PERBANDINGAN ANTARA PEMBERIAN ANTIBIOTIKA PROFILAKSIS PADA SEKSIO SESAR SESUAI ALUR KLINIS RSUP DR SARDJITO DENGAN ANTIBIOTIKA DOSIS MULTIPEL TERHADAP KEJADIAN INFEKSI LUKA OPERASI

https://doi.org/10.22146/jkr.35444

Ardian Rahmansyah(1*), Mohammad Hakimi(2), Rukmono Siswishanto(3)

(1) Department of Obstetrics and Gynecology, Faculty of Medicine, University of Gadjah Mada
(2) Department of Obstetrics and Gynecology, Faculty of Medicine, University of Gadjah Mada
(3) Department of Obstetrics and Gynecology, Faculty of Medicine, University of Gadjah Mada
(*) Corresponding Author

Abstract


Background: Clinical pathway recommend the use of short-term prophylaxis antibiotics for cesarean section. Long-term antibiotics or multiple doses was found in clinical practice. There are differences in the mode of administration and the number of doses administered at sardjito hospital.

Objective: To determine the effectiveness of short-term antibiotic prophylaxis in cesarean section appropriate to clinical pathway in the prevention of surgical site infection (ssi), the incidence of fever, dysuria events, length of stay.

Method: The study used randomized clinical trial. The study subjects who underwent cesarean section and meet the inclusion and exclusion criteria in the period July 2013 to January 2014 divided into an intervention group (n = 52) who received ampicillin 2 gram pre and post-cesarean section, and a control group (n = 54) who received ampicillin 2 gram pre cesarean section and 1 gram every 8 hours for 6 times. Observed on days 3 and 10 post-cesarean section. The primary outcomes assessed were the incidence of surgical wound infection based on the criteria of surgical site infection from Centers for Disease Control
and Prevention. Secondary outcomes assessed were the incidence of fever, dysuria events, length of stay. Homogeneity analysis were conducted on subject. Outcome analysis performed bivariate with t test and chi squared test.

Results and Discussion : A total of 106 subjects can be analyzed. SSI events in the intervention group at day 3 was 3.8% (n = 52) and control group was 1.84% (n = 54) with p>0.05 RR 2.077 (95% CI 0.194 to 22.219). SSI on day 10 of 7.7% (n = 52) in the intervention group versus 9.3% (n = 54) in controls with p<0.05 RR 0.831 (CI 95%, 0.236 to 2.924). Fever events on day 3 by 5.8% in the intervention group versus 3.7% in
controls with p>0.05 RR 1.558 (95% CI 0.271 to 8.948) and on day 10 was 3.8% versus 3.7 % with p>0.05 RR 1.038 (95% CI 0.152 to 7.102). Dysuria not found on day 3 and but on 10 found 5.8% in the intervention group versus 11.1% with p>0.05 RR 0.519 (IK95% 0.137 to 1.968). Length of stay after cesarean section for 3.21 ± 0.412 days in the intervention group and 3.26 ± 0.442 days in the control group with p>0.05 (95% CI -0.213 - 0.117).

Conclusion: There is no significant difference in the incidence of surgical wound infections, the incidence of fever, dysuria, length of stay between short-term prophylaxis antibiotics ampicillin appropriate to clinical pathway and long-term or multiple doses prophylaxis antibiotics. Short term antibiotics prophylaxis are more efficiently with the same effectiveness in preventing outcomes research.

Keywords: prophylaxis antibiotics, ampicillin, short term regimen, long term regimen, cesarean section, surgical site infection.

 


Keywords


prophylaxis antibiotics; ampicillin; short term regimen; long term regimen; cesarean section; surgical site infection.

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References

Hopkins L, Smaill FM. 2010. Antibiotic prophylaxis regimens and drugs for cesarean section (Review). Cochrane Database Of Systematic Reviews. Handerson E. 1995. Incidence of Hospital Acquired-Infections Associated with Caesarean Section. J Hasp Infect. 29:245-255. Soper D. 2009. Prevention of Surgical Site Infection. Infectious Disease in Obstetric and Gynecology a Systematic Approach Management. ACOG. www. acog.org Opoku BK. 2007. Prophylactic Antibiotic During Caesarean Sections At Komfo Anokye Teaching Hospital, Kumasi. Ghana Medical Journal; Volume 41: 48-51. Petri, W.A. 2006. Penicillins, Chepalosporins, And Other Beta Lactam Antibiotics. Goodman and Gilman The Pharmacological Basis of Therapeutics. 11 edition. 44:1127-1154 Rubin RH. 2006. Surgical wound infection:epidemiology, pathogenesis, diagnosis andmanagement. BMC Infectious Disease. BMC Infectious Diseases 2006, 6 : 171 http://www. biomedcentral.com/ 1471-2334/6/171 Surgical Site Infection (SSI) Event. CDC’s Guideline for Prevention of Surgical Site Infection 1999. http://www.cdc.gov/nhsn/PDFs/ pscManual/9pscSSIcurrent.pdf Dahlan MS. 2008. Langkah-Langkah Membuat Proposal Penelitian Bidang Kedokteran dan Kesehatan. Jakarta: Sagung Seto. Dahlan MS. 2009. Besar sampel dan cara pengambilan sampel dalam penelitian kedokteran dan kesehatan. Edisi 3. Jakarta: Salemba Medika. Bayles, K.W. 2000. The bactericidal action of penicillin: New clues to an unsolved mystery. Trends Microbiol. 8:81274-81278 Garner JS. 1985. Supercedes guideline for prevention of surgical wound infections. CDC guideline for prevention of surgical wound infection. Revised 1995. Infect Control 1986;7(3):193-200. Gibbs RS. 1980. Clinical risk factors for puerperal infection. Obstet Gynaecol; 55: 1785-1835. Kausar R, Yasmeen L. 2010. Elective caesarean section; short antibiotic prophylaxis versus prolonged antibiotic therapy. Professional Med J Jun 2010;17(2):304-307. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. 1999. Guideline for Prevention of Surgical Site Infection. The Hospital Infection Control Practices Advisory Committee. AJIC: American Journal of Infection Control. volume 27:97-134 Mitt P, Lang K, Peri A, Meimets M. 2005. Surgical site infection during cesarean section in Estonian university hospital: post discharge surveylance and analysis of risk factors. Infection Control and Hospital Epidemilogy volume 26:449-454. Schalkwyk J, Van Eyk N. 2010. Antibiotic Prophylaxis In Obstetric Procedures volume 247. SOGC Clinical Practice Guideline. Society of Obstetricians and Gynaecologists of Canada. http://sogc.org/wpcontent/uploads/2013/01/gui247CPG1009E_000.pdf Shakya A. 2010. Comparison of single versus multiple doses of antibiotic prophylaxis in reducing post-elective Caesarean section infectious morbidity. Kathmandu Univ Med J (KUMJ). Apr-Jun;



DOI: https://doi.org/10.22146/jkr.35444

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