Faktor Risiko Infeksi Luka Operasi (ILO) dan Rasionalitas Antibiotik Profilaksis Bedah di RSUP Dr. Sardjito Yogyakarta
Rosylianti Rosylianti(1), Ika Puspitasari(2*), Rizka Humardewayanti Asdie(3)
(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Faculty of Pharmacy, Universitas Gadjah Mada
(3) Departemen Penyakit Dalam FKKMK UGM
(*) Corresponding Author
Abstract
Healthcare assoicated infections (HAIs) merupakan merupakan infeksi yang didapatkan pasien ketika menerima pelayanan kesehatan di fasilitas kesehatan. Salah satu jenis HAIs yang dapat dicegah adalah infeksi luka operasi (ILO), yakni melalui pemberian antibiotik profilaksis bedah (APB). Penelitian ini bertujuan untuk mengetahui besar kejadian ILO selama periode penelitian, besar ABP rasional, pengaruh pemberian APB rasional terhadap ILO, dan faktor risiko yang meningkatkan risiko ILO. Penelitian dilaksanakan di RSUP Dr. Sardjito Yogyakarta dengan rancangan cohort prospektif pada subjek dengan kriteria inklusi usia ≥18 tahun, menjalani bedah obstetri-ginekologi, digestif dan tumor dengan kelas operasi bersih/bersih-terkontaminasi, dan menerima ABP. Subjek dieksklusi jika didiagnosis infeksi sebelum operasi dan menjalani pemasangan implan. Pengamatan luka operasi dilakukan hingga 30 hari pascabedah. Sejumlah 95 pasien bersedia menjadi subjek penelitian. Terdapat 96 pemberian ABP selama periode penelitian. ILO dialami oleh 17,9% (IK 95% 10,2-25,6%) subjek. Ditemukan 13 pemberian antibiotik tidak tepat indikasi. Dari 83 pemberian ABP dengan indikasi, hanya ditemukan 1,2% pemberian ABP rasional menurut algoritma Gyssens (kategori 0). Jenis ketidakrasionalan paling tinggi yaitu kategori IIa (tidak tepat dosis) 95,1%. Penelitian ini tidak dapat menentukan pengaruh pemberian antibiotik profilaksis terhadap penurunan kejadian ILO. IMT >27 kg/m2 secara bermakna meningkatkan risiko ILO dengan OR 5,91 (IK 95% 1,20-18,37; p<0,05).
Kata kunci: antibiotik profilaksis, analisis Gyssens, ILO
Keywords
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DOI: https://doi.org/10.22146/farmaseutik.v1i1.53094
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