Pola Penggunaan Antibiotik Profilaksis pada Pasien Bedah Orthopedi: Kajian Literatur Sistematik dan Meta Analisis

Tri Tanayawati, Rika Yulia, Fauna Herawati

Sari


ABSTRACT

 

Surgical site infection (SSI) is an infection acquired after surgery or surgical procedures. It accounts for approximately 14-16% of all nosocomial infections in hospitalized patients, and almost 90% have bacterial growth in surgical incisions. This meta-analysis aims to determine the pattern of prophylactic antibiotic use in orthopedic surgery patients and the effectiveness of this practice in preventing SSI. Method of collecting articles related to the pattern of prophylactic antibiotic use in orthopedic surgery patients. The inclusion and exclusion criteria. The inclusion criteria are articles obtained according to previously determined keywords, all articles obtained by searching the last 10 years, and articles with a Randomized Controlled Trial (RCT) research design. The results of a meta-analysis of the combined data from 4 RCT articles, with a total number of patients in the intervention group of 1059 and the control group of 1003, showed no significant difference (RR = 0.83; 95% CI = 0.6 - 1.14). Prophylactic antibiotic administration in orthopedic surgery using cephalosporins did not show any significant difference compared to those who did not use antibiotics. Likewise, extended antibiotic administration did not show any significant difference in preventing postoperative infections.

 

Keywords: Surgical Site Infection, Prophylactic Antibiotics, Orthopedic Surgery, Clean Surgery.

 

 

ABSTRAK

 

Infeksi daerah operasi (IDO) merupakan infeksi yang diperoleh setelah tindakan operasi atau bedah. Kejadian Infeksi daerah operasi (IDO) menyumbang sekitar 14-16% dari semua infeksi nosokomial pada pasien rawat inap dan hampir 90% terdapat pertumbuhan bakteri di sayatan bedah. Untuk mengetahui pola penggunaan antibiotik profilaksis pada pasien bedah orthopedi dan mengetahui efektivitas penggunaan antibiotik profilaksis untuk mencegah terjadinya IDO melalui meta analisis. Metode pengumpulan artikel-artikel terkait dengan pola penggunaan antibiotik profilaksis pada pasien bedah orthopedi. Adapun kriteria inklusi dan ekslusi. Kriteria inklusi yaitu artikel yang diperoleh sesuai dengan keyword yang ditetapkan sebelumnya; semua artikel yang diperoleh dengan pencarian 10 tahun terakhir; artikel dengan desain peneltian Randomize Controlled Trial (RCT). Hasil meta analisis dari penggabungan data artikel 4 RCT dengan total jumlah pasien pada kelompok intervensi 1059 pasien dan kelompok kontrol 1003 pasien, menunjukkan tidak ada perbedaan signifikan (RR = 0,83; 95% CI = 0,6 - 1,14). Pemberian antibiotik profilaksis pada bedah orthopedi penggunaan sefalosporin tidak menunjukan perbedaan yang bermakna dengan yang tidak menggunakan antibiotik. Begitu juga pada pemberian antibiotik yang di-perpanjang tidak berbeda bermakna dalam mencegah terjadi infeksi post operasi

 

Kata Kunci: Infeksi Daerah Operasi, Antibiotik Profilaksis, Bedah Orhopedi, Operasi Bersih


Teks Lengkap:

Download Artikel

Referensi


Ashp. (2013). Clinical Practice Guidlines For Antimicrobial Prophykaxis In Surgery. Ashp Therapeutic Guidlines.

Aydin, M., Karadogan, E. N., & Kadanali, A. (2020). Effectiveness Of Surgical Prophylaxis Where The Antibiotic Resistance Is High. Infectious Diseases And Clinical Microbiology, 2(3), 128–132. Https://Doi.Org/10.36519/10.36519/Idcm.2020.0027

Backes, M., Dingemans, S. A., Dijkgraaf, M. G. W., Van Den Berg, H. R., Van Dijkman, B., Hoogendoorn, J. M., Joosse, P., Ritchie, E. D., Roerdink, W. H., Schots, J. P. M., Sosef, N. L., Spijkerman, I. J. B., Twigt, B. A., Van Der Veen, A. H., Van Veen, R. N., Vermeulen, J., Vos, D. I., Winkelhagen, J., Carel Goslings, J., … Vries Annebeth, M. De. (2017). Effect Of Antibiotic Prophylaxis On Surgical Site Infections Following Removal Of Orthopedic Implants Used For Treatment Of Foot, Ankle, And Lower Leg Fractures A Randomized Clinical Trial. Jama - Journal Of The American Medical Association, 318(24), 2438–2445. Https://Doi.Org/10.1001/Jama.2017.19343

