Characteristics of patients associated with antibiotic use among gastrointestinal surgery at the Academic Hospital, Universitas Gadjah Mada

  • Pingki Arum Saskiya Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta
  • Taufiqurohman Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta
  • Chairun Wiedyaningsih Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta
Keywords: digestive surgery;, antibiotic;, gyssens;, drug use;, rationality

Abstract

Digestive surgery is a treatment for diseases of the parts of the body involved in digestion, which has a fairly high risk of infection. The study aimed to obtain a description of the types and specific characteristics of patients and the rationality of antibiotic use among digestive surgery patients. This study was conducted using observational analysis. Data on antibiotic use was collected prospectively from medical records of digestive surgery inpatients at the Academic Hospital Universitas Gadjah Mada (UGM) from January to March 2023. The Gyssens method was used to evaluate qualitatively the use of antibiotics. A total of 76 patients met the inclusion and exclusion criteria. No significant difference between the number of male and female patients was identified. The results showed that 24 (31.58%) acute appendicitis patients are the primary diagnosis most often encountered in patients undergoing digestive surgery. The most frequently used prophylactic antibiotics for digestive surgery patients were ceftriaxone (53.85%) and cefazolin (41.03%). Meanwhile, the most frequently used therapeutic antibiotics were ceftriaxone (41.94%) and levofloxacin (29.03%). The Gyssens analysis shows that large irrational use of antibiotics is still observed.

References

Healey MA, Shackford SR, Osler TM, Rogers FB, Burns E. Complications in surgical patients. Arch Surg 2002; 137(5):611-8.

https://doi.org/10.1001/archsurg.137.5.611

Pinto A, Faiz O, Davis R, Almoudaris A, Vincent C. Surgical complications and their impact on patients’ psychosocial well-being: a systematic review and meta-analysis. BMJ Open 2016; 6(2):e007224.

https://doi.org/10.1136/bmjopen-2014-007224

Ebogo Titus NT, Nzinga JR, Nchufor NR, Njuma TE, Ntih LM, Sena GR, et al. Epidemiology of surgical site infection following abdominal surgeries at a reference hospital in North-West Cameroon. J West Afr Coll Surg 2021; 11(2):1-6.

https://doi.org/10.4103/jwas.jwas_51_22

[WHO] World Health Organization. Infection prevention and control [Internet]. [cited 2023 Nov 22]. Available from: https://www.who.int/teams/integrated-health-services/infection-prevention-control/surgical-site-infection

Seidelman JL, Mantyh CR, Anderson DJ. Surgical site infection prevention: a review. JAMA 2023; 329(3):244-52.

https://doi.org/10.1001/jama.2022.24075

Gillespie BM, Harbeck E, Rattray M, Liang R, Walker R, Latimer S, et al. Worldwide incidence of surgical site infections in general surgical patients: A systematic review and meta-analysis of 488,594 patients. Int J Surg 2021; 95:106136.

https://doi.org/10.1016/j.ijsu.2021.106136

Mengistu DA, Alemu A, Abdukadir AA, Mohammed Husen A, Ahmed F, Mohammed B, et al. Global incidence of surgical site infection among patients: systematic review and meta-analysis. Inquiry 2023; 60:469580231162549.

https://doi.org/10.1177/00469580231162549

De Simone B, Sartelli M, Coccolini F, Ball CG, Brambillasca P, Chiarugi M, et al. Intraoperative surgical site infection control and prevention: A position paper and future addendum to WSES intra-abdominal infections guidelines. World J Emerg Surg 2020; 15(1):10.

https://doi.org/10.1186/s13017-020-0288-4

Syaiful RA, Mazni Y, Prasetyo ML, Lalisang TJM. Surgical site infection after digestive surgery in a single tertiary hospital in indonesia: Six years of data. Med J Indones 2020; 29(3):310-5.

https://doi.org/10.13181/mji.oa.192698

Alemkere G. Antibiotic usage in surgical prophylaxis: A prospective observational study in the surgical ward of Nekemte referral hospital. PLoS One 2018; 13(9):e0203523.

https://doi.org/10.1371/journal.pone.0203523

Freitas ACT, Ferraz ÁAB, Barchi LC, Boin IFSF. Antibiotic Prophylaxis for abdominal surgery: when to recommend? Brazilian college of digestive surgery position paper. Arq Bras Cir Dig 2023; 36:e1758.

https://doi.org/10.1590/0102-672020230040e1758

Van Tuong P, Xiem CH, Anh NC, Quang LN. Assessment of antibiotic prophylaxis in surgical patients and association factors at Thu Duc District Hospital, Ho Chi Minh City, Vietnam in 2018. Heal Serv Insights 2021; 14: 11786329211029354.

