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"Infeksi daerah operasi (IDO) merupakan salah satu komplikasi pembedahan. Hal tersebut menjadi beban untuk pasien dan penyedia kesehatan. Sebagian besar IDO dapat dicegah, dengan salah satu upaya pencegahan yaitu pemberian antibiotik profilaksis sesuai pedoman. Namun, pemberian antibiotik tersebut dapat tidak sesuai dengan pedoman yang ada yang dapat memicu IDO. Di rumah sakit penulis, terdapat pedoman yang dibuat untuk pemberian antibiotik profilaksis yang tepat. Studi ini menganalisis kepatuhan pemberian antibiotik profilaksis berdasarkan pedoman yang ada dan hubungannya dengan IDO. Pasien yang menjalani operasi elektif di Rumah Sakit dr. Cipto Mangunkusumo pada bulan Maret - Agustus 2019 diinklusikan dalam studi ini. Data mengenai pemberian antibiotik profilaksis dan karakteristik pasien dikumpulkan. Insidens IDO dievaluasi dalam waktu 30-90 hari pascaoperasi sesuai dengan definisi durasi waktu terjadinya IDO. Analisis data menggunakan uji Chi square. Insidens IDO dalam studi ini yaitu 11,3%. Tingkat kepatuhan pemberian antibiotik profilaksis sesuai pedoman rumah sakit yaitu 55%. Secara statistik, tidak ada hubungan yang bermakna antara kepatuhan pemberian antibiotik profilaksis sesuai pedoman terhadap IDO (p = 0,225). Jenis luka operasi (p = 0,001) dan penggunaan drain (p = 0,046) adalah dua faktor yang memiliki hubungan bermakna terhadap IDO. Analisis multivariat terhadap faktor risiko IDO menyatakan bahwa dua faktor memiliki hubungan bermakna terhadap IDO, yaitu jenis luka operasi (p = 0,003; OR 6,30[IK95% 1,90-20,83]) dan penggunaan drain (p = 0,032; OR 3,45[IK95% 1,12-10,67]). Sebagian besar subjek yang menjalani operasi elektif memiliki kepatuhan pemberian antibiotik sesuai pedoman yang baik. Namun, secara statistik, studi ini menemukan bahwa tidak ada hubungan yang bermakna antara kepatuhan pemberian antibiotik profilaksis sesuai pedoman terhadap IDO.

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One of surgical procedure complications is surgical site infection (SSI). It is a burden on both patients and health care providers. Most of SSIs are preventable, with prophylactic antibiotics administration as one of the interventions to control the incidence of SSI. However, it is prone to non-compliance leading to SSI. For this reason, our hospital created guideline about antibiotics administration. In this study, we analyze the compliance of prophylactic antibiotics administration and its relation to surgical site infection. Patients who underwent elective surgery at dr. Cipto Mangunkusumo Hospital in March-August 2019 were included. Prophylactic antibiotics administration and patient medical characteristics were recorded. We evaluated SSI incidence in 30–90 days postoperatively according to the type of surgery. Analysis was performed using Chi square. The incidence of SSI was 11.3%. The compliance of prophylactic antibiotics administration to hospital guideline was 55%. There was no significant association between the prophylactic antibiotics administration adherence to hospital guideline with SSI (p = 0.225). The type of surgical wound (p = 0.001) and the usage of drains (p = 0.046) were two significant factors related to SSI. Based on multivariate analysis of risk factors affecting SSI, there were two factors, the type of surgical wound (p = 0.003; OR 6.30[95CI 1.90-20.83]) and the usage of drain (p = 0.032; OR 3.45[95CI 1.12-10.67]). More than half of our subjects underwent elective surgery has good compliance of prophylactic antibiotics administration according to hospital guideline. However, statistically in this study, we found no significant association between the compliance of prophylactic antibiotics administration and SSI."