Balraj, N., Devara, P. K., & Ramesh, R. (2023). Comparative Analysis Of Surgical Site Infection Rates Between Clean And Contaminated Cases : A Comprehensive Hospital-Wide Study. Cdc, 1529–1532. Https://Doi.Org/10.47009/Jamp.2023.5.4.304

Bozzo, A., Yeung, C. M., Sande, M. Van De, Ghert, M., & Healey, J. H. (2023). Operative Treatment And Outcomes Of Pediatric Patients With An Extremity Bone Tumor: A Secondary Analysis Of The Parity Trial Data. J Bone Joint Surg Am, 105(Suppl 1), 65–72. Https://Doi.Org/10.2106/Jbjs.22.01231.Operative

Branch-Elliman, W., O’brien, W., Strymish, J., Itani, K., Wyatt, C., & Gupta, K. (2019). Association Of Duration And Type Of Surgical Prophylaxis With Antimicrobial-Associated Adverse Events. Jama Surgery, 154(7), 590–598. Https://Doi.Org/10.1001/Jamasurg.2019.0569

Cdc. (2019). Antibiotic Resistance Threats In The United States 2019. Cdc, 10(1). Https://Doi.Org/10.1186/S13756-020-00872-W

Coque, T. M. (2023). Strengthening Environmental Action In The One Health Response To Antimicrobial Resistance. In J. S. Amanda Lawrence-Brown (Unep) (Ed.), United Nations Environment Programme. Https://Doi.Org/10.18356/9789210025799

De Jonge, S. W., Boldingh, Q. J. J., Solomkin, J. S., Dellinger, E. P., Egger, M., Salanti, G., Allegranzi, B., & Boermeester, M. A. (2020). Effect Of Postoperative Continuation Of Antibiotic Prophylaxis On The Incidence Of Surgical Site Infection: A Systematic Review And Meta-Analysis. The Lancet Infectious Diseases, 20(10), 1182–1192. Https://Doi.Org/10.1016/S1473-3099(20)30084-0

Funiciello, E., Lorenzetti, G., Cook, A., Goelen, J., Moore, C. E., Campbell, S. M., Godman, B., Tong, D., Huttner, B., Chuki, P., & Sharland, M. (2024). Identifying Aware Indicators For Appropriate Antibiotic Use : A Narrative Review. Journal Of Antimicrobial Chemotherapy, 79(12), 3063–3077. Https://Doi.Org/10.1093/Jac/Dkae370

Habteweld, H. A., Yimam, M., Tsige, A. W., Wondmkun, Y. T., Endalifer, B. L., & Ayenew, K. D. (2023). Surgical Site Infection And Antimicrobial Prophylaxis Prescribing Profile, And Its Determinants Among Hospitalized Patients In Northeast Ethiopia: A Hospital Based Cross-Sectional Study. Scientific Reports, 13(1), 1–9. Https://Doi.Org/10.1038/S41598-023-41834-7

Higgins, J. P. T., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savović, J., Schulz, K. F., Weeks, L., & Sterne, J. A. C. (2011). The Cochrane Collaboration’s Tool For Assessing Risk Of Bias In Randomised Trials. Bmj (Online), 343(7829), 1–9. Https://Doi.Org/10.1136/Bmj.D5928

Hussain, S. A., Khan, S., Raza, A. A., Durrani, S. N., Jamil, T., & Khan, A. G. (2023). Incidence Of Surgical Site Infections In Clean And Clean Contaminated Surgeries. International Journal Of Health Sciences, 6, 6948–6955. Https://Doi.Org/10.53730/Ijhs.V6ns7.13938

Kemenkes Ri. (2021). Panduan Penatagunaan Antimikroba Di Rumah Sakit. Kementerian Kesehatan Republik Indonesia, 1(2021), 1–68.

Kuswandi. (2019). Resistensi Antibiotik (Nanik (Ed.); Pertama). Gadjah Mada University Press.

