Prospective auditing of antimicrobial stewardship program among breast cancer patients in Dr. M. Djamil Hospital Padang
Article Sidebar
Main Article Content
Abstract
Surgery has been used as part of the treatment of breast cancer, but surgery has a potential risk of infection due to the effect of normal flora on the body and air in the ward environment. The decrease of antibiotics effectiveness is caused by bacterial resistance to antibiotics. The purpose of this study was to find out the pattern of bacteria, antibiotic sensitivity patterns and patterns of antibiotic use among breast cancer patients in the surgery ward Hospital M. Djamil Padang. An observational prospective study design was performed in this study, whereby data was collected from the medical records of patients admitted to the surgery wards of Hospital Dr. M. Djamil Padang from April – September 2017. Results showed the bacterial identification in patients were Staphylococcus aureus and Klebsiella sp. while from the air were found Staphylococcus aureus, Staphylococcus epidermidis and Klebsiella sp. Based on the sensitivity pattern on surgical wounds during April-May 2017 reported amoxicillin/ clavulanic acid and meropenem were good (>80%) while on August-September 2017 was meropenem. Airborne sensitivity patterns result during April-May 2017 were not found, while on August-September 2017 gentamicin, ciprofloxacin and meropenem were good (>80%). Among 32 patients admitted during study period only 7 patients who fulfilled the inclusion criteria. The most common antibiotic used was ceftriaxone 7 (77,8%). The evaluation of the rationale use of antibiotics were 6 (66.7%) appropriate medication, 9 (100%) appropriate dosage, 7 (77.8%) appropriate time duration, 9 (100%) appropriate route, 7 (100%) appropriate patient, 4 (45,1%) appropriate indication and potentially drug interaction 1 (14,28%) as a minor potency.
Article Details
The authors retain the copyright and grant the journal the right of first publication simultaneously under the Creative Commons Attribution License. This license allows others to share the work with proper acknowledgment of authorship and initial publication in this journal. Authors are permitted and encouraged to deposit their articles in institutional repositories, on their personal websites, or in other online repositories after the article has been published in JSFK.
References
Pratiwi, S.T. (2008). Mikrobiologi Farmasi. Jakarta: Erlangga Medical Series.
Permenkes RI. (2011). Pedoman Umum Penggunaan Antibiotik. Jakarta: Menteri Kesehatan Republik Indonesia.
Gelband, H., Molly Miller, P., Pant, S., Gandra, S., Levinson, J., Barter, D., ... & Laxminarayan, R. (2015).The state of the world's antibiotics 2015. Wound Healing Southern Africa, 8(2), 30-34.
Golkar, Z., Bagasra, O., & Pace, D. G. (2014). Bacteriophage therapy: a potential solution for the antibiotic resistance crisis. The Journal of Infection in Developing Countries, 8(2), 129-136.
Barlam, T.F., Cosgrove, S.E., Abbo, L.M.,, Macdougall, C., Schuetz, A.N... & Trivedi, K.K. (2016). Implementing an Antibiotic Stewardship Program: Guidelines by Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infectious Disease. America: Oxford University Press for the Infectious Diseases Society of America.
Liew, Y. X., Lee, W., Tay, D., Tang, S. S. L., Chua, N. G. S., Zhou, Y., ... & Chlebicki, M. P. (2015). Prospective audit and feedback in antimicrobial stewardship: Is there value in early reviewing within 48h of antibiotic prescription?. International journal of antimicrobial agents, 45(2), 168-173.
Wijaya, R. S., Albertus, A., & Wibowo, P. (2015). The antimicrobial stewardship programmes reduce multidrug resistant Acinetobacter baumannii infection in the Intensive Care Unit (ICU) of Siloam Hospital, Tangerang, Indonesia. Journal of Microbiology, Immunology and Infection, 48(2), S50.
Lim, M. K., Lai, P. S. M., Ponnampalavanar, S. S. L. S., Omar, S. F. S., Taib, N. A., Yusof, M. Y., ... & Kamarulzaman, A. (2015). Antibiotics in surgical wards: use or misuse? A newly industrialized country’s perspective. The Journal of Infection in Developing Countries, 9(11), 1264-1271.
Siegel, R. L., Miller, K. D., & Jemal, A. (2016). Cancer statistics, 2016. CA: a cancer journal for clinicians, 66(1), 7-30.
Kemenkes RI. (2015). Infodatin Pusat Data dan Informasi Kementerian Kesehatan RI. Jakarta Selatan.
Ramli, M. (2015). Update breast cancer management diagnostic and treatment. Majalah Kedokteran Andalas.38(1):28-53.
Gil-Londoño, J. C., Nagles-Pelaez, J. A., Maya-Salazar, W. A., Madrid, J., Maya-Restrepo, M. A., Agudelo-Pérez, R. A., & Ochoa, J. (2016). Surgical site infection after breast cancer surgery at 30 days and associated factors. Infectio.
Permatasari, L. (2016). Studi Penggunaan Obat Analgetik untuk Penanganan Nyeri pada Pasien Kanker Payudara Bangsal Bedah Wanita RSUP Dr M.Djamil Padang periode bulan Februari sampai dengan Mei 2016. (Skripsi).Fakultas Farmasi Universitas Andalas.
American Cancer Society. Breast Cancer Facts & Figures 2015-2016. Diakses pada tanggal 4 Oktober 2017 dari https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2015-2016.pdf.
