scholarly journals Pengaruh Program Pengendalian Resistensi Antimikroba terhadap Penggunaan Antibiotik Profilaksis pada Bedah Obstetri dan Ginekologi

2020 ◽  
Vol 10 (2) ◽  
pp. 145
Author(s):  
Winarni Winarni ◽  
Nanang Munif Yasin ◽  
Tri Murti Andayani
Keyword(s):  
Incidence Rate ◽  
Clinical Outcomes ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Total Sample ◽  
Prophylactic Antibiotics ◽  
Control Group ◽  
Stewardship Program ◽  
The Relationship

The incidence of surgical site infections (SSI) in obstetric and gynecological surgery is quite high. Rational prophylactic antibiotics in surgery are important strategies for the prevention of SSI. Antimicrobial Stewardship Program (ASP) for rational prophylactic antibiotic use has been carried out. This study aims to determine the rationality of the use of prophylactic antibiotics and incidence rate of SSI, the effect of ASP on the rationality of prophylactic antibiotics and clinical outcomes in obstetric and gynecology surgery. This study used a quasi-experimental pretest postest design without control group with retrospective data collection. Research time for 2 months from May to June 2019. The subjects of this study were obstetric and gynecology surgery patients at Pandan Arang Hospital Boyolali in 2018 who were divided into 2 groups: patients before the ASP and patients after the ASP with a total sample of 93 patients each group. An evaluation of the type, dose, time of administration, route of administration, and duration of prophylactic antibiotics were performed against the standard. Data analysis used the Pearson Chi-square test to see the relationship between rationality and clinical outcomes with ASP. The rationality of prophylactic antibiotic use increased from 0 (0%) cases before the ASP to 52 cases (55.9%) after the ASP. The SSI incidence rate before ASP was 9.7%, down to 4.3% after ASP. There was a significant relationship between the rationality of prophylactic antibiotics and ASP (p <0.05) but the relationship between clinical outcome (SSI incidence) and ASP was not significant (p> 0.05). The result of this study can be used to promote the implementation of ASP in other wards to increase rational use of antibiotics.

EVALUASI PENGGUNAAN ANTIBIOTIK PROFILAKSIS PADA PASIEN BEDAH SESAR (SECTIO CAESAREA) DI RSUD ULIN BANJARMASIN TAHUN 2017

2020 ◽  
Vol 5 (2) ◽  
pp. 146
Author(s):  
Saftia Aryzki ◽  
Hidayatun Nisa ◽  
Dian Yunita Gamaliana
Keyword(s):  
Cesarean Section ◽  
Medical Records ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Total Sample ◽  
Prophylactic Antibiotics ◽  
Sectio Caesarea ◽  
Record Data ◽  
Experimental Type ◽  
Third Generation Cephalosporins

 Cesarean section (Sectio Caesarea) is an attempt to remove the fetus through surgery on the abdominal wall and uterus. The use of inappropriate prophylactic antibiotics will lead to infection and resistance. The purpose of this study was to determine prophylactic antibiotic use, in cesarean section patients, to know prophylactic antibiotic use in cesarean section patients in accordance with antibiotic use guidelines (PPAB) Ulin Hospital in 2017, to know prophylactic antibiotic use in cesarean section patients in accordance with Permenkes RI Number 2406 / PER / XII / 2011. This research is a non-experimental type of descriptive study retrospectively by taking medical record data of cesarean section patients at Ulin Banjarmasin Hospital in 2017 with saturated sampling method, obtained a population of 99 medical records of cesarean section with a total sample of 99 medical records. The use of prophylactic antibiotics in Ulin Banjarmasin Public Hospital is a class of third generation cephalosporins namely ceftriaxone and cefotaxime with doses of 1-2 grams / day and duration of 3-5 days. Comparison of the percentage of prophylactic antibiotic use with the guidelines for drug use in Ulin Hospital in Banjarmasin in 2017 is the name and class of 100% is appropriate and 0% is not appropriate, the dose is 100% appropriate and 0% is not appropriate, the duration of administration is 69.70% is appropriate and 30.30% is not corresponding. Comparison of the percentage of prophylactic antibiotic use with Permenkes RI Number 2406 / PER / XII / 2011 is the name and class of 0% is appropriate and 100% is not appropriate, the dose is 0% is appropriate and 100% is not appropriate, the duration of giving 0% is appropriate and 100 % it is not in accordance with.

Is perioperative antibiotic necessary in straightforward implant placement procedures?

2020 ◽  
Author(s):  
Elçin Bedeloğlu ◽  
Mustafa Yalçın ◽  
Cenker Zeki Koyuncuoğlu
Keyword(s):  
Clavulanic Acid ◽  
Dental Implant ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Implant Failure ◽  
Control Group ◽  
Implant Placement ◽  
Significant Difference ◽  
Amoxicillin Clavulanic Acid ◽  
Experimental Group

The purpose of this non-random retrospective cohort study was to evaluate the impact of prophylactic antibiotic on early outcomes including postoperative pain, swelling, bleeding and cyanosis in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 males, 30 females) whose dental implant placement were completed, included to the study. Patients used prophylactic antibiotics were defined as the experimental group and those who did not, were defined as the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 h preoperatively and 1 g amoxicillin + clavulanic acid twice a day for 5 days postoperatively while the control group had received no prophylactic antibiotic therapy perioperatively. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration and implant failure were analyzed on postoperative days 2, 7, and 14 and week 12. No statistically significant difference was detected between the two groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 ( p &gt;0.05), while the severity of pain and swelling were greater on day 2 compared to day 7 and 14 and week 12 in both groups ( p =0.001 and p &lt;0.05, respectively). Similarly, no significant difference was found between the two groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the two groups with regard to the percentage of flap dehiscence assessed at other time points. Within limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized control clinical studies with higher numbers of patients and implants are needed to substantiate our findings.

scholarly journals Survey of Surgeons Regarding Prophylactic Antibiotic Use in Inguinal Hernia Repair

2018 ◽  
Vol 107 (3) ◽  
pp. 208-211 ◽  
Author(s):  
A. P. MacCormick ◽  
J. A. Akoh
Keyword(s):  
Surgical Site Infection ◽  
Perceived Risk ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Hernia Surgery ◽  
Trust Network ◽  
Surgical Trainees ◽  
Infected Mesh

Purpose: The use of prophylactic antibiotics in the mesh repair of inguinal hernias remains controversial. The aim of this study was to determine the perception of surgeons about surgical site infection and how this affects their clinical practice. Methods: A SurveyMonkey of general surgeons and senior surgical trainees was conducted via the local trust network and the questionnaire was displayed on the website of the Association of Surgeons of Great Britain and Ireland and Association of Surgeons in Training. Results: Eighty-one responses were received from surgeons who perform an average of 75 hernia repairs per year – the majority by open technique. Thirty-six (44.4%) used routine antibiotic prophylaxis, 40 (49.4%) selectively, and five (6.2%) not at all as the five surgeons who did not use antibiotics perceived their surgical site infection rate to be <1% and have never removed an infected mesh from a hernia wound. There was no clear difference between those who use prophylactic antibiotics routinely or selectively as the experience of mesh explantation is similar (56% versus 55% had 2–10 meshes removed respectively). Seventy-seven (95%) of surgeons felt a new specific set of guidelines was required. Conclusion: This study highlights the fact that in the absence of clear guidelines, most surgeons base their use of prophylactic antibiotics on their perceived risk or experience of surgical site infection. There is a strong need for a new set of guidelines to address the use of prophylactic antibiotics in groin hernia surgery.

scholarly journals Postdischarge antibiotic use for prophylaxis following spinal fusion

2020 ◽  
Vol 41 (7) ◽  
pp. 789-798
Author(s):  
David K. Warren ◽  
Katelin B. Nickel ◽  
Jennifer H. Han ◽  
Pam Tolomeo ◽  
Christopher J. Hostler ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Linear Models ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Factors Associated ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Surgical Admission ◽  
Significant Factors