Ling, M. L., Apisarnthanarak, A., Abbas, A., Morikane, K., Lee, K. Y., Warrier, A., & Yamada, K. (2019). Apsic Guidelines For The Prevention Of Surgical Site Infections. Antimicrobial Resistance And Infection Control, 8(1), 1–8. Https://Doi.Org/10.1186/S13756-019-0638-8

Marwa, J. M., Ngayomela, I. H., Seni, J., & Mshana, S. E. (2015). Cefepime Versus Ceftriaxone For Perioperative Systemic Antibiotic Prophylaxis In Elective Orthopedic Surgery At Bugando Medical Centre Mwanza, Tanzania: A Randomized Clinical Study. Bmc Pharmacology And Toxicology, 16(1), 1–9. Https://Doi.Org/10.1186/S40360-015-0039-4

Menz, B. D., Charani, E., Gordon, D. L., Leather, A. J. M., Ramani Moonesinghe, S., & Phillips, C. J. (2021). Surgical Antibiotic Prophylaxis In An Era Of Antibiotic Resistance: Common Resistant Bacteria And Wider Considerations For Practice. Infection And Drug Resistance, 14(November), 5235–5252. Https://Doi.Org/10.2147/Idr.S319780

Nagata, K., Yamada, K., Shinozaki, T., Miyazaki, T., Tokimura, F., Tajiri, Y., Matsumoto, T., Yamakawa, K., Oka, H., Higashikawa, A., Sato, T., Kawano, K., Karita, T., Koyama, T., Hozumi, T., Abe, H., Hodohara, M., Kohata, K., Toyonaga, M., … Okazaki, H. (2022). Effect Of Antimicrobial Prophylaxis Duration On Health Care-Associated Infections After Clean Orthopedic Surgery: A Cluster Randomized Trial. Jama Network Open, 5(4), E226095. Https://Doi.Org/10.1001/Jamanetworkopen.2022.6095

Passos;, M. A. T. ; P. E. P.-F. (2005). Antibiotics Prophylaxis In Laparoscopy. Abcd Arq Bras Cir Dig, 70(4), 269–272.

Peraturan Menteri Kesehatan Ri. (2021). Pedoman Penggunaan Antibiotik. Permenkes Ri, 1–97.

Prudencio, R. M. De A., Campos, F. S. M., Loyola, A. B. A. T., Junior, I. A., Novo, N. F., Ferreira, L. M., & Veiga, D. F. (2020). Antibiotic Prophylaxis In Breast Cancer Surgery. A Randomized Controlled Trial. Acta Cirurgica Brasileira, 35(9), 1–7. Https://Doi.Org/10.1590/S0102-865020200090000007

Pudji Wahyuningsih, I. (2020). Analisis Pelaksanaan Bundles Care Ido Terhadap Kejadian Infeksi Daerah Operasi Dan Dampaknya Terhadap Lama Rawat Pasien. Jurnal Health Sains, 1(6), 366–376. Https://Doi.Org/10.46799/Jhs.V1i6.66

Rayess Ahmad Bhat, Syed Altamash, & Pandey, R. (2023). Incidence And Predictors Of Surgical Site Infection In Major Abdominal Surgeries At A Tertiary Care Center In Delhi. Asian Journal Of Pharmaceutical And Clinical Research, 16(10), 204–207. Https://Doi.Org/10.22159/Ajpcr.2023.V16i10.49494

Sanders, F. R. K., Goslings, J. C., Mathôt, R. A. A., & Schepers, T. (2019). Target Site Antibiotic Concentrations In Orthopedic/Trauma Extremity Surgery: Is Prophylactic Cefazolin Adequately Dosed? A Systematic Review And Meta-Analysis. Acta Orthopaedica, 90(2), 97–104. Https://Doi.Org/10.1080/17453674.2019.1577014

Stallard, S., Savioli, F., Mcconnachie, A., Romics, L., Norrie, J., Dudman, K., & Morrow, E. S. (2022). Antibiotic Prophylaxis In Breast Cancer Surgery ( Paus Trial ): Randomised Clinical Double-Blind Parallel-Group Multicentre Superiority Trial. British Journal Of Surgery, 109(12), 1224–1231. Https://Doi.Org/10.1093/Bjs/Znac280




DOI: https://doi.org/10.33024/mahesa.v5i8.18854

Refbacks

  • Saat ini tidak ada refbacks.


Publisher: Universitas Malahayati Lampung

Creative Commons License
Semua artikel dapat digunakan dibawah lisensi Creative Commons Attribution-ShareAlike 4.0 International License


kostenlose besucherzähler