ABSTRACT
Akhmadi Arief, Diah Rumekti Hadiati, Irwan Taufiqur Rachman
Obstetrics and Gynecology Departement
Medical Faculty of Gadjah Mada University, Sardjito Hospital Yogyakarta
Background: Antibiotics usage in patients undergoing caesarean section was still excessive and not uniform, both the type and purpose of antibiotics administration. In DR. Sardjito and its affiliated hospitals differ in terms of antibiotics.
Objective: To determine the effectiveness of prophylactic administration antibotics and therapeutic protocols on the incidence of infection in caesarean section.
Methodology: In a randomized clinical trial, a number of 140 study subjects were divided into two groups each test group as many as 70 people. The test group received prophylactic antibiotic cefotaxime 1 gram was given 60 minutes before incision and the control group received antibiotic therapeutic protocols, namely cefotaxime 1 gram twice, 60 minutes and 12 hours after incision. On day 3 and 7 post-Caesarean section was observed for signs of surgical site infection and endometritis. Infection criteria set based on criteria specific infection of the Center for Disease Control. Outcomes assessed were the incidence of surgical site infection and endometritis. Homogentias test performed on research subjects. Outcomes were analyzed with a kei test analysis with quadratic bivariate and multivariate analysis.
Results: A total of 140 subjects performed the analysis. Obtained from the test group the incidence of surgical wound infections by 11.4% on the third day and 10% in the control group with p > 0.05 and RR 1.16 (0.39-3.39). On the seventh day of surgical wound infection obtained in the test group and 1.4% in the control group was also 1.4% with p > 0.05 and RR 1 (0.61-13.61). Overall surgical site infection in the test group was 12.9% and 11.4% for the control group with p value > 0.05 and RR 1.14 (0.41-3.15). There were no incidence of endometritis in the two groups both the third and seventh day.
Conclusion: The incidence of infection in the prophylactic and therapeutic antibiotics are similar and not statistically significant. Antibiotic prophylaxis is more effective and efficient given at 60 minutes before the incision is made.
Keywords: antibiotic prophylaxis, cefotaxime, Caesarean section, surgical site infection, endometritis.