AbstractObjective:Despite recommendations to discontinue prophylactic antibiotics after incision closure or <24 hours after surgery, prophylactic antibiotics are continued after discharge by some clinicians. The objective of this study was to determine the prevalence and factors associated with postdischarge prophylactic antibiotic use after spinal fusion.Design:Multicenter retrospective cohort study.Patients:This study included patients aged ≥18 years undergoing spinal fusion or refusion between July 2011 and June 2015 at 3 sites. Patients with an infection during the surgical admission were excluded.Methods:Prophylactic antibiotics were identified at discharge. Factors associated with postdischarge prophylactic antibiotic use were identified using hierarchical generalized linear models.Results:In total, 8,652 spinal fusion admissions were included. Antibiotics were prescribed at discharge in 289 admissions (3.3%). The most commonly prescribed antibiotics were trimethoprim/sulfamethoxazole (22.1%), cephalexin (18.8%), and ciprofloxacin (17.1%). Adjusted for study site, significant factors associated with prophylactic discharge antibiotics included American Society of Anesthesiologists (ASA) class ≥3 (odds ratio [OR], 1.31; 95% CI, 1.00–1.70), lymphoma (OR, 2.57; 95% CI, 1.11–5.98), solid tumor (OR, 3.63; 95% CI, 1.62–8.14), morbid obesity (OR, 1.64; 95% CI, 1.09–2.47), paralysis (OR, 2.38; 95% CI, 1.30–4.37), hematoma/seroma (OR, 2.93; 95% CI, 1.17–7.33), thoracic surgery (OR, 1.39; 95% CI, 1.01–1.93), longer length of stay, and intraoperative antibiotics.Conclusions:Postdischarge prophylactic antibiotics were uncommon after spinal fusion. Patient and perioperative factors were associated with continuation of prophylactic antibiotics after hospital discharge.

Infection risk in endovascular neurointerventions: a comparative analysis of 549 cases with and without prophylactic antibiotic use

2020 ◽  
Vol 132 (3) ◽  
pp. 797-801 ◽  
Author(s):  
Jan-Karl Burkhardt ◽  
Omar Tanweer ◽  
Miguel Litao ◽  
Pankaj Sharma ◽  
Eytan Raz ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Medical Center ◽  
Prophylactic Antibiotic ◽  
Systemic Infection ◽  
Antibiotic Use ◽  
Infection Risk ◽  
Prophylactic Antibiotics ◽  
Oral Antibiotic ◽  
Systematic Analysis ◽  
Significant Difference

OBJECTIVEA systematic analysis on the utility of prophylactic antibiotics for neuroendovascular procedures has not been performed. At the authors’ institution there is a unique setup to address this question, with some attending physicians using prophylactic antibiotics (cefazolin or vancomycin) for all of their neurointerventions while others generally do not.METHODSThe authors performed a retrospective review of the last 549 neurointerventional procedures in 484 patients at Tisch Hospital, NYU Langone Medical Center. Clinical and radiological data were collected for analysis, including presence of prophylactic antibiotic use, local or systemic infection, infection laboratory values, and treatment. Overall, 306 aneurysms, 117 arteriovenous malformations/arteriovenous fistulas, 86 tumors, and 40 vessel stenosis/dissections were treated with coiling (n = 109), Pipeline embolization device (n = 197), embolization (n = 203), or stenting (n = 40).RESULTSAntibiotic prophylaxis was used in 265 of 549 cases (48%). There was no significant difference between patients with or without antibiotic prophylaxis in sex (p = 0.48), presence of multiple interventions (p = 0.67), diseases treated (p = 0.11), or intervention device placed (p = 0.55). The mean age of patients in the antibiotic prophylaxis group (53.4 years) was significantly lower than that of the patients without prophylaxis (57.1 years; p = 0.014). Two mild local groin infections (0.36%) and no systemic infections (0%) were identified in this cohort, with one case in each group (1/265 [0.38%] vs 1/284 [0.35%]). Both patients recovered completely with local drainage (n = 1) and oral antibiotic treatment (n = 1).CONCLUSIONSThe risk of infection associated with endovascular neurointerventions with or without prophylactic antibiotic use was very low in this cohort. The data suggest that the routine use of antibiotic prophylaxis seems unnecessary and that to prevent antibiotic resistance and reduce costs antibiotic prophylaxis should be reserved for selected patients deemed to be at increased infection risk.

scholarly journals Assessment of Prophylactic Antibiotic Use in Patients with Surgical Site Infections

2013 ◽  
Vol 48 (7) ◽  
pp. 560-567 ◽  
Author(s):  
Whitney J. Goede ◽  
Jenna K. Lovely ◽  
Rodney L. Thompson ◽  
Robert R. Cima
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotic ◽  
Surgical Care ◽  
Control Unit ◽  
Surgical Site Infections ◽  
Perioperative Period ◽  
Antibiotic Use ◽  
Infection Prevention And Control ◽  
Improvement Project ◽  
Antibiotic Selection