"Pendahuluan. Saat ini, infeksi daerah operasi (IDO) tetap menjadi komplikasi paling umum dari prosedur bedah. Dalam pencegahannya, antibiotik profilaksis menjadi pilihan pertama dan menyebabkan penggunaan antibiotik yang tinggi. Namun, pemberian antibiotik harus didasarkan pada strategi, yaitu stewardship. Oleh karena itu, penelitian ini bertujuan untuk menilai penggunaan antibotik menggunakan metode Gyssens. Metode Studi kohort retrospektif menganalisis pemberian antibiotik pada sebagian besar operasi elektif besar, termasuk tiroidektomi, mastektomi, dan kolesistektomi yang dilakukan di Rumah Sakit Umum Dr. Cipto Mangunkusumo, Jakarta, Indonesia dari Januari hingga Juli 2023. Indikasi, jenis, dosis, waktu, interval, durasi, dan rute pemberian adalah variabel yang diteliti. Hasil Dari 191 subjek yang menjalani prosedur bedah elektif paling umum, 30 menggunakan antibiotik kombinasi. Kategori Gyssens 0 terdiri dari 165 subjek (86,5%), dan 11 subjek (5,8%) diklasifikasikan sebagai kategori IIA, yang menunjukkan dosis yang tidak sesuai (tidak memadai, tidak mencukupi). Ketidakakuratan penggunaan antibiotik teridentifikasi sebagai pemberian pada waktu yang salah (5,8%), pemilihan antibiotik yang kurang tepat (3,1%), dosis yang salah (2,6%), dan waktu pemberian yang tidak tepat (2,1%). Hubungan antara kategori Gyssens dengan SSI menunjukkan nilai p > 0,05 dengan odds ratio 1, yang menunjukkan bahwa pemberian antibiotik yang sesuai maupun tidak sesuai dari kategori Gyssens tidak menunjukkan hubungan pada kejadian IDO atau non-IDO. Kesimpulan Tingkat kepatuhan penatagunaan antibiotik pada kasus bedah elektif terbanyak di Departemen Bedah RSUPN dr. Cipto Mangunkusumo yang dinilai menggunakan alur Gyssens mencapai 86,4% dan memerlukan perbaikan.

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Introduction. Nowadays, surgical site infections (SSI) remain the most common complication of surgical procedures. In prevention, the prophylactic antibiotic is the first option and somehow leads to the high use of antibiotics. However, antibiotic administration should be based on the strategies, which is the stewardship. Thus, the study aimed to assess using Gyssens' method. Method. A retrospective cohort study analyzed the antibiotic administration of most major elective surgeries, including thyroidectomy, mastectomy, and cholecystectomy proceeded in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia from January to July 2023. Indication, type, dosage, timing, interval, and duration and route of administration were the variables of interest. Results. Of 191 subjects who underwent the most common elective surgery procedures, 30 used combination antibiotics. Gyssens category 0 consists of 165 subjects (86.5%), and 11 subjects (5.8%) were classified as category IIA, indicating inappropriate dose (inadequate, insufficient). Inaccuracies were identified as mistimed administration (5.8%), less effective antibiotic selection (3.1%), incorrect dosage (2.6%), and inappropriate timing (2.1%). The association of Gyssens categories with SSIs showed a p–value of > 0.05 with an odds ratio of 1, indicating that both appropriate and inappropriate antibiotics of the Gyssens category showed no impact on SSIs or non–SSIs. Conclusion. The adherence to antimicrobial stewardship in the most common elective surgery in the Department of Surgery, dr. Cipto Mangunkusumo General Hospital was 86.4 and subjected to improvement."

