Evaluasi Clinical Pathway Seksio Sesarea: Keefektifan Penggunaan Antibiotika Injeksi Cefotaxime 2 Gram dalam 24 Jam untuk Mencegah Terjadinya Infeksi Luka Operasi


Rathi Manjari Fauziah(1*), Rukmono Siswishanto(2), Shofwal Widad(3)

(1) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM
(2) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM
(3) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM
(*) Corresponding Author


Background: The usage of prophylactic antibiotics in Dr. Sardjito Hospital, Yogyakarta, is still diverse. Previously, prophylactic antibiotics that were given would be in a form of multidose and or multidrug regimen. Recently, a clinical pathway for c-section had been set up to uniform the antibiotics given. Cefotaime 2g, given intravenously, in 24 hours is the antibiotic of choice. Unfortunately, there was no data about the effetiveness of cefotaime that can be used as a basis of clinical pathway. 

Objective: Comparing the incidence of surgical site infection (SSI) between cefotaime 2g,/24 hours (clinical pathway or CP) with previous regimen of prophylactic antibiotics (non-clinical pathway or nonCP) and also identify the risk factors.

Method: This is a retrospective cohort study with 129 subjects, divided into two groups. The CP group consists of 63 subjects, while non-CP group consists of 66 subjects. The surgical site infection was observed in the day 3 and day 10 aer C-section. Multivariat analysis was used to determine the risk factors of SSI.

Result and Discussion: SSI incidence in the CP group at day 3 was higher compared to non-CP group, but it was not statistically significant (OR 4,73 95% CI 0,52 43,04), eukocytosis (>17000/mcl) was the independent risk factor for SSI (OR 7,54 95% CI 1,25 45,39).

Conclusion: SSI incidence between two groups was not statistically significant but was clinically significant. The presence of leukocytosis is becoming the risk factor for SSI.

Keywords: prophylactic antibiotic, c-section, cesarean section, surgical site infectio


prophylactic antibiotic; c-section; cesarean section; surgical site infection

Full Text:



  1. SIGN. Antibiotic Prophylaxis in Surgery. SIGN 104. Scottish Intercoll Guidel Netw. 2008,July.
  2. Smaill F, Gyte G. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section (Review). Cochrane database Syst Rev. 2010;(1).
  3. Centre for Healthcare Improvement. Patient Safety and Quality Improvement Service. http://www. med.upenn.edu. Acces on July 2012.
  4. Westen EHMN, Kolk PR, Van Velzen CL, Unkels R, Mmuni NS, Hamisi AD, Nakua RE, Viek ALM, van Beekhuizen HJ. Single-dose compared with multiple day antibiotic prophylaxis for cesarean section in low-resource settings, a randomized controlled, noninferiority trial. Acta Obs Gynecol Scand. 2015; 94:43–9.
  5. Krieger Y, Walfisch A, Sheiner E. Surgical site infection following cesarean deliveries: trends and risk factors. J Matern Neonatal Med. 2016;7058:1– 5.
  6. Wloch C, Wilson J, Lamagni T, Harrington P, Charlett A, Sheridan E. Risk factors for surgical site infection following caesarean section in England: Results from a multicentre cohort study. BJOG. 2012;119(11):1324–33.
  7. Chu K, Maine R, Trelles M. Cesarean section surgical site infections in sub-Saharan Africa: A multicountry study from Medecins sans Frontieres. Present from 9th Annu Electr Util Environ Conf. 2015;39(2):350–5.
  8. Farret TCF, Dallé J, da Silva Monteiro V, Riche CVW, Antonello VS. Risk factors for surgical site infection following cesarean section in a Brazilian Women’s Hospital: a case-control study. Braz J Infect Dis. 2014; 19(2):113–7.
  9. Schneid-Kofman N, Sheiner E, Levy A, Holcberg G. Risk factors for wound infection following cesarean deliveries. Int J Gynecol Obstet. 2005;90:10–5.
  10. Mahdi H, Gojayev A, Buechel M, Knight J, SanMarco J, Lockhart D, et al. Surgical site infection in women undergoing surgery for gynecologic cancer. Int J Gynecol Cancer. 2014.,24(4):779–86.
  11. Sagi HC, Dziadosz D, Mir H, Virani N, Olson C. Obesity, leukocytosis, embolization, and injury severity increase the risk for deep postoperative wound infection after pelvic and acetabular surgery. J Orthop Trauma. 2013; 27(1);6-10.
  12. Cohen B, Dery E, Cattan A, Matot I. Is Leukocytosis a Common Finding in the Postoperative Period ? A3067. The anesthesiology Annual Meeting, 2013.
  13. Canzoneri BJ, Lewis DF, Groome L, Wang Y. Increased Neutrophil Numbers Account for Leukocytosis in Women with Preeclampsia. Am J Perinatol. 2009;26(10):729–32.
  14. Mihu D, Sabau L, Costin N, Ciortea R, Oancea M, Malutan A. Evaluation of Leukocytes and Neutrophils , Markers of Inflammatory Syndrome in Preeclampsia. 2010;27(3):15–22.
  15. Mpogoro FJ, Mshana SE, Mirambo MM, Kidenya BR, Gumodoka B, Imirzalioglu C. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrob Resist Infect Control. 2014;3(1):25.
  16. Guo S, Dipietro LA. Factors affecting wound healing. J Dent Res. 2010;89(3):219–29.

DOI: https://doi.org/10.22146/jkr.36039

Article Metrics

Abstract views : 2447 | views : 6814


  • There are currently no refbacks.

Copyright (c) 2016 Jurnal Kesehatan Reproduksi

Jurnal Kesehatan Reproduksi Indexed by:



Departemen Obstetri dan Ginekologi, FK-KMK, UGM/RS Dr. Sardjito
Jl. Kesehatan No. 1, Sekip Utara, Yogyakarta 55281
Tlp: (0274) 511329 / Faks: (0274) 544003
Email: jurnal.kesehatanreproduksi@ugm.ac.id
Cp: Dwi Astuti +6281802698043