KAJIAN LITERATUR: POLA PENGGUNAAN ANTIBIOTIK PROFILAKSIS PADA PASIEN DENGAN PERSALINAN SECTIO CAESAREA

Nanda Nur Maulidya(1), Rika Yulia(2), Fauna Herawati(3*)

(1) Mahasiswa Fakultas Farmasi, Universitas Surabaya
(2) Departemen Farmasi Klinis-Komunitas, Fakultas Farmasi, Universitas Surabaya.
(3) Departemen Farmasi Klinis-Komunitas, Fakultas Farmasi, Universitas Surabaya.
(*) Corresponding Author

Abstract

ABSTRAK

               Sectio caesarea atau bedah sesar merupakan prosedur pembedahan untuk kelahiran janin melalui insisi pada dinding abdomen dan uterus. Sectio caesarea merupakan salah satu prosedur bedah yang memerlukan antibiotik profilaksis dalam pelaksanaannya. Penelitian ini bertujuan untuk mereview kejadian infeksi luka operasi dan profil penggunaan antibiotik profilaksis pada pasien sectio caesarea. Metode yang digunakan pada penelitian ini merupakan kajian literatur atau sistematik review yang menggunakan desain penelitian Randomized Controlled Trial dengan terbitan publikasi tahun 2011-2020. Didapatkan sebanyak 18 artikel yang digunakan sebagai sampel penelitian. Berdasarkan hasil sintesis data, antibiotik golongan sefalosporin yaitu cefazolin merupakan antibiotik yang paling sering digunakan pada pasien yang menjalani sectio caesarea elektif, sedangkan untuk sectio caesarea darurat antibiotik yang paling sering digunakan adalah golongan makrolida yaitu azitromisin. Dari 18 artikel penelitian terebut, dilihat juga kesesuaian jenis dan dosis antibiotik terhadap guideline ASHP dan WHO. Antibiotik profilaksis efektif dalam menurunkan risiko kejadian demam, infeksi luka operasi, infeksi saluran kemih, dan endometritis. Waktu pemberian antibiotik baik sebelum sayatan kulit maupun sesudah penjepitan tali pusat tidak berbeda signifikan terhadap outcome yang terjadi. Berdasarkan hasil penelitian, disimpulkan bahwa penggunaan antibiotik profilaksis pada pasien sectio caesarea elektif sudah sesuai dengan rekomendasi pada guideline yaitu menggunakan antibiotik sefazolin, sedangkan pada pasien sectio caesarea darurat belum sesuai karena menggunakan antibiotik azitromisin.

Kata Kunci: Antibiotik profilaksis, bedah sesar, infeksi luka operasi

ABSTRACT

Caesarean section or sectio caesarea is a surgical procedure for the delivery of the fetus through an incision in the abdominal wall and uterus. Sectio caesarea is a surgical procedure that requires prophylactic antibiotics in its implementation. This study aims to review the incidence of surgical wound infection and the profile of the use of prophylactic antibiotics in sectio caesarean patients. The method used in this study is a literature review or systematic review using the Randomized Controlled Trial research design with publications in 2011-2020. There were 18 articles used as research samples. Based on the results of data synthesis, the cephalosporin class of antibiotics, namely cefazolin, is the most commonly used antibiotic in patients undergoing elective caesarean section, while for emergency cesarean sections, the most commonly used antibiotic is the macrolide group, azithromycin. Of the 18 research articles, it was also seen the suitability of the types and doses of antibiotics against the ASHP and WHO guidelines. Prophylactic antibiotics are effective in reducing the risk of fever, surgical wound infections, urinary tract infections, and endometritis. The time of giving antibiotics both before the skin incision and after the clamping of the umbilical cord was not significantly different from the outcome. Based on the results of the study, it was concluded that the use of prophylactic antibiotics in elective cesarean section patients was in accordance with the recommendations in the guidelines, namely using the antibiotic cefazolin, while in emergency cesarean section patients it was not appropriate because the antibiotic azithromycin was used.

Keywords: Antibiotic prophylactic, sectio caesarea, surgical site infection

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