ANALISIS PENGGUNAAN ANTIBIOTIK EMPIRIS DAN PROFILAKSIS PASIEN BEDAH SARAF RSUD PROF. DR. MARGONO SOEKARJO

Abstract

Effective antibiotic use to prevent infections is crucial in reducing risks associated with surgical procedures. Surgical Site Infection (SSI) refers to infection occurring at the surgical wound within 30 days post-operation. Widespread and inappropriate antibiotic use is a major contributor to antibiotic resistance. One of the flagship programs at RSUD Prof. Dr. Margono Soekarjo Purwokerto is neurosurgery, which requires antibiotic therapy. Therefore, qualitative and quantitative analyses are necessary to ensure rational antibiotic use. Inclusion criteria comprised all neurosurgical patients aged over 18 years with complete medical records who underwent neurosurgery and received antibiotic therapy.

This was a descriptive study using retrospective data collected from medical records of neurosurgical patients between January and December 2023 at RSUD Prof. Dr. Margono Soekarjo Purwokerto. Data were analyzed qualitatively using the Gyssens method (evaluated by three reviewers) and quantitatively using the Defined Daily Dose (DDD) method, as stipulated in Indonesian Ministry of Health Regulation No. 8/2015 on the Antimicrobial Resistance Control Program in Hospitals. Analyses compared administered antibiotic therapy against the hospital’s antimicrobial usage guidelines.

Among 348 analyzed patients, demographic data showed 281 patients (80.75%) were aged 18–60 years; males (177 patients, 50.86%) slightly outnumbered females (171 patients, 49.14%). The most common hospitalization duration was 6–10 days (195 patients, 56.03%). The most frequent neurosurgical procedure was craniotomy (207 cases, 59.48%). Evaluation of empirical antibiotic use via the Gyssens method revealed 198 patients (56.88%) were categorized as “Category 0” (appropriate antibiotic use), while ceftriaxone showed the highest DDD value at 342 DDD/100 patient-days. For prophylactic antibiotic use among 283 patients, the Gyssens method indicated 131 patients (47.99%) fell into “Category IVA” (a more effective antibiotic alternative exists), with cefazolin recording the highest DDD at 4.51 DDD/100 patient-days.