Evaluation of antibiotic prophylaxis administration at the orthopedic surgery clinic of tertiary hospital in Jakarta, Indonesia

Objective: To evaluate the effectiveness of the use of antibiotic prophylaxis in preventing surgical site infections, at orthopedic surgery unit in tertiary hospital, Dr. Mintohardjo Navy Hospital, Jakarta, Indonesia. Methods: This study was a cross-sectional study conducted retrospectively on the orthopedic unit of the Dr. Mintohardjo Navy Hospital, Jakarta, Indonesia between January to December 2012. Assessment of appropriateness of antibiotic prophylaxis was carried out based on the Scottish Intercollegiate Guidelines and The National Guidelines of Antibiotic Usage in Indonesia. Results: A total of 163 samples consisted of men (73%) and women (27%) with an age range less than 12 years (9.8%), 12-25 years (23.3%), 26-65 years (58.9%) and over 65 years (8.0%). The most commonly antibiotic prophylaxis used in this study was ceftriaxone (87.8%), followed by gentamycin (3.7%), cefotaxime (3.7%), cefoporaxone (1.2%), siprofloksasin (1.2%), fosfomycin (0.6%), meropenem (0.6%), and vancomycin (0.6%). Of the 163 patients 8 (4.9%) patients developed a surgical site infection of all orthopedic surgical patients who received antibiotic prophylaxis. The pathogens isolated from surgical site infection were Escherichia coli (23.08%), coliform (18.62%), Staphylococcus aureus (18.00%), Pseudomonas aeruginosa (12.15%), and Alkaligenes sp. (9.31%). Conclusions: The Compliance of antibiotics prophylaxis administration at orthopedic surgery unit in Dr. Mintohardjo Naval Hospital has not been in accordance with the guidelines of the national or international standards. Therefore it is necessary to do some improvements to ensure better compliance with standard guidelines.