Evaluasi penggunaan profilaksis antibiotik bedah umum di Rumah Sakit Pemerintah di Yogyakarta
DOI:
https://doi.org/10.32504/hspj.v6i1.655Keywords:
cephalosporin, general surgery, prophylacticAbstract
Surgical Site Infections (SSI) is an infection with surgery and surgical procedure, which occurs in the incision area or around the tissue. SSI increases the incidence of patients being admitted to the Intensive Care Units (ICU) by 60%, 5 times being hospitalized and 2 times dying. Giving prophylactic antibiotics before and after surgery will help reduce SSI if the administration of the appropriate type of drug, appropriate dose, appropriate time, and route of administration. The purpose of the study is to analyze the accuracy of the selection to reduce the incidence of SSI. This study is a cross-sectional study with retrospective data collection through the medical records of patients with general surgery in March 2019 with data from January until February 2019. The data collection technique was in the form of total sampling with inclusion and exclusion criteria. Data analysis was carried out by evaluating the use of prophylactic antibiotics and accompanying drugs descriptively and analytically in percentage. The result of the study using prophylactic antibiotics in 51 general surgery patients received the result that preoperative antibiotics were given in 98% of patients, all of the patients received antibiotics with the appropriate indication, an appropriate type of drug, and appropriate route of administration but 78,42% of patients received underdose for cefuroxime and ceftriaxone. Postoperative antibiotics were given to 80,39% of patients and all patients received appropriate indication and route of drug administration, but 15,68% of patients received an inappropriate type of antibiotic, namely ceftriaxone, and 52.93% of patients received an inappropriate dose, namely cefuroxime (underdose), cefazolin (underdose) and metronidazole (overdose). The results of this study can be used as a consideration for the selection of appropriate prophylactic antibiotics to prevent the occurrence of SSI.
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Keywords: prophylactic antibiotic, general surgery, cephalosporin
References
Colás-Ruiz E, Del-Moral-Luque JA, Gil-Yonte P, Fernández-Cebrián JM, Alonso-GarcÃa M, Villar-del-Campo MC, et al. Incidence of surgical site infection and risk factors in rectal surgery: A prospective cohort study. Cir Esp. 2018;96(10):640–7.
Davat M, Wuarin L, Stafylakis D, Abbas M, Harbarth S, Hannouche D, et al. Should antibiotic prophylaxis before orthopedic implant surgery depend on the duration of pre-surgical hospital stay? Antimicrob Resist Infect Control. 2018;7(1):1–7.
Berriós-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152(8):784–91.
Healthcare Improvement Scotland. SIGN 104. Antibiotic prophylaxis in surgery. 2014.
Mangram AJ, Horan TC, Pearson ML, Silver LC, William R. Guideline for Prevention of Surgical Site Infection , 1999. 1999;97–134.
Blidaru A. Breast cancer surgery. Chir. 2017;112(4):359–64.
Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. In: ASHP Therapeutic Guidelines. 2013. p. 73–156.
Stanford Health Care. SHC Surgical Antimicrobial Prophylaxis Guidelines [Internet]. 2017. Available from:
World Health Organization. WHO Guidelines for Safe Surgery 2009 Safe Surgery Saves Lives. 2009. 1–133 p.
Marsaoly SFA. Infeksi Luka Post Operasi Pada Pasien Post Operasi Di Bangsal Bedah PKU Muhammadiyah Bantul. Muhammadiyah University of Yogyakarta; 2016.
Haryanti L, Pudjiadi AH, Ifran EKB, Thayeb A. Prevalens dan Faktor Risiko Infeksi Luka Operasi Pasca-bedah. Sari Pediatr. 2013;15(4):207–12.
Centers for Disease Control and Prevention (CDC). Surgical Site Infection Event (SSI) [Internet]. 2021. Available from:
https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/ImportingProcedureData.pdf
National Healthcare Safety Network. Surgical Site Infection Event ( SSI ). Centres for Disease Control and Prevention. 2021. p. 1–39.
Zunnita O, Sumarny R, Kumalawati J. Pengaruh Antibiotik Profilaksis Terhadap Kejadian Infeksi Luka Operasi. Fitofarmaka. 2018;8(1):39–45.
IJsselmuiden CB, Faden RR. The New England Journal of Medicine Downloaded from nejm.org on January 31, 2011. For personal use only. No other uses without permission. Copyright © 1992 Massachusetts Medical Society. All rights reserved. N Engl J Med. 1992;326(5):281–6.
Dellinger EP. Prophylactic antibiotics: Administration and timing before operation are more important than administration after operation. Clin Infect Dis. 2007;44(7):928–30.
Ierano C, Manski-Nankervis JA, James R, Rajkhowa A, Peel T, Thursky K. Surgical antimicrobial prophylaxis. Aust Prescr. 2017 Dec 1;40(6):225–9.
Sankaran S, Rajagopal G, Achamkulangara S. Effects of antibiotic prophylaxis on surgical wounds: A study in a tertiary care centre of central Kerala. J Acad Clin Microbiol [Internet]. 2016 [cited 2021 Nov 17];18(1):12. Available from:
Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14(1):73–156.
Sanabria A, DomÃnguez LC, Valdivieso E, Gómez G. Prophylactic antibiotics for mesh inguinal hernioplasty: A meta-analysis. Ann Surg. 2007;245(3):392–6.
Anderson DJ, Podgorny K, Berrios-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals : 2014 Update. Infect Control Hosp Epidemiol. 2014;35(6):605–27.
de Jonge SW, Gans SL, Atema JJ, Solomkin JS, Dellinger PE, Boermeester MA. Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection: A systematic review and meta-analysis. Medicine (Baltimore) [Internet]. 2017 Jul 1 [cited 2021 Nov 16];96(29):e6903. Available from:http://www.ncbi.nlm.nih.gov/pubmed/28723736
Kementrian Kesehatan Republik Indonesia. Pedoman Umum Penggunaan Antibiotik [Internet]. Pedoman Umum Penggunaan Antibiotik. 2011. p. 3–39. Available from:
farmalkes.kemkes.go.id
Megawati S, Rahmawati F, Djoko W. Evaluasi penggunaan antibiotik profilaksis pada pasien bedah. J Manaj dan Pelayanan Farm Univ Gajah Mada. 2015;5(2):127–34.
Muliani N, Herawati F, Yulia R, Wijono H. Quantity and quality profiles of antibiotics pre, on, and post surgery in a hospital setting. Int J Clin Pharm. 2021 Oct 1;43(5):1302–10.
Yuen KY. Antibiotic prophylaxis for hernia repair. Clin Infect Dis [Internet]. 2005 Mar 15 [cited 2021 Nov 17];40(6). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003769.pub4/full
Sadraei-Moosavi SM, Nikhbakhsh N, Darzi AA. Postoperative antibiotic therapy after appendectomy in patients with non-perforated appendicitis. Casp J Intern Med [Internet]. 2017 [cited 2021 Nov 17];8(2):104. Available from: /pmc/articles/PMC5494044/
Ayazi K, Togh AM, Qaderi S, Tarki FE, Samsami M, Nematihonar B, et al. Oral Metronidazole and Cexime as Prophylaxis on Wound Complications of Uncomplicated Appendicitis Following Appendectomy: A Randomized Clinical Trial. 2021 [cited 2021 Nov 19]; Available from:
https://doi.org/10.21203/rs.3.rs-502029/v1
Putra ON, Doso Saputro I, Yuniar A, Hidayatullah N. A retrospective surveillance of the prophylactic antibiotics for debridement surgery in burn patients. Int J Burns Trauma [Internet]. 2021 [cited 2021 Nov 19];11(2):96. Available from: /pmc/articles/PMC8166663/.
