Prinsip Umum

Antibiotik profilaksis
Teguh Sarry Hartono
PPDS Mikrobiologi Klinik
September 2010

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Antibiotic treatment can be

• 2 Pr
Page
Therapeutic Guidelines. Antibiotics.
Ver.13. 2006
Profilaksis :
Medical
Surgical

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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)

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Surgical
 1/3 penggunaan antibiotik di RS
 “inappropriate use” berkisar 30%-90%, terutama
yang berhubungan dengan waktu dan durasi
pemberian (2006)

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 Surgical......

Definisi
 Penggunaan antibiotik untuk mencegah
terjadinya infeksi pada lokasi pembedahan

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)
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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 )

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 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%.

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 ANTIBIOTIC PROPHYLAXIS

• 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%.

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

• Prophylaxis is advisable and the risk of infection

is up to 20%.

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 ANTIBIOTIC PROPHYLAXIS
• 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).

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Thank You!

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Referensi
http://curriculum.toxicology.wikispaces.n
1. et/file/view/Antibiotics+PM4144.ppt -
23092010

2. Therapeutic Guidelines. Antibiotics. Ver.13. 2006

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

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