prinsip umum antibiotik profilaksis

Prinsip UmumAntibiotik profilaksis

Teguh Sarry HartonoPPDS Mikrobiologi Klinik

September 2010

Antibiotic treatment can be• Prophylactic antibiotics prevent serious infection in specific situations (e.g. preventing the spread of disease).• Presumptive antibiotic therapy is indicated in some circumstances (e.g. a human bite to the hand• Use empirical antibiotic therapy — which is aimed at the likely causative organism — to manage an infection until microbiological culture and susceptibility results are known • When the cause of an infection is confirmed,

directed therapy is aimed at the specific pathogen (definitive)

Therapeutic Guidelines. Antibiotics.

Ver.13. 2006

Profilaksis :

Medical

Surgical

Medical Prevention of reccurent rheumatic fever

Prevention of endocarditis

Dental procedures and interventions procedures

Prevention of infections in joint protheses

Chemoprophylaxis for meningitis

Treatment of latent infection (TB)

Prophylaxis of IO (HIV-AIDS)

PEP (viral)

Surgical 1/3 penggunaan antibiotik di RS

“inappropriate use” berkisar 30%-90%, terutama

yang berhubungan dengan waktu dan durasi

pemberian (2006)

Definisi Penggunaan antibiotik untuk mencegah

terjadinya infeksi pada lokasi pembedahan

Surgical......

Indikasi Profilaksis dipertimbangkan bila ada resiko terjadinya

infeksi yang bermakna (reseksi kolon)

Infeksi pasca operasi yang dapat menimbulkan

kosekunsi yang berat – walau jarang terjadi – (infeksi

yang berhubungan dengan impaln protetik)

ANTIBIOTIC PROPHYLAXIS

• Prophylaxis in clean-contaminated/ high risk clean wounds

• Antibiotic is given just before patient sent for surgery

• Duration of antibiotic is controversial ( one dose- 24 hour regimen )

ANTIBIOTIC PROPHYLAXIS BASED ON SURGICAL WOUND CLASSIFICATION

• A. Clean : CLASS I e.g. surgeries on thyroid gland, breast, hernia,

• • No need for prophylaxis in clean surgeries, except for :

o Immunucompromised patients, e.g. diabetics, patients using corticosteroids.

o If the surgery include inserting foreign materials such as artificial valves.

o High risk patients like those with infective endocarditis.

The risk of postoperative wound infection is around 2%.


• B. Clean/Contaminated (minimal contamination) : CLASS II e.g., biliary,urinary, GI tract surgery

• Prophylaxis is advisable, and the risk of infection is about 5-10%.


• C. Contaminated (gross contamination) : CLASS III e.g. during bowel surgery

• Prophylaxis is advisable and the risk of infection is up to 20%.


• D. Dirty : CLASS IV through established infection e.g., peritonitis ( up to 50% )

• The use of antibiotic is considered to be of therapeutic nature (not prophylactic).

Thank You!

Referensi

http://curriculum.toxicology.wikispaces.net/file/view/Antibiotics+PM4144.ppt - 23092010

Therapeutic Guidelines. Antibiotics. Ver.13. 2006

1.

2.

3. http://www.slideshare.net/shabeelpn/surgical-infections- 3612070/download - 23092010

prinsip umum antibiotik profilaksis

Documents