Faktor-Faktor yang Berhubungan dengan Komplikasi Apendisitis dan Efektivitas Penggunaan Antibiotik Profilaksis pada Pasien Apendektomi di RSPAD Gatot Soebroto
Factors Associated with Complicated Appendicitis and the Effectiveness of Prophylactic Antibiotic Use in Appendectomy Patients at Gatot Soebroto Army Hospital
DOI:
https://doi.org/10.25026/jsk.v5i6.2109Keywords:
Apendisitis, faktor risiko, antibiotik profilaksisAbstract
Appendicitis is often identified based on clinical characteristics. Appendectomy is the main therapy because antibiotics alone are not effective. However, appendectomy poses a risk of Surgical Site Infection (SSI), necessitating prophylactic antibiotic usage. This study aims to analyze the relationship between leukocyte type, clinical characteristics, and surgical factors with the type of appendicitis and to analyze the effectiveness of prophylactic antibiotic use. Antibiogram analysis used pus specimen cultures. A cross-sectional retrospective design covered 139 subjects treated from 2019-2021 at Gatot Soebroto Army Hospital. Data collection, through purposive sampling, followed set criteria. The chi-square test was used to determine relationships, followed by the logistic regression test. Complicated appendicitis appeared in 18% of males and 11.5% of females. The 15-40 age group (59%) had most cases and a high complicated appendicitis rate (51.2%). Three subjects experienced SSIs across age groups: <15, 15-40, and 41-65, with two of them being male. Neutrophil and lymphocyte counts related to appendicitis type. Dominant factors linked to appendicitis type were length of stay, operation duration, ASA (American Society of Anasthesiologists) score, age, and type of surgery. The most commonly used prophylactic antibiotics are cephalosporins. Prophylactic antibiotics were mostly effective in preventing SSI (97.8%). Gram-negative bacteria generally cause appendicitis, antibiotics that are resistant are generally from the penicillin group.
Keywords: Appendicitis, risk factors, prophylactic antibiotics, SSI
Abstrak
Apendisitis diidentifikasikan berdasarkan karakteristik klinis. Apendiktomi menjadi terapi utama karena antibiotik saja tidak efektif, namun apendiktomi berisiko IDO (Infeksi Daerah Operasi) sehingga diperlukan antibiotik profilaksis. Penelitian ini bertujuan untuk menganalisis hubungan antara tipe leukosit, karakteristik klinis, dan faktor pembedahan dengan tipe apendisitis serta menganalisis efektivitas penggunaan antibiotik profilaksis. Analisis antibiogram dilakukan berdasarkan kultur spesimen pus. Desain retrospektif cross-sectional digunakan dengan 139 subjek yang dirawat sejak 2019 hingga 2021 di RSPAD Gatot Soebroto. Pengumpulan data menggunakan metode purposive sampling sesuai kriteria yang dibuat oleh peneliti. Uji chi square digunakan untuk mengetahui adanya hubungan, kemudian dilanjutkan dengan uji regresi logistik. Apendisitis komplikata terjadi pada 18% pasien pria dan 11,5% pasien wanita. Usia terbanyak pada rentang 15-40 tahun (59%) dan usia tersebut memiliki persentase appendisitis komplikata tertinggi (51,2%). 3 subjek mengalami IDO berusia <15 tahun, 15-40 tahun, dan 41-65 tahun, 2 di antaranya adalah pria. Terdapat hubungan antara neutrofil dan limfosit dengan jenis apendisitis. Urutan faktor yang paling berhubungan dengan tipe apendisitis adalah lama rawat, lama operasi, skor ASA (American Society of Anasthesiologist), usia, dan tindakan operasi. Antibiotik profilaksis yang paling sering digunakan adalah golongan sefalosporin. Antibiotik profilaksis sebagian besar efektif mencegah kejadian IDO (97,8%). Bakteri Gram-negatif secara umum menjadi penyebab apendisitis, antibiotik yang resisten umumnya adalah golongan penisilin.
Kata Kunci: Apendisitis, faktor risiko, antibiotik profilaksis, IDO
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