Key result
Prophylactic antibiotics associate with a ~1% surgical site infection rate despite poor guideline adherence.
Cross-Sectional (n=577)
No
Although surgical site infection incidence was low (1.1%), surgical antibiotic prophylaxis at this Indonesian referral hospital relied heavily on broad-spectrum third-generation cephalosporins (cefotaxime) rather than guideline-recommended agents, highlighting the need for improved antimicrobial stewardship.
Low SSI rate observed with cefotaxime despite guideline nonadherence; leaves open whether stewardship interventions are needed in surgical prophylaxis.
Objective: This study was conducted to evaluate the prophylactic antibiotic administration in the surgical clinic of Dr. H. Marzoeki Mahdi Hospital, Bogor, Indonesia.Methods: The data were assessed from the medical records of all patients who underwent surgery from January to December 2013 retrospectively. Antibiotic prophylaxis was assessed based on the Scottish Intercollegiate Guidelines and the National Guidelines of Antibiotic Usage, which includes the type, time, and duration of prophylactic administration of antibiotics.Results: A total of 577 patients were included in this study, consisting of 202 men and 375 women. The most frequently performed surgery is a common surgery 347 (60.1%), followed by obstetric operations 176 (30.5%), and orthopedic surgery 54 (9.4%). In this study, all patients received prophylactic antibiotics before surgery. Cefotaxime (87.8%) was the most commonly used antibiotics for surgical prophylaxis. Of the 577 patients, only 1.1% of patients reported with surgical site infection (SSI).Conclusion: This study shows that adherence to the guidelines of surgical antibiotic prophylaxis is still very low. Therefore, efforts should be made to increase the compliance of using antibiotic prophylaxis in accordance with standard guidelines to improve the rational use of antibiotics.
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Rokhmah et al. (2017) conducted a cross-sectional in Surgical patients receiving prophylactic antibiotics (n=577). Surgical antibiotic prophylaxis (predominantly cefotaxime and ceftriaxone) was evaluated on Surgical site infection (SSI) and adherence to surgical antibiotic prophylaxis guidelines. Prophylactic antibiotic administration (predominantly cefotaxime in 87.8% of cases) resulted in a 1.1% surgical site infection rate despite very low adherence to standard guidelines.
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