Background Providing proper antibiotics is undoubtedly crucial to prevent infections during surgery. Objective This study set out to evaluate the medication administration in antibiotic prophylaxis using both quantitative and qualitative methods. Setting The study employed a retrospective design and observed patients who underwent surgical procedures during hospitalization at a private hospital in Indonesia within the period of January-June 2019. Methods The data obtained were evaluated quantitatively and qualitatively; and analyzed descriptively. The quantitative evaluation used the defined daily dose (DDD) per 100 bed-days. The qualitative evaluation was expressed as the percentage of antibiotic suitability based on antibiotic administration, i.e. (1) type; (2) timing; (3) dosage; (4) duration; and (5) route. Main outcome measure Suitability of antibiotic prophylaxis in a hospital setting. Results There were 164 prescriptions recorded from 20 types of surgical procedures, of which the most common was cholecystectomy (23 patients, 14%). Most antibiotics were administered 61-120 min before the incision time (55 patients, 37%), and had a duration of more than 24 h (119 patients, 80%). The total DDD per 100 bed-days for pre-, on-, and post-surgery antibiotic use were 44.2, 33.3, and 66.7 respectively. The suitability profiles of the antibiotics used according to the Antibiotic Use Guideline for Hospital (2018) were as follows: 26.3% right type, 52.9% right time, 24.8% right dosage, 19.1% right duration, 91.8% right route, while according to American Society of Health-System Pharmacists Therapeutic Guidelines (2014) there were 17.6% right type, 53.4% right time, 16.4% right dosage, 19.1% right duration, and 96.6% right route. Conclusion Ceftriaxone was the first-choice prophylactic antibiotic administered in this Indonesian hospital. The data indicate a considerable non-compliance with local and international guidelines. Keywords Antibiotic prophylaxis • DDD per 100 bed-days • Inappropriate prescriptions • Surgery Impacts on practice• Evaluating antibiotic prophylaxis is useful for assessing the possibility of inappropriate antibiotic use. • Surgeons tend to prescribe prophylactic antibiotics for all types of surgery despite the absence of prerequisites for some of them.• Frequent inappropriate use of antibiotics can increase the cost of treatment and antibiotic resistance in patients. • Increasing adherence to guidelines and the use of appropriate prophylactic antibiotics are important points in prevention of surgical site infection and control of microbial resistance. • To increase adherence, training is needed to normalize antibiotic selection in accordance with international and local guidelines.

Clean surgery without contamination does not require prophylactic antibiotics, but there are high-risk surgical procedures that may cause infection and/or involve vital organs such as the heart, brain, and lungs, and these indeed require the use of antibiotics. This study aimed to determine the quantity of antibiotic use based on the defined daily dose (DDD) per 100 bed days and the quality of antibiotic use based on the percentage of concordance with The American Society of Health-System Pharmacists (ASHP) therapeutic guidelines (i.e., route of administration, time of administration, selection, dose, and duration). This includes the profiles of surgical site infection (SSI) in surgical patients from January through June 2019. The study subjects were 487 surgical patients from two hospitals who met the inclusion criteria. There were 322 patients out of 487 patients who had a clean surgical procedure. Ceftriaxone (J01DD04) was the most used antibiotic, with a total DDD/100 bed days value in hospitals A and B, respectively: pre-surgery: 14.71, 77.65, during surgery: 22.57, 87.31, and postsurgery: 38.34, 93.65. In addition, 35% of antibiotics were given more than 120 min before incision. The lowest concordance to ASHP therapeutic guideline in hospital A (17.6%) and B (1.9%) was antibiotic selection. Two patients experienced SSI with bacterial growths of Proteus spp., Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. The usage of prophylactic antibiotics for surgical procedures was high and varied between hospitals. Hospital B had significantly lower concordance to antibiotic therapeutic guidelines, resulting to a higher infection rate, compared with hospital A. ASHP adherence components were then further investigated, after which antibiotic dosing interval and injection time was found to be a significant predictor for positive bacterial growth based on logit–logistic regression. Further interventions and strategies to implement antibiotic stewardship is needed to improve antibiotic prescriptions and their use.

Amebiasis is one of the gastrointestinal tract infection disease caused by Entamoeba histolytica ,a parasitic protozoan. Amebiasis is the second disease, caused by parasite, that leading cause of death after malaria. Infection occurs through faecal-oral route and after ingestion a contaminated food and beverages by human faeces. The pathogenesis of E. histolytica can be classified into 3 processes, i.e: death of host cell, inflammation, and parasitic invasion. The recent years, a molecularly amebiasis pathogenesis has been developed, i.e: adherence, phagocytosis, tropogocytosis of host cell and how the parasites can survive and attack host cells so it can cause an infection in humans. Molecular development is an important thing to be considered in the selection of amebiasis therapy.

Penelitian ini bertujuan untuk mengetahui profil kuantitas penggunaan antibiotik berdasarkan metode DDD/100 patient-days dan kualitas penggunaan antibiotik berdasarkan persentase kesesuaian (indikasi, waktu pemberian, durasi, dosis, dan rute pemberian) terhadap ASHP, PPAB, dan Formularium Rumah Sakit, serta profil Infeksi Daerah Operasi (IDO) pada pasien bedah di RSP NTB periode Januari-Juni 2019. Metode penelitian menggunakan desain penelitian deskriptif dengan pengambilan data secara retrospektif terhadap data rekam medik sampel penelitian. Subyek penelitian adalah pasien bedah periode Januari-Juni 2019 yang memenuhi kriteria inklusi, yaitu sebanyak 323 sampel penelitian. Hasil yang diperoleh dari penelitian ini yaitu kuantitas penggunaan antibiotik periode Januari-Juni 2019 di dominasi oleh antibiotik ceftriaxone (J01DD04) dengan nilai total DDD/100 patient-days pada pre operasi yaitu 77,655, on operasi 87,31, dan post operasi 93,65. Kesesuaian pemilihan antibiotik profilaksis berdasarkan guideline ASHP sebesar 1,9%, PPAB 15,5%, dan Formularium RSP NTB 100%, sedangkan kesesuaian durasi, waktu pemberian, dosis, dan rute pemberian berdasarkan ASHP berturut-turut yaitu 19,2%, 42,7%, 1,5%, dan 100%. Sampel penelitian yang mengalami IDO yaitu 2 dari 323 sampel (0,62%) dengan hasil pertumbuhan bakteri yaitu Proteus sp., Staphylococcus aureus, S. epidermidis, dan E.coli. Uji sensitivitas keseluruhan bakteri penyebab IDO ditemukan masih sensitif terhadap antibiotik seperti chloramphenicol, amoxicillin-clavulanic acid, vancomycin, cefoxitin, dan oxacillin