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ABSTRACT
Prophylaxis Antibiotic Utilization Study in Orthopaedic Surgery Which Cases
Are Open Fracture Grade II And III (Study at SMF Orthopaedic and
Traumatology Dr. Soetomo Hospital Surabaya)
Nosocomial infection is the main cause of increasing mortality and
morbidity to the hospitalized patients. About 70% of the entire nosocomial
infection, come from the patients with surgery.
Prophylaxis antibiotic is used to prevent wound infections after various
surgical procedures. Prophylaxis antibiotic should be safe, bactericidal, and
effective against the most common organisms causing infections in orthopaedic
surgery.
The objective of this study was to identify the antibiotic utilization, in related
to the type of the antibiotic used, the dose, the time of administration before insicion
was done, duration of the administration, and the successful of antibiotic usage in
preventing infection. The method of this study was a descriptive retrospective
drug utilization study (DUS) using the data performed in medical chart review of the
patients with open fracture grade II and III in the related ward, about 53 patients’ data
were obtained from July to December 2003.
The result of the study revealed that Staphylococcus aureus, Eschericia coli
and Pseudomonas aeruginosa were the most common organisms causing nosocomial
infections. The commonly administered drugs respectively in 33.3 % were 1st
generation of cephalosporine (single drug), followed with 1st generation of
cephalosporine in combination with aminoglycoside (25.4%), and 3 drugs
combination between 1st generation of cephalosporine with aminoglycoside and
Procaine Benzil Penicilline (PPC) (3.2%). Instead of 1st generation of
cephalosporine, some patients also received 2nd generation of cephalosporine (8%)
and 3rd generation of cephalosporine (25.4%). It was also observed that 3rd
generation of cephalosporine could be used with aminoglycoside (4.8%).
The use of these antibiotics in terms of class respectively in 62% was not
appropriate, but dosage, time of administration, and duration of the dose were
confirmed and fulfiled the requirement of the standard prophylaxis use of
antibiotics in orthopaedic surgery.
Keywords : antibiotic, prophylaxis, orthopaedic, cephalosporine, aminoglycoside,
procaine benzil penicilline (PPC)