Uji Perbandingan Antibiotik Profilaksis Ceftriaxone versus Cefazolin pada Bedah Obstetri dan Ginekologi

https://doi.org/10.22146/jmpf.59779

Asri Rahayu(1), Fita Rahmawati(2*), Tri Murti Andayani(3), Ammar Siradjuddin(4)

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(3) Departemen Farmakologi dan Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(4) Kepala SMF Obstetri dan Ginekologi RSUD dr. Dradjat Prawiranegara Serang
(*) Corresponding Author

Abstract


Surgical site infection (SSI) is the most common complication in postoperative surgical patients which is associated with high morbidity, mortality, and cost burden. These complications can be prevented by giving proper prophylactic antibiotics. Cefazolin is a recommended prophylactic antibiotic, but in the practice in Indonesia hospital, there are still many uses of ceftriaxone. This study aimed to compare the clinical outcome and safety of cefazolin and ceftriaxone as prophylactic antibiotics in preventing SSI in obstetric and gynecological surgical patients. The study design was double-blind randomized controlled trial. The data collection was conducted from January to June 2020 at dr. Dradjat Prawiranegara Regional Hospital Serang. A total of 82 subjects who met the inclusion criteria were divided into two groups by block randomization, 41 subjects were given cefazolin and 41 subjects were given ceftriaxone. The clinical outcome was measured by preventing SSI for the effectiveness and side effects for safety outcomes in both groups. The comparison of effectiveness and side effects were analyzed using the bivariate test (chi-square or fisher’s exact test) and relative risk (RR). The study showed that the effectiveness of cefazolin was the same as ceftriaxone in preventing SSI for 30 days (RR= 0.89; p= 0.724; 95%CI: 0,193-3,133) with the number of SSI 12.2% vs 9.8%. Side effects included nausea, vomiting, and phlebitis was observed in the administration of antibiotic by intravenous push (IVP) pre-operating.  Cefazolin have safetier than ceftriaxone with the incidence of side effects were 9.8% vs 29.3% ((RR = 0,33; p= 0.003; 95% CI: 0.076-0.895).  Cefazolin is an antibiotic recommended by Indonesian Ministry of Health and the Association of Obstetrics and Gynecology.  This study encourages the use of cefazolin to prevent resistance due to ceftriaxone to overuse.