Background Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial health care costs, with increased morbidity and death. The Surgical Care Improvement Project (SCIP) contains standards that are nationally reported with the aim of improving patient outcomes after surgery. Our institution's standards for antimicrobial prophylaxis in the perioperative period are more stringent than these measures and may be considered “beyond SCIP.” The 4 elements of appropriate antimicrobial prophylaxis are timing, antibiotic selection, dosing, and intraoperative redosing. Objective To quantify antimicrobial SSI prophylaxis compliance in accordance with institutional standards and to identify potential opportunities for improvement. Methods Patients aged 18 years or older were included if they had an SSI between January 1, 2009, and June 30, 2010, according to the database maintained prospectively by the Infection Prevention and Control Unit. Adherence to our institution's practice standards was assessed through analysis of antibiotics administered—timing in relation to the incision, closure, and tourniquet inflation times for the procedure and antibiotic selection, dose, and redosing. Results Overall noncompliance with all 4 elements of antimicrobial prophylaxis was 75.4% among the 760 cases. Repeat dosing had the greatest noncompliance (45.1%); antibiotic selection had the lowest incidence of noncompliance (10.8%). Conclusions Noncompliance existed in each element of antimicrobial SSI prophylaxis, with antibiotic redosing leading in noncompliance. With the implementation of tools to assist the surgical team in following institutional standards, noncompliance will likely decline and additional research opportunities will exist.

scholarly journals DETERMINANTS OF STUNTING IN CHILDREN AGED 24-59 MONTHS IN THE KASREMAN COMMUNITY HEALTH CENTER

2020 ◽  
Vol 1 (2) ◽  
pp. 146
Author(s):  
Devi Kesumawati ◽  
Nurul Hidayah
Keyword(s):  
Community Health Center ◽  
Total Sample ◽  
Primary Data ◽  
Control Group ◽  
P Value ◽  
Z Score ◽  
Work Area ◽  
Study Case ◽  
The Relationship ◽  
Case Design

Introduction: In Indonesia stunting still the main problem and concern in the field of nutrition, this condition in mark with height not according to age measured use the z-score. Children said stunting if the z-score <- 2SD until ≥- 3 SD and very short if < - 3 SD. Methods: This study to attemps to analyze the determinant. Stunting using study correlation with case design study case control done measurements on past (retrospektif) 38 group with the total sample case and 38 respondents. Results: The control group thr kind of data used primary data. Respondents who experienced anemia is 20 and 15 respondents (39,5 %) have children stunting and 5 responden (13,5 %) has a normal, with p-value p= 0,019 (p < 0,005) showing there the relationship between the anemia as the stunting in the work area Puskesmas Kasreman Conclusion: The conclusion of research is several factors such in minutely in the work area Puskesmas Kasreman, risk heving the anemia higher have children stunting. Expected health service, parents and knowledge of the factor causing people to stunting to prevent the occurrence stunting

scholarly journals Implementation and Impact of an Antimicrobial Stewardship Program at a Non-freestanding Children's Hospital

2018 ◽  
Vol 23 (2) ◽  
pp. 84-91 ◽  
Author(s):  
J. Michael Klatte ◽  
Kathleen Kopcza ◽  
Alexander Knee ◽  
Evan R. Horton ◽  
Erica Housman ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Control Group ◽  
Children's Hospital ◽  
Hospital Readmission Rates ◽  
Stewardship Program ◽  
Children’S Hospital ◽  
Acceptance Rates

OBJECTIVES Pediatric Antimicrobial Stewardship Programs (ASP) have been associated with improvements in antibiotic utilization and patient outcomes; however, ASP studies originating from non-freestanding children's hospitals are lacking. In this study, we present the implementation and impact of a multidisciplinary ASP that employs a collaborative physician and pharmacist driven thrice-weekly prospective audit-with-feedback approach at a non-freestanding children's hospital. METHODS Implementation was assessed via descriptive design. Pediatric inpatients maintained on predefined targeted antibiotics of interest for 48 to 72 hours preceding ASP review were eligible for inclusion. Outcomes evaluated included ASP recommendation and provider acceptance rates (overall and by antibiotic and provider specialty). Impact was examined using an interrupted time series design (with a preimplementation period of August 1, 2013, to July 31, 2014 and postimplementation period of December 1, 2014 to May 31, 2016). Eligibility included all targeted antibiotic usage among pediatric inpatients, with a control group comprising those who received antibiotics requiring preauthorization. Outcomes analyzed included days of antibiotic therapy per 1000 patient days (DOT/1000 PD) and 30-day hospital readmission rates over time. RESULTS Postimplementation, 882 antibiotic reviews were performed on 637 patients, with 327 recommendations generated. Reviews of patients maintained on vancomycin and clindamycin, and of those under care of intensivist and hospitalist physicians, were most likely to prompt recommendations. A mean targeted antibiotic usage decrease of 24.8 DOT/1000 PD (95% confidence interval, −62 to 14) was observed postimplementation, with no change in 30-day readmissions (0.64% during both periods). CONCLUSIONS ASP implementation at a non-freestanding children's hospital was feasible and allowed for identification of areas for targeted quality improvement, while demonstrating modest antibiotic use reduction without adversely impacting patient care.

