Evaluasi Penggunaan Antibiotik Profilaksis Pada Pasien Bedah Kategori Highly Recommended Di Rumah Sakit “X” Kota Prabumulih

Abstract

Based on Permenkes RI No.2406 / Menkes / per / XII / 2011 on General Guidelines for the Use of Antibiotics that prophylaxis antibiotics intended to reduce and prevent to occurrence of Surgical Site Infection (SSI), inhibiting the emergence of resistance, reduce the morbidity and mortality of patients, as well as to minimize the value of health care and prophylaxis antibiotics in highly recommended surgical procedures has been proven to be firm and effective. However, from several studies there are still many discrepancies in the use of prophylaxis antibiotics and there are several cases in patients with highly recommended surgical procedures that are not given prophylaxis antibiotics, so this research aims to evaluate the use of prophylaxis antibiotics in highly recommended surgical patients. This research was observational research. The data was obtained retrospectively by searching the medical record data of highly recommended surgical patient in Hospital”X” Prabumulih period of January-December 2019 using the Purposive sampling method which is further analyzed descriptively using the applicable guidelines. From 77 medical records of patients collected found 1 patient (1.30%) who did not get antibiotics and from 76 medical record data that met the inclusion criteria there were 119 prophylaxis antibiotic use and overall there were 8 uses (6.72%). Suitability based on antibiotic type as much as 110 (92.44%), antibiotic doses as many as 95 (86.36%), delivery route as much as 110 (100%), delivery time as much as 103 (93.64%), delivery interval of 8 (7.27%), and length of delivery as much as 44 (40%). Overall, the using of prophylaxis antibiotics is not fully appropriate and the most common discrepancies are found at the interval of administration. Keywords: Prophylaxis antibiotics; Surgery; Evaluation; Highly Recommended AbstrakBerdasarkan Permenkes RI No.2406/Menkes/per/XII/2011 tentang Pedoman Umum Penggunaan Antibiotik bahwa pemberian antibiotik profilaksis ditujukan untuk menurunkan dan mencegah terjadinya Infeksi Luka Operasi (ILO), menghambat munculnya resistensi, menurunkan morbiditas dan mortalitas pasien, serta untuk meminimalkan biaya pelayanan kesehatan dan pemberian antibiotik profilaksis pada prosedur bedah kategori highly recommended telah terbukti tegas dan efektif. Namun, dari beberapa penelitian masih banyak dijumpai ketidaksesuaian dalam penggunaan antibiotik profilaksis serta terdapat beberapa kasus pada pasien prosedur bedah kategori highly recommended yang tidak diberikan antibiotik profilaksis maka penelitian ini bertujuan untuk mengevaluasi penggunaan antibiotik profilaksis pada pasien bedah kategori highly recommended. Penelitian ini merupakan penelitian observasional. Data diperoleh secara retrospektif melalui penelusuran data rekam medik pasien bedah kategori highy recommended di Rumah Sakit “X” Kota Prabumulih periode Januari-Desember 2019 dengan menggunakan metode purposive sampling yang selanjutnya dianalisis secara deskriptif menggunakan pedoman yang berlaku. Dari 77 rekam medik pasien yang terkumpul ditemukan 1 pasien (1,30%) yang tidak mendapat antibiotik profilaksis dan dari 76 data rekam medik yang memenuhi kriteria inklusi terdapat 119 penggunaan antibiotik profilaksis dan secara keseluruhan didapat kesesuaian sebanyak 8 penggunaan (6,72%). Kesesuaian berdasarkan jenis antibiotik sebanyak 110 (92,44%), dosis antibiotik sebanyak 95 (86,36%), rute pemberian sebanyak 110 (100%), waktu pemberian sebanyak 103 (93,64%), interval pemberian sebanyak 8 (7,27%), dan lama pemberian sebanyak 44 (40%). Secara keseluruhan, penggunaan antibiotik profilaksis belum sepenuhnya sesuai dan ketidaksesuaian yang paling banyak ditemukan yaitu pada interval pemberian.

Optimizing antibiotic use in Indonesia: A systematic review and evidence synthesis to inform opportunities for intervention

“…There were 49 reports that reported data on the appropriateness of antibiotic prescribing, of which 18 27 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 (3167 prescriptions) used Gyssens method and 31 (7826 prescriptions) 23 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 used reference guidelines. Most were conducted in hospitals (37 reports, 74.0%), in Java (33 reports, 66.0%), and in adults (29 reports, 58.0%) and between 2016-2021 (62 reports, 62.0%) (Tables S5 and S6).…”

Optimizing antibiotic use in Indonesia: a systematic review and synthesis of current evidence to inform opportunities for intervention

“…A total of 49 reports reported data on the appropriateness of antibiotic prescribing, of which 18 33, 39–55 (3167 prescriptions) used Gyssens method and 31 (7826 prescriptions) 20, 56–85 used reference guidelines. Most were conducted in hospitals (37 reports, 74.0%), in Java (33 reports, 66.0%), and in adults (29 reports, 58.0%) ( Table S5-S6 ).…”