Desiyana, L.S., Soemardi, A.S., Radji. M. (2008). Evaluasi penggunaan antibiotika profilaksis di ruang bedah rumah sakit kanker dharmis Jakarta dan hubungannya dengan kejadian infeksi daerah operasi. Indonesian Journal of Cancer. 4:126-131.
Bratzler, D. W., Dellinger, E. P., Olsen, K. M., Perl, T. M., Auwaerter, P. G., Bolon, M. K., ... & Steinberg, J. P. (2013). Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surgical infections, 14(1), 73-156.
Eroglu, A., Durdu Karasoy, H. K., & Baskan, S. (2014). National practice in antibiotic prophylaxis in breast cancer surgery. Journal of clinical medicine research, 6(1), 30..
Crawford, C. B., Clay, J. A., Seydel, A. S., & Wernberg, J. A. (2016). Surgical Site Infections in Breast Surgery: The Use of Preoperative Antibiotics for Elective, Nonreconstructive Procedures. International journal of breast cancer, 2016.
Samaranayake L. (2012). Essential Microbiology for Dentistry. Edisi 14. China: Elsevier.
CDC (Center for Disease Control and Prenvention). Klebsiella Pneumoniae in Healthcare Settings. Diakses pada tanggal 27 September 2017 dari https://www.cdc.gov/hai/organisms/klebsiella/klebsiella.html.
Morison, M.J,. (2001). Seri Pedoman Praktis Manajemen Luka. Jakarta: EGC.
Solomon, F. B., Wadilo, F. W., Arota, A. A., & Abraham, Y. L. (2017). Antibiotic resistant airborne bacteria and their multidrug resistance pattern at University teaching referral Hospital in South Ethiopia. Annals of clinical microbiology and antimicrobials, 16(1), 29.
Awosika, S. A., Olajubu, F. A., & Amusa, N. A. (2012). Microbiological assessment of indoor air of a teaching hospital in Nigeria. Asian Pacific journal of tropical biomedicine, 2(6), 465-468.
Ekhaise, F., Ighosewe, O. U., & Ajakpovi, O. D. (2008). Hospital in door airborne microflora in private and government owned hospitals in Ben In City, Nigeria.
Utami, E.R. (2011).Antibiotika, resistensi, dan rasionalitas terapi. Sainstis,1(4):124-138.
Permenkes RI. (2015). Program Pengendalian Resistensi Antimikroba di Rumah Sakit. Jakarta: Menteri Kesehatan Republik Indonesia.
Feglo, P., Afriye, A.A. (2014). Environmental impact on postoperative wound infections in a privatly owned hospital in Ghana. African Journal of Microbiology research, 8(5), 1620-1626.
Leta, D., Aragaw, K., & Merid, Y. (2016). Antibiotics Susceptibility Pattern of Hospital Indoor Airborne Bacteria in Hawassa University Teaching and Referral Hospital, South Ethiopia.
Habak, J. E., Varma, S., Kiani, M., Twaddle, A., & Emmerton, L. M. (2013). Prophylactic antibiotic use in breast cancer surgery patients. Journal of Pharmacy Practice and Research, 43(2), 101-104.
Kemenkes RI. (2016). Formularium Nasional. Jakarta: Menteri Kesehatan Republik Indonesia.
Nurkusuma, D.D., Dewi, A. (2017). Efisiensi penggunaan antibiotik profilaksis sefalosporin pada kasus operasi bersih di rumah sakit umum daerah temanggung. Proceeding Health Architecture. (1):67-73.
McEvoy, G. K. (2011). AHFS Drug Information Essential. American Society of Health-System Pharmacists. Inc., Bethesda, Maryland.
Sean, C. S., & Paul, B. (2009). Martindale, the complete drug reference. The Pharmaceutical Press, London, 1409.
Zulfikar, F., & Wiratmo, W. (2015). Studi Penggunaan Antibiotik pada Kasus Bedah Apendiks di Instalasi Rawat Inap RSD dr. Soebandi Jember Tahun 2013 (The Use of Antibiotics in Case Studies App. Pustaka Kesehatan, 3(1), 44-49.
Adriani, K.P. (2017). Evaluasi Rasionalitas Penggunaan Antibiotik Pasien Infeksi Saluran Kemih Dewasa di Instalasi Rawat Inap Rumah Sakit Bethesda Yogyakarta. (Skripsi). Fakultas Farmasi Universitas Sanata Dharma.
Sari, A.D. (2015). Pola Penggunaan Antibiotik pada Pasien Fraktur Terbuka di RSUP Dr. M. Djamil Padang. (Skripsi). Fakultas Farmasi Universitas Andalas.
Schull, P. (2008). Mcgraw-Hill's IV Drug Handbook. McGraw Hill Professional.
Wiryalie, L. (2017). Ceftriaxone-hospital pack. CDK-250,44(3): 231-234.
Kemenkes RI. (2011). Modul Penggunaan Obat Rasional. Jakarta: Menteri Kesehatan Republik Indonesia.
Rikomah, S.A. (2016). Farmasi Klinik. Yogyakarta. CV Budi Utama
Medscape, Drug Interaction Chacker. Diakses pada tanggal 4 Oktober 2017 dari https://reference.medscape.com/drug-interactionchecker.
Ismail, M., Iqbal, Z., Khattak, M. B., Javaid, A., Khan, M. I., Khan, T. M., & Asim, S. M. (2012). Potential drug-drug interactions in psychiatric ward of a tertiary care hospital: prevalence, levels and association with risk factors. Tropical Journal of Pharmaceutical Research, 11(2), 289-296.