"Kejadian infeksi luka operasi menjadi salah satu jenis infeksi nosokomial yang sering banyak terjadi di beberapa negara. Belum maksimalnya penggunaan antibiotik profilaksis ditandai dengan penggunaannya yang tidak sesuai dengan pedoman yang telah ditetapkan secara nasional maupun internasional mengakibatkan meningkatnya resiko kejadian infeksi luka operasi. Tujuan penelitian ini adalah untuk menilai dan mengevaluasi faktor-faktor yang mempengaruhi penggunaan antibiotik profilaksis bedah terhadap kejadian infeksi luka operasi yang dievaluasi selama 23 hari di RS Marzoeki Mahdi Bogor. Penelitian menggunakan desain penelitian cross sectional. Pengambilan sampel secara total sampling dan retrospektif dengan menggunakan data sekunder (rekam medis). Sampel penelitian sebanyak 577 rekam medis pasien sejak Januari 2013-Desember 2013. Hasil yang diperoleh menunjukkan bahwa terdapat 6 kejadian infeksi luka operasi (1,04%) dengan penggunaan antibiotik profilaksis tidak sesuai dengan Kepmenkes no 2046 tahun 2011. Tidak terdapat hubungan antara jenis dan waktu penggunaan antibiotik terhadap kejadian infeksi luka operasi serta tidak terdapat hubungan antara faktor resiko dengan kejadian infeksi luka operasi. Kesimpulan dari penelitian ini bahwa kejadian infeksi luka operasi di RS Dr H Marzoeki Mahdi cukup rendah dibandingkan penelitian lain yang pernah dilakukan dan tidak terdapat pengaruh signifikan antibiotik profilaksis serta faktor resiko terhadap kejadian infeksi luka operasi.

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Surgical site infection is one of nosocomial infection that frequently happened in some countries. Unappropriate used of prophylactic antibiotic signed by the used of antibiotic not accordance with local or international guidelines and it caused surgical site infection increase.

This study aim to assesed and evaluated factors that affect antibiotic prophylactic use to surgical site infection in Marzoeki Mahdi Hospital Bogor. The design of this study cross sectional with total sampling, and data collected retrospectively. Sample of this study are 577 patient from January 2013- December 2013.

The result showed surgical site infection occur in 6 patients (1,04%), the used od prophylactic antibiotic is not appropriate Kepmenkes No 2046. There is no relationship between types and duration of prophylactic antibiotic to surgical site infection cases and also there is no relation between risk factors and surgical site infection cases.

In this study we can conclude incidence of surgical site infection in Dr. H. Marzoeki Mahdi Hospital was low and there is no significant relation between prophylactic antibiotic used and risk factors with surgical site infection cases."

"ABSTRAKLatar belakang: Penggunaan antibiotik profilaksis bedah bertujuan untuk mencegah infeksi daerah operasi pada pasien yang dianggap mempunyai risiko tinggi. Meskipun kebijakan penggunaan antibiotik profilaksis dalam operasi telah ditetapkan, masih terdapat penggunaan yang tidak sesuai yang dapat menyebabkan peningkatan risiko resistensi antibiotik dan peningkatan biaya perawatan di rumah sakit.Tujuan: Mengevaluasi ketepatan penggunaan antibiotik profilaksis serta efisiensi biaya penggunaan antibiotik profilaksis pada pasien bedah digestif di RSUPN-CMMetode: Penelitian ini merupakan studi retrospektif. Data sekunder diambil dari rekam medik pasien rawat inap Departemen Bedah RSUPN-CM selama periode Januari hingga Desember 2015. Pada penelitian ini 102 pasien yang mendapatkan antibiotik profilaksis dievaluasi berdasarkan panduan NHS Lanaskhire untuk ketepatan dosis dan waktu pemberian pada tindakan pembedahan dan panduan antibiotik profilaksis divisi bedah digestif RSUPN-CM untuk pemilihan antibiotik berdasarkan indikasi tindakan.Hasil: Dari 102 pasien penelitian 81,4 pasien mendapatkan antibiotik profilaksis dengan indikasi sesuai tindakan dan 90,8 pasien mendapatkan antibiotik profilaksis tepat dosis. Berdasarkan ketepatan waktu pemberian antibiotik profilaksis, sebanyak 52 pasien mendapatkan antibiotik profilaksis tepat waktu 30 menit . Sementara itu, pasien yang mendapatkan antibiotik profilaksis lebih dari satu dosis yang berarti bukan lagi profilaksis sebanyak 15,7 . Tambahan biaya obat akibat pemberian antibiotik profilaksis yang tidak sesuai pedoman sebesar Rp. 16.016.007,-.Kesimpulan: Hasil penelitian menunjukkan masih adanya penggunaan antibiotik profilaksis yang tidak sesuai pedoman pada pasien bedah digestif RSUPN-CM. Pemberian antibiotik profilaksis yang tidak sesuai pedoman dapat menyebabkan peningkatan biaya perawatan rumah sakit. Diperlukan upaya untuk meningkatkan kepatuhan terhadap pedoman yang digunakan.hr>b>ABSTRACT"Background Prophylactic antibiotic is used to prevent surgical wound infections in surgery patients who are considered to have high risk of contamination. Despite established guideline, some studies reported inappropriate use of prophylactic antibiotic which potentially increase the risk of antibiotic resistance and hospitalization cost.Aim To evaluate the appropriateness and cost of prophylactic antibiotic usage in digestive surgery patients at Cipto Mangunkusumo hospital.Methods This was a retrospective study conducted on digestive surgery patients. Secondary data were collected from medical records of hospitalized patients in Surgery Department of Cipto Mangunkusumo hospital during the periode January to Desember 2015. In this study, 102 patients receiving prophylactic antibiotics were evaluated based on NHS Lanaskhire guideline for dosage and timimg in accordance with surgical types and guideline of digestive surgery division Cipto Mangunkusumo hospital for antibiotic selection.Results In 102 patients 81,3 patients received prophylactic antibiotics with appropriate indications and 91,2 patients received prophylactic antibiotics with appropriate doses. While 52 patient received prophylactic antibiotic with appropriate timing of 30 minutes. Meanwhile, patients that received prophylactic antibiotics more than once, which means not prophylactic anymore, were accounted for 15,7 . The estimated extra cost due to of inappropriate use of prophylactic antibiotics was Rp. 16.016.007, .Conclusion The results showed that inappropriate use of antimicrobial prophylaxis was still found in digestive surgery Cipto Mangunkusumo hospital and it increased drug cost. The most frequent inappropriateness was the timing of administration followed by inappropriate indication and dose. More work is needed in order to increase the adherence to the guidelines. "

"Angka kejadian bedah caesar di seluruh dunia terus meningkat setiap tahun. Namun, angka risiko kematian pasca bedah caesar sangat tinggi akibat infeksi. Pemakaian suatu jenis antibiotik profilaksis pada sebagian kasus bedah caesar telah terbukti dapat mengurangi kejadian infeksi luka operasi. Tujuan penelitian ini untuk mengetahui pola penggunaan antibiotik profilaksis serta kerasionalan antibiotik profilaksis yang digunakan pada pasien bedah caesar di RSUPN Dr. Cipto Mangunkusumo tahun 2015. Penelitian dilakukan secara observasional dengan menggunakan metode deskriptif dan data diperoleh dari rekam medis pasien secara retrospektif. Pengambilan data dilakukan dengan teknik purposive sampling. Evaluasi kerasionalan penggunaan antibiotik profilaksis dinilai dari ketepatan pasien, tepat indikasi, tepat obat, tepat dosis, tepat waktu pemberian dan tanpa infeksi luka operasi. Pasien yang memenuhi kriteria sebagai subjek penelitian sebanyak 245 pasien. Data yang diperoleh menunjukkan bahwa jenis antibiotik profilaksis yang paling banyak digunakan adalah sefazolin (72,66%). Pada penelitian terdapat pasien bedah caesar yang menerima antibiotik profilaksis 100% tepat pasien, 100% tepat indikasi, 98,78% tepat obat, 98,37% tepat dosis dan 72,24% tepat waktu pemberian, serta 98,37% tanpa infeksi luka operasi. Penggunaan antibiotik profilaksis pada pasien bedah sesar terbukti 72,24% pasien menunjukkan kerasionalan. The number of caesarean section in all over the world continue to increase each year. But the rate of post caesarean section risk of death is very high due to infection. The use of a type of antibiotics prophylaxis in some cases of caesarean section has been proven to reduce the occurrence of surgical site infection. The purpose of this study was to know the image of antibiotic prophylaxis and the rationality of antibiotic prophylaxis on caesarean section patients in RSUPN Dr. Cipto Mangunkusumo in 2015. This study was conducted in observation using descriptive method and the data is acquired from medical record investigation retrospectively. Data were collected using purposive sampling technique. Rational use of antibiotics assessed evaluation of the appropriate patient, appropriate indication, appropriate drug, appropriate dose, appropriate time and without the provision of surgical site infection. Eligible patients as subjects of research were 245 patients. Data obtained showed that the most common kind of antibiotic prophylaxis that being used is cefazoline (72.66%). In this study were caesarean patients who received antibiotic prophylaxis showed 100% appropriate patient, 100% appropriate indication, 98.78% appropriate drug, 98.37% appropriate dose, 72.24% appropriate time and 98.37% no surgical site infection. The usage of antibiotic prophylaxis in patients with proven 72.24% caesarean section patients showed rationality."