Keywords


Antibiotik profilaksis; ILO; ceftriaxone; cefazolin

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References

  1. Torres B, I S, Umscheid craig. A. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784-791.
  2. Chairani F, Puspitasari I, Asdie RH. Insidensi dan Faktor Risiko Infeksi Luka Operasi pada Bedah Obstetri dan Ginekologi di Rumah Sakit. J Manaj dan Pelayanan Farm Univ Gajah Mada. 2019;9(4):274-283 https://jurnal.ugm.ac.id/jmpf/article/view/48024.
  3. Sumarningsih P, Yasin MN, Asdie HR. Effect of Risk Factors on the Occurrence of SSI in Patients with Obstetrics and Gynecology Surgery at Dr. RSUP Sardjito Yogyakarta. Maj farmasetik. 2020;16(1):43-49.
  4. Pathak A, Mahadik K, Swami MB, et al. Incidence And Risk Factors For Surgical Site Infections In Obstetric And Gynecological Surgeries From A Teaching Hospital In Rural India. Antimicrob Resist Infect Control. 2017;6:1-8.
  5. Oh AL, Goh LM, Abdullah N, et al. Original Article Antibiotic usage in surgical prophylaxis : a prospective surveillance of surgical wards at a tertiary hospital in Malaysia. J infect Ctries. 2014;8.
  6. Alfouzan W, Fadhli M, Abdo N, Alali W, Dhar R. Surgical site infection following cesarean section in a general hospital in Kuwait : trends and risk factors. Epidemiol Infect. 2019. https://pubmed.ncbi.nlm.nih.gov/31597580/
  7. Baron S, Jouy E, Larvor E, Eono F, Bougeard S. Impact of Third-Generation-Cephalosporin Administration in Hatcheries on Fecal Escherichia coli Antimicrobial Resistance in. 2014;58(9):5428-5434. https://aac.asm.org/content/58/9/5428
  8. PPRA. Pedoman Penggunaan Antimikroba Profilaksis dan Terapi. In: RSUD Dr. Dradjat Prawiranegara Serang. ; 2018.
  9. Hussain Z, Curtain C, Mirkazemi C, Gadd K, Peterson GM, Zaidi STR. Prophylactic Cefazolin Dosing and Surgical Site Infections: Does the Dose Matter in Obese Patients? Obes Surg. 2019;29 (1):159-165. https://pubmed.ncbi.nlm.nih.gov/30267229/
  10. Pop-vicas A, Mls SJ, Safdar N. Cefazolin as surgical antimicrobial prophylaxis in hysterectomy : A systematic review and meta-analysis of randomized controlled trials. Infect Control Hosp Epidemiol. 2018:1-8.
  11. Phoolcharoen N, Nilgate S, Rattanapuntamanee O. A randomized controlled trial comparing ceftriaxone with cefazolin for antibiotic prophylaxis in abdominal hysterectomy. Int J Gynecol Obstet. 2012;119(1):11-13.
  12. Jyothi S, M VN, Pratap K, Asha K. Antibiotic prophylaxis for hysterectomy and cesarean section : Amoxicillin-clavulanic acid versus cefazolin. J Obs Gynecol India. 2010;60(5):419-423. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394618/
  13. James D, Steer P, Weiner C, Crowther C. Studies : A Reference Table for Clinicians To the Editor : In Reply : ACOG Pract Bull Clin Manag Guidel Obstet. 2010:868. https://journals.lww.com/greenjournal/Citation/2010/04000/Pregnancy_and_Laboratory_Studies__A_Reference.35.aspx
  14. Sastroasmoro Sudigdo, Ismael Sofyan. Dalam : Sastroasmoro, Sudigdo dan. In: Dasar-Dasar Metodologi Penelitian Klinis.; 2011:384-385. https://opac.perpusnas.go.id/DetailOpac.aspx?id=1111569
  15. Dahlan S. . Besar Sampel dan Cara Pengambilan sampel dalam Penelitian Kedokteran dan Kesehatan seri 2 edisi 4. In: Besar Sampel Dan Cara Pengambilan Sampel Dalam Penelitian Kedokteran Dan Kesehatan.; 2016:105. https://opac.perpusnas.go.id/DetailOpac.aspx?id=699349
  16. Bratzler DW, Delinger P., Olsen KM, Peri TM. Clinical practice guidelines for antimicrobial prophylaxis in surgery. ASHP Rep. 2013;70:195-283.
  17. Shenoy D, Nalluri K, Manasa C, Reddy P, Srinivasan R. Journal of Drug Delivery and Therapeutics A study on evaluation of risk factors and anti-microbial prophylaxis in the prevention of surgical site infection. J Drug Deliv Ther. 2019;9:159-166. http://jddtonline.info/index.php/jddt/article/view/2477
  18. Anderson JD, Sexton JD. Antimicrobial prophylaxis for prevention of surgical site infection in adults. Up to Date. 2018;1-35:90. https://www.uptodate.com/contents/antimicrobial-prophylaxis-for-prevention-of-surgical-site-infection-in-adults
  19. Mamo T, Abebe TW, Chichiabellu TY, Anjulo AA. Risk factors for surgical site infections in obstetrics : a retrospective study in an Ethiopian referral hospital. Patient Saf Surg. 2017;11:24:1-9.
  20. Kemenkes RI. Pedoman Umum Penggunaan Antibiotik. Peraturan Menteri Kesehatan RI Nomor 2406/Menkes/Per/XII/2011. http://iai.id/library/pelayanan/permenkes-no-2406-thn-2016-ttg-pedoman-umum-penggunaan-antibiotik
  21. AL Jama EF. Risk factors for wound infection after lower segment cesarean section. Qatar Med J. 2012;2012(2). https://pubmed.ncbi.nlm.nih.gov/25003037/
  22. Allen J, David M, Veerman JL. Systematic review of the cost-effectiveness of preoperative antibiotic prophylaxis in reducing surgical-site infection. BJS Open. 2018;(Cdc).
  23. POGI. Perkumpulan Obstetri Dan Ginekologi Indonesia Indonesian Society Of Obstetrics And Gynecology. Perkumpulan Obstet Ginekol Indones. 2013. https://pogi.or.id/publish/
  24. Marsh K, Ahmed N, Decano A, Pung S, Jie X. Safety of intravenous push administration of beta-lactams within a healthcare system. Am J Heal Pharm. 2020;77(9):8-11.
  25. Spencer S, Ipema H, Hartke P, et al. Intravenous Push Administration of Antibiotics : Literature and Considerations. SAGE. 2018;53 (3)(Mc 886).
  26. Bradley JS, Wassel RT, Lee L, Nambiar S. Intravenous Ceftriaxone and Calcium in the Neonate : Assessing the Risk for Cardiopulmonary. J Pediatr. 2020;123(4).
  27. Lu J, Cai C, GU Y, Tang Y. Analysis On 113 Cases Of Adverse Reactions Caused By Β-Lactam Antibiotics. Tradit Complement Altern Med. 2013;10:83-87. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3794396/
  28. Biggar C, Nichols C. Comparison of Postinfusion Phlebitis in Intravenous Push Versus Intravenous Piggyback Cefazolin. Art Sci Infus Nurs Art Sci Infus Nurs. 2012:384-388.
  29. Mclaughlin JM, Scott RA, Koenig SL, Mueller SW. Intravenous Push Cephalosporin Antibiotics in the Emergency Department. Adv J. 2017;39(4):295-299.
  30. Gandhi R., Elshaboury SN. I.V. push administration of medications reconstituted with 0.9% sodium chloride injection. Am J Heal Pharm. 2018;75(12):851-852.
  31. Kemenkes RI. Standar pelayanan kefarmasian di Rumah sakit Peraturan menteri kesehatan RI no 72 tahun 2016. Standar pelayanan kefarmasian di Rumah sakit. 2016; (72): 2016. https://peraturan.bpk.go.id/Home/Details/114491/permenkes-no-72-tahun-2016




DOI: https://doi.org/10.22146/jmpf.59779

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