ivanoff, 2002 also showed that since 1990 more and more of Salmonella typhi are resistant not only to the oral antibiotics used previously useful such as chloramphenicol, ampicillin and Kotrimoxazol but also against new antibiotil like Ceftriaxone. Seftriakon included in a class of third-generation cephalosporin that works by inhibiting peptidoglycan transpeptidase that inhibited cell wall synthesis. Mechanisms of resistance against Salmonella typhi Ceftriaxone is a way to produce β-lactamase enzymes that break down β-lactam of Ceftriaxone and eliminate power antimikrobanya (Petri, 2007). 
Factors affecting antibiotic sensitivity pattern of Salmonella typhi among others a history of previous typhoid fever, history of antibiotic usage is the use of antibiotics when sick, I know the rules of use of antibiotics obtained by prescription and without a prescription that is whether or not recommended by doctors, both in terms of dosage, method and duration of administration.The spread of bacterial resistance to antibiotics can last a result of the selection process as well as genetically. The spread of resistance is a result of the selection process is due to selective pressure (selective pressure) than the use of antibiotics. On the spread of resistance is genetically according to Baron, 2005 and Madigan, 2000 there are three mechanisms of genetic changes in prokaryotic transformation, transduction and conjugation.Salmonella typhi is a prokaryotic so that genetic change can occur through three mechanisms.Nurtjahyani prove that the Salmonella typhi resistant to chloramphenicol if taken plasmidnya, then inserted into the culture of Salmonella typhi were sensitive to chloramphenicol, the sensitive Salmonella typhi that is turned into a resistant to chloramphenicol due to receive a transfer plasmid DNA from chloramphenicol-resistant Salmonella typhi. Shanahan in Nurtjahyani, 2007 in molecular clinical isolates of Salmonella typhi were also found antibiotic resistant Salmonella typhi encoded by one of 4 types of plasmids. Plasmid as an intermediary gene resistant to chloramphenicol, trimethoprim and Ceftriaxone is a CAT type I, dihydrofolate reductase type VII, and TEM-I β lactamase. 
From there the data above, indicates that the sensitivity of Salmonella typhi bacteria to some antibiotics for the treatment of typhoid fever particularly chloramphenicol and Ceftriaxone constantly changing. For patients with typhoid fever at Dr. Soetomo chloramphenicol could be an option for the treatment of typhoid fever in the Ceftriaxone. As for patients with typhoid fever in RSSA Malang use of chloramphenicol and Ceftriaxone need consideration because of the high resistance rate against Salmonella typhi. 
The disadvantage is the number of samples that were cultured typhoid fever patients are too few of 19 samples (4.4%) of 427 patients with typhoid fever being treated at Dr. Soetomo and 13 samples (5.2%) of 250 patients with typhoid fever treated at Dr. Saiful Anwar Malang. Samples which caused a little too strict inclusion criteria: only patients who were given the first treatment with chloramphenicol or Ceftriaxone and have studied the sensitivity test, and not all the antibiotics that have been carried out sensitivity tests on typhoid fever patients used as samples. Difficulties experienced in addition to conclusions because the sample is less, of researchers studied 32 patients who could not know that typhoid fever patients studied had a history of previous typhoid fever or not, history of use of chloramphenicol and Ceftriaxone are not listed in medical records. In addition, based on examination of specimens, samples used for a variety of specimens, which shows the course of the disease spisemen typhoid fever that can affect the sensitivity of Salmonella typhi. 

CONCLUSION 
The conclusion is as follows: 
1. In the period 2008 to 2009, chloramphenicol is still sensitive to Salmonella typhi at Dr. Soetomo that is equal to 63.3% 
2. In the period 2008 to 2009, chloramphenicol resistant to Salmonella typhi in Dr. Saiful Anwar Malang that is equal to 76.9% 
3. In the period 2008 to 2009, resistance to Salmonella typhi Ceftriaxone at Dr. Soetomo and in Dr. Saiful Anwar Malang. 


REFERENCES 

Darmowandodo Widodo, Udjiani Pawitro Edi, Monique Noorvitry, 2005, Typhoid Fever, Child Pathology Diagnosis & Penatalaksaan. EGC.Jakarta, pp: 1-49. 

Ministry of Health of East Java, 2008, Health Report 2008. 
Surabaya. 

Dzen, Sjoekoer M, 2004, Medical Bacteriology, Bayumedia Publishing. Malang, pp: 187-274. 

Balbi HJ, 2004, Chloramphenicol American Academy of Pediatrics, Pediatrics in Review 25, pp :284-288. 

Baron, 2005, Medical Microbiology, Edition 4 The University of Texas Medical at Galveston. 

Husein, Besse'Nurlinda Mustary, 2007. Study Use of Antibiotics in Patients with Typhoid Fever Children - Inpatient In Rumkital Dr. Ramelan Surabaya, ADLN Digital Collections 

Musnelina lilies, 2004, Cost Effectiveness Analysis of Treatment of Typhoid Fever Children 
 Using chloramphenicol and Ceftriaxone in Jakarta Fatmawati Hospital Year 2001 - 2002, (online), 


Petri WA Jr, 2007, penicillin, cephalosporins and other lactam antibiotics.In: Goodman & Gillman's, Basic Pharmacology and Therapeutics, edition XI.pp: 1127-225. 

Ryan J.K. & Ray GC, 2004, Sherris Medical Microbiology An Introduction to Infections diseases, Issue 4. USA. Mc Graw Hill, pp.55-215. 

Rampengan TH, 2008, Tropical Infectious Diseases in Children, Second Edition. EGC, Jakarta.pp: 46-64 

Soewandojo Eddy, Suharto, Usman Hadi, Nasronudin, 2007, Typhoid Fever Early Detection and Management, Textbook of Medicine.Airlangga University Press, Singapore, pp :293-300. 

Djoko Widodo, 2007, Typhoid Fever, IMU Disease, Fourth Edition, F akultas Medicine, University of Indonesia. Jakarta.pp: 1752-175.