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Abstrak :
ABSTRAK
Hubungan Ketidaktepatan Pemberian Antibiotika Profilaksis denganKejadian Infeksi Daerah Operasi Post Laparatomi di RSPADGatot Soebroto Tahun 2014-2017Pembimbing : dr. Asri C. Adisasmita MPH., M.Phil., Ph.DInfeksi Daerah Operasi IDO termasuk salah satu dari Healthcare AssociatedInfection rsquo;s HAI 39;s yang paling banyak ditemukan seiring dengan meningkatnya jumlahtindakan operasi. Laparatomi merupakan jenis tindakan operasi yang paling berisikountuk terjadinya infeksi. Salah satu upaya pencegahan infeksi daerah operasi denganpemberian antibiotika profilaksis yang diberikan sebelum, saat dan sampai 24 jam setelahoperasi pada kasus yang secara klinis tidak didapatkan tanda-tanda infeksi. Penelitian inibertujuan untuk mengetahui hubungan ketidaktepatan pemberian antibiotika profilaksisdengan kejadian infeksi daerah operasi post laparatomi di RSPAD Gatot Soebroto Tahun2014-2017. Desain penelitian menggunakan studi kasus kontrol dengan pengambilan datasecara retrospektif menggunakan 268 sampel dari data rekam medik pasien post operasilaparatomi di RSPAD Gatot Soebroto pada tahun 2014-2017, kasus yaitu 67 pasien yangterjadi IDO dan kontrol 201 pasien tidak terjadi IDO . Analisa data dengan uji regresilogistik dengan conditional matching. Hasil penelitian menunjukkan waktu pemberianantibiotika profilaksis pre operasi tidak tepat memiliki risiko 5.17 kali terhadap kejadianinfeksi daerah operasi OR= 5.17 ; 95 CI=1.85-14.40 setelah dikontrol dengan variabellain. Variabel kovariat yang berhubungan terhadap kejadian infeksi daerah operasi yaitudiagnosis operasi digestif OR=3.51; 95 CI=1.04-11.83 , kadar albumin OR= 3.83;95 CI= 1.30-11.25 dan penyakit penyerta OR = 4.05 ; 95 CI=1.40-11.66 . Hasilpenelitian ini dapat menjadi masukan bagi RSPAD Gatot Soebroto untuk lebihmeningkatkan kepatuhan penggunaan antibiotika profilaksis secara tepat waktu, jenis,dosis dan durasi pemberian sesuai panduan untuk mencegah kejadian infeksi daerahoperasi.Kata Kunci: Antibiotika Profilaksis, Infeksi daerah operasi, Laparatomi.

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ABSTRACT
Correlation of Inappropriate Antibiotic Prophylaxis with PostLaparatomy Surgical Site Infection at Gatot Soebroto Army CentralHospital Year 2014 to 2017Counsellor dr. Asri C. Adisasmita MPH., MPhil., Ph.DSurgical Site Infection SSI is one of the most commonly infection foundHealthcare Associated Infection 39 s HAI 39 s type as surgery procedure increases.Laparotomy is the type of surgery that is the most at risk for infection. One of theprevention efforts of surgical site infection is antibiotic prophylaxis administrationbefore, during and up to 24 hours after surgery in cases of clinically missing signs ofinfection. This study aims to determine the correlation of inappropriate antibioticsprophylaxis with the post laparatomy surgical site infection in Army Central Hospital RSPAD Gatot Soebroto from 2014 to 2017. The research design was case controlstudy with retrospective data retrieval, using 268 samples from medical record data ofpost laparotomy patient at Army Central Hospital RSPAD Gatot Soebroto from 2014to 2017, cases of 67 patients with SSI and control of 201 patients without SSI . Datawas analyzed using regression logistic conditional matching test. The result of thestudy showed that the inappropriate timing of antibiotic administration in preoperativetreatment made a risk of 5.17 times higher on the incidence of surgical site infection OR 5.17 95 CI 1.85 14.40 after control of other variables. Covariate variables,related to the incidence of surgical site infection, was digestive operation diagnose OR 3.51 95 CI 1.04 11.83 , albumin level OR 3.83 95 CI 1.30 11.25 and comorbid disease OR 4.05 95 CI 1.40 11.66 . The results of this studyhopefully can be an input data for Army Central Hospital RSPAD Gatot Soebroto,to improve adherence of correct timing, type, dose and duration of antibioticsprophylaxis according to guidelines of surgical site infection prevention.Key words Antibiotic Prophylaxis, Surgical Site Infection, Laparatomy

Abstrak :
Infeksi daerah operasi (IDO) merupakan infeksi pada sayatan atau organ yang terjadi setelah pembedahan. Upaya pencegahan terhadap infeksi ini menjadi semakin penting dengan jumlah operasi yang semakin meningkat. Pemberian antibiotik profilaksis seringkali dianggap sebagai pencegahan IDO yang paling mudah dilakukan. Namun ketidaktepatan dalam penggunaannya dapat menjadi faktor risiko penyebab terjadinya IDO. Tujuan penelitian ini adalah untuk menganalisis ketidaktepatan penggunaan antibiotik profilaksis pada pasien bedah di RSUD Kota Depok pada periode Januari-Maret 2020. Penelitian ini dilakukan secara observasional dengan disain penelitian deskriptif cross sectional dan pengambilan data dilakukan secara retrospektif. Analisis dilakukan pada sampel sebanyak 139 menggunakan metode Gyssens. Hasil analisis ketidaktepatan penggunaan antibiotik profilaksis dengan metode Gyssens yaitu pada kategori VI sebanyak 138 sampel (99,28%), kategori V sebanyak 83 sampel (60,14%) kategori IVa sebanyak 52 sampel (94,54%). Untuk kategori IVb sampai IIc memiliki nilai yang sama yaitu sebanyak 0 sampel. Kategori I semua sampel tidak tepat waktu pemberian sehingga analisa berakhir pada kategori I dengan jumlah 3 sampel.(100%). Sedangkan angka kejadian infeksi daerah operasi pada pasien bedah di RSUD Kota Depok periode 1 Januari -19 Maret 2020 sebanyak 2,87%. Faktor penyebab terjadinya infeksi daerah operasi karena ketidaktepatan penggunaan antibiotik profilaksis pada waktu pemberian, kepatuhan pasien dan penyakit penyerta (komorbid). ......Surgery area infection (SSI) is an infection of the incision or organ that occurs after surgery. prevention against this infection is becoming increasingly important with an increasing number of operations. Treatment of prophylactic antibiotics as the easiest prevention of SSIs. However, inaccuracy in its use can be a factor in causing SSI. The purpose of this study was to analyze the inaccuracy of prophylactic use in surgical patients at RSUD Kota Depok in the period January-March 2020. This study was conducted observational with a cross-sectional descriptive study and data collection was carried out retrospectively. The analysis was carried out on a sample of 139 using the Gyssens method. The results of the inaccuracy analysis of prophylactic antibiotics using the Gyssens method were 138 samples (99.28%) in category VI, 83 samples (60.14%) in category IVa as many as 52 samples (94.54%). For categories IVb to IIc, there are 0 samples. Category I all samples are not presented on time so that the analysis ends in category I with a total of 3 samples. (100%). Meanwhile, the incidence of infection in the surgical area in surgical patients at the Depok City Hospital for the period January 1-March 19 2020 was 2.87%. Factors causing regional infection due to inappropriate use of prophylactic antibiotics at the specified time, patient and comorbidities (comorbid).

Abstrak :
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 :
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.

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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.