scholarly journals Perioperative antimicrobial prophylaxis in patients receiving antibiotic therapy

2021 ◽  
Author(s):  
Yiwei Yin ◽  
Eljim P Tesoro ◽  
Alan E Gross ◽  
Jeffery J Mucksavage
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotic ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
Surgical Site Infections ◽  
Dose Interval ◽  
Prophylactic Antibiotics ◽  
Antibiotic Administration

Objective: Antimicrobial prophylaxis is administered perioperatively to prevent surgical site infections. However, in patients who have already received antibiotics for the treatment of active infections prior to surgery, the risks and benefits of administering prophylactic antibiotics are unknown. We aimed to assess the necessity of perioperative prophylactic antibiotic administration in patients receiving antibiotic treatment for active infections. Method: This was a retrospective, chart-review cohort study. Between January 2018 to May 2018, adult patients who underwent inpatient surgery at the University of Illinois Hospital and Health Sciences System, and were prescribed prophylactic antibiotics based on institutional protocol, while receiving antibiotic treatment within 48 hours prior to surgery, were included in the study. The primary endpoint was the rate of duplicative antibiotic therapy, which was defined as the administered prophylactic antibiotic (1) exhibiting similar or narrower bacterial coverage as the treatment antibiotic(s), and (2) given within the dose interval of the treatment antibiotic(s). Results: A total of 158 patients were included in the study, of which 70 (44.3%) received duplicative antibiotic therapy, whereas 88 (55.7%) did not. Differences in the incidence of acute kidney injury, C. difficile infection, and surgery site infections were not statistically significant between the two groups. Conclusion We found that it was common for patients receiving therapeutic systematic antibiotics to perioperatively be prescribed additional prophylactic antibiotics at our institution. However, additional prophylactic antibiotics can be unnecessary in decreasing the incidence of surgical site infections.

scholarly journals Incidence of post operative surgical site infection in thyroid surgery following single dose of prophylactic antibiotic

2020 ◽  
Vol 22 (1) ◽  
pp. 15-20
Author(s):  
Md Abul Hossan ◽  
Md Ariful Islam ◽  
Tapas Chakraborty ◽  
Firoz Ahmed Khan ◽  
Md Mozharul Islam
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Site Infection ◽  
Thyroid Surgery ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Empirical Antibiotic Therapy ◽  
Site Infection ◽  
Cross Sectional

Surgical site infection after thyroid surgery is a less common incidence. Prophylactic antibiotic before surgery and empirical antibiotic therapy after surgery is a common practice in our country. But international guidelines do not suggest antibiotic in clean surgical procedure. Aim: To compare the incidence of surgical site infection after thyroid surgery with and without empirical antibiotic therapy. Method: It was a cross sectional study, done from July 2010 to December 2010 in 3 medical college hospitals in Dhaka city. Total 100 cases were included in this study, 50 cases for study in which only single prophylactic antibiotic used half an hour before operation, 50 cases for control in which 7 days antibiotic used per orally in addition to prophylaxis. Result: Among 100 cases male were 24 & female 76 (M: F= 1:3.2). Oldest patient was 56 yrs & youngest 21yrs. 47% patient operated for solitary thyroid nodule, 35% multinodular goiter & only 6% diffuse goiter. 47% patient was done hemithyroidectomy & only 7% total thyroidectomy. All the operations were completed within 2 hours where 40% within one hour. No surgical site infections were found in both study and control cases. Conclusion: There is no statistical difference between routine antibiotic use and no use of antibiotic after thyroid surgery. Bangladesh J Otorhinolaryngol; April 2016; 22(1): 15-20

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