https://doi.org/10.1177/11786329211029354

Palacios-Saucedo GDC, de la Garza-Camargo M, Briones-Lara E, Carmona-González S, García-Cabello R, Islas-Esparza LA, et al. Assessment of antibiotic use and impact of an intervention intended to modify the prescribing behavior in surgical prophylaxis in 6 hospitals in the metropolitan area of Monterrey, Mexico. Cir Cir 2017; 85(6):459-70.

https://doi.org/10.1016/j.circir.2016.10.033

Abdel-Aziz A, El-Menyar A, Al-Thani H, Zarour A, Parchani A, Asim M, et al. Adherence of surgeons to antimicrobial prophylaxis guidelines in a tertiary general hospital in a rapidly developing country. Adv Pharmacol Sci 2013; 2013:842593.

https://doi.org/10.1155/2013/842593

Setiawati Y, Farhadi A. The use of prophylactic antibiotics on orthopaedic procedures in an academic hospital in Indonesia. Int Islam Med J 2021; 2(2):88-94.

https://doi.org/10.33086/iimj.v2i2.2155

Stephanie E. Slovin’s formula sampling techniques. Sciencing [Internet]. 2020; (2020):1-3.

https://sciencing.com/slovins-formula-sampling-techniques-5475547.html

Gyssens IC. Audits for monitoring the quality of antimicrobial prescriptions. Antibiot Policies Theory Pract 2005; 197-226.

https://doi.org/10.1007/0-387-22852-7_12

Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: Modern understanding of pathogenesis, diagnosis, and management. Lancet 2015; 386(10000):1278-87.

https://doi.org/10.1016/S0140-6736(15)00275-5

Chandrasekaran TV, Johnson N. Acute appendicitis. Surg [Internet] 2014; 32(8):413-7.

https://www.sciencedirect.com/science/article/pii/S0263931914001185

Humes DJ, Simpson J. Acute appendicitis. BMJ 2006; 333(7567):530-4.

https://doi.org/10.1136/bmj.38940.664363.AE

Acute Appendicitis: When Is It an Emergency? [Internet]. [cited 2023 Nov 22].

https://www.healthgrades.com/right-care/appendectomy/acute-appendicitis

Limato R, Lazarus G, Dernison P, Mudia M, Alamanda M, Nelwan EJ, et al. Optimizing antibiotic use in Indonesia: a systematic review and evidence synthesis to inform opportunities for intervention. Lancet Reg Heal Southeast Asia 2022; 2:100013.

https://doi.org/10.1016/j.lansea.2022.05.002

Obst W, Esser T, Kaasch AJ, Geginat G, Meyer F, Croner RS, et al. The need of antimicrobial stewardship in post-operative infectious complications of abdominal surgery. Visc Med 2022; 38(5):345-53.

https://doi.org/10.1159/000526785

Mustika Sari R, Ayu Dewi Sartika R, Andrajati R. Study on the inaccuracy of prophylactic antibiotic use and analysis causes of surgical site infection of surgical patients at the Depok City Hospital for January-March 2020 period. Int J Innov Sci Res Technol 2021; 6(7):542-9.

https://ijisrt.com/assets/upload/files/IJISRT21JUL081.pdf

Masyrifah M, Andrajati R, Yudhorini LT. Qualitative evaluation of antibiotics use with gyssens method in sepsis patients at Fatmawati Central General Hospital Jakarta. Pharm Sci Res 2022; 9(2):67-80.

https://doi.org/10.7454/psr.v9i2.1259

Wong LP, Alias H, Husin SA, Ali ZB, Sim B, Ponnampalavanar SSLS. Factors influencing inappropriate use of antibiotics: findings from a nationwide survey of the general public in Malaysia. PLoS One 2021; 16(10):1-12.

https://doi.org/10.1371/journal.pone.0258698

Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File Jr TM, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA 2016; 315(17):1864-73.

https://doi.org/10.1001/jama.2016.4151

Sganga G. New perspectives in antibiotic prophylaxis for intra-abdominal surgery. J Hosp Infect 2002; 50:S17-21.

https://doi.org/10.1053/jhin.2001.1124

Marano L, Carbone L, Poto GE, Calomino N, Neri A, Piagnerelli R, et al. Antimicrobial prophylaxis reduces the rate of surgical site infection in upper gastrointestinal surgery: a systematic review. Antibiotics 2022; 11(2):230.

https://doi.org/10.3390/antibiotics11020230

Bahawal MS, Al-Radhi HK, Algrais AA, Alzohayan BF, Almusally AA, Alfulaij AY, et al. Antibiotics used in gastrointestinal surgery prophylaxis and treatment of postoperative infection. Egypt J Hosp Med 2017; 69(5):2486-92.

https://doi.org/10.12816/0041699

Published
2024-02-13
Section
Articles