"Surgical site infections are the second most frequent nosocomial infection after catheter infection. They are associated with increase morbidity and mortality, iength of stay in hospital and cost of care. Antibiotic prophylaxis use is addressed to reduce incidence of surgical site infection. The aim of this research was to find out the pattern of antibiotic prophylaxis use; incidence of surgical site infection; association between antibiotic prophylaxis use and incidence of surgical site infection; and other factors that influence the incidence of surgical site infection. This research was carried out in Dr. Cipto Mangunkusumo Hospital Jakarta and it was a retrospective study with cross-sectional design. A total of 220 samples had been taken proportional randomly according to the type of surgery division from 1,841 medical records in 2005. The result showed that the most antibiotic prophylaxis frequently used was cephalosporin (first and third generation). followed by phosphomycin and metronidazole. Most of the patients were given antibiotic prophylaxis in inappropriate time and the duration of use was more than one day. This study found that the incidence of surgical site infection was 8.6% with the highest percentage occurred at orthopedic surgery (23.3%). Statistically, there was no relationship of class. Timing and duration of antibiotic prophylaxis use with incidence of surgical site infection. Adherence of antibiotic prophylaxis use to hospital guideline was not influenced the incidence of surgical site infection. Multivariate analysis with logistic regression analysis showed that the incidence of surgical site infection were influenced by the type of surgery (OR=2.6) and the use of antibiotics during hospitalization prior to surgery (OR=3.2). The conclusion of this research were the incidence of surgical site infection relatively high and class. timing, duration and adherence to hospital guideline of antibiotic prophylaxis use did not influence it. The wound contaminated and the use antibiotics during hospitalization prior to surgery were risk factors for surgical site infection. It was recommended that the hospital management revise the currently used surgical antibiotic prophylaxis guideline which is no longer relevant to the current situation."

"[ABSTRAK Infeksi daerah operasi merupakan hal yang harus diperhatikan oleh para ahli bedah mengingat tingginya morbiditas dan mortalitas pada pasien yang menderita infeksi daerah operasi Penulis ingin melakukan analisa secara garis besar bagaimana infeksi daerah operasi terutama pada infeksi daerah operasi pada operasi dengan golongan operasi bersih dan bersih tercemar Dilakukan penelitian retrospektif terhadap semua pasien divisi bedah digestif FKUI RSCM dari september 2012 hingga Juli 2014 Pasien dinilai berdasarkan kondisi preoperatif intraoperatif dan pasca operatif Dari data yang terhimpun selama penelitian di dapatkan 57 pasien menderita infeksi daerah operasi Delapan persen dari seluruh total operasi bedah digestif Keganasan kolorektal adenocarcinoma kolorektal menempati urutan pertama 22 39 Didapatkan 2 kasus yang merupakan operasi dengan tipe operasi bersih Didapatkan 17 kasus yang merupakan operasi dengan tipe bersih terkontaminasi Kata kunci Infeksi Daerah Operasi Pembedahan abdominal ABSTRACTSurgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery , Surgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery ]"