Antibiotic prophylaxis compliance for clean-contaminated wounds in a district hospital in Jakarta

Abstract

AbstrakLatar belakang: Insidens infeksi luka operasi (ILO) masih menjadi masalah namun kejadiannya dapatdikurangi dengan tindakan pencegahan yaitu antara lain dengan pemberian antibiotik profilaksis.Penelitian ini bertujuan untuk menilai kesesuaian penggunaan antibiotik profilaksis pada pasien bedahbersih-terkontaminasi.Metode: Penelitian potong lintang di sebuah rumah sakit umum daerah (RSUD) di Jakarta pada periode1 Januari sampai 31 Desember 2013. Data berasal dari rekam medik pasien dewasa yang menjalanipembedahan dengan kriteria kelas luka bedah bersih-terkontaminasi kecuali bedah sesar. Analisis datadilakukan secara deskriptif. Sebagai standar penggunaan antibiotika digunakan Permenkes RI No.2406/2011 tentang pedoman antibiotik nasional dan pedoman standar internasional untuk profilaksis bedah.Hasil: Sebanyak 626 subjek diikutsertakan dalam penelitian dengan bedah ginekologi (49,5%) dangenitourinari (32,6%) merupakan tindakan bedah terbanyak dan lebih dari 80% bedah elektif. Jenisantibiotik yang paling umum digunakan baik preoperatif maupun postoperatif adalah seftriakson (49,8%),ampisilin/sulbaktam (11,7%) dan sefuroksim (8,3%). Keseluruhan ketepatan antibiotik profilaksis diketahui96,8% tepat indikasi prosedur bedah, 21,5% tepat obat dan hanya 2,3% tepat waktu pemberiannya 60menit sebelum operasi.Kesimpulan: Kepatuhan antibiotik profilaksis untuk bedah bersih-terkontaminasi di suatu RSUD Jakartabelum sesuai dengan pedoman nasional dan standar internasional. (Health Science Journal of Indonesia2015;6:57-62)Kata kunci: antibiotik, bedah, bersih-terkontaminasi, kepatuhan, profilaksis. AbstractBackground: The incidence of surgical site infection (SSI) is still a problem, but its occurrence can bereduced by preventive action such as the provision of antibiotic prophylaxis in surgery. This study aimedto describe the compliance of antibiotic prophylaxis in clean-contaminated wounds.Methods: This cross-sectional study design was conducted in a district hospital in Jakarta during periodof January 1 to December 31, 2013. The data came from medical records of adult subjects who underwentsurgery with criteria clean-contaminated wound except caesareans. The standard for antibiotic based onIndonesian Ministry of Health Decree No. 2406/2011 for national antibiotics guidelines and internationalstandard guidelines for surgical prophylaxis.Results: A total of 626 subjects were included in the study. Gynecological (49.5%) and genitourinary surgery(32.6%) were the most frequent of surgeries performed. More than 80% of the surgery were elective. Mostcommonly administered antibiotic preoperatively as well as postoperatively was ceftriaxone (49.8%),ampicillin/sulbactam (11.7%) and cefuroxime (8.3%). Overall antibiotics prophylaxis appropriatenessshowed 96.8% in surgery procedures, 21.5% in choice of antibiotic and only 2.3% in time administrationthat given 60 min before first skin incision.Conclusions: The compliance of antibiotics prophylactic for clean-contaminated wounds in a districthospital Jakarta has not been in conformity with the national guideline and international standards. (HealthScience Journal of Indonesia 2015;6:57-62)Keywords: antibiotic, clean-contaminated, compliance, prophylaxis, surgery.