The Effect of the Application of Prophylactic Antibiotic Guidelines on the Quality of Antibiotic Use of Cesarean Section Patients at the “X” Hospital in South Tangerang

  • Eliasna Ekariani Ginting
  • Ratih L Dian
  • Utami R Hesty
  • Dewi Mustika
  • Dadan Ramdhani
Keywords: antibiotic prophylaxis, Van der Merr & Gyssens category, cesarean section


In accordance with the Regulation of the Minister of Health of the Republic of Indonesia No.8 of 2015 concerning the Antimicrobial Resistance Control Program (PPRA), “X” hospital had issued Antibiotic Prophylactic Guidelines since September 2018. The effectiveness of implementing these guidelines needs to be analyzed, especially on the use of prophylactic antibiotics for cesarean section because there are studies mentioned that women who undergo cesarean delivery have a 5-20 times risk of infection if prophylactic antibiotics are not given when compared to normal delivery. This study aimed to evaluate the effects of prolylactic antibiotic guideline application on the quality of antibiotic use and the incidence of SSI (Surgical Site Infection) in patients undergoing cesarean section. Patient characteristics and the types of antibiotics used were compared through the medical records of cesarean section patients for the period of October 2017 – September 2018 (before there was a prophylactic antibiotic guide (pre-guide group)) and October 2018 – September 2019 (after there was a prophylactic antibiotic guide (post-guide group)). The quality of antibiotic use was analyzed using the Van der Merr & Gyssens quality category, Kruskal Wallis test analysis was conducted to determine whether there were differences in the quality of antibiotic use and the incidence of the SSI before and after the application of prophylactic antibiotic guidelines. 187 patients (79.91%) in the pre-guide group and 157 patients (64.88%) in post-guided antibiotic prophylaxis. The gestational age at 37 weeks – 41 weeks was 227 patients (97.01%) pre-guide and 230 patients (95.04%) post-guided prophylactic antibiotics. The most types of prophylactic antibiotics used in the pre-guidance were ceftriaxone in 104 patients (44.44%) and ceftizoxime in 91 patients (38.89%). While the most types of antibiotics in post-guidance were ceftizoxime 118 patients (48.76%) and ceftriaxone 84 patients (34.71%). The quality of antibiotic use with category 0 (wise) before antibiotic guidelines was 4.13% (27 patients) and after there was an antibiotic guideline was 3.78% (25 patients). Analysis with Kruskall Wallis test showed that there was no difference in the quality of prophylactic antibiotic use in pre and post prophylactic antibiotics guidelines surgical in “X” hospital. There was no SSI incidence in all patients either before or after the prophylactic antibiotic guidelines were in place.