The Quantitative and Qualitative Analysis of Antibiotic Use in Bone Fracture Patients in a Public Hospital in Indonesia

Abstract

Introduction: Prophylactic antibiotic therapy has an important role in facilitating optimal postoperative healing. Inappropriate use of antibiotics in hospitals will increase the cost of therapy and the incidence of nosocomial infections of infectious microorganisms. Preoperative prophylactic antibiotics are believed to reduce the incidence of surgical site infections. Objective: This study aims to determine the pattern of antibiotic use and analyse the use of antibiotics qualitatively by the Gyssen method and quantitatively by the defined daily dose (DDD) method in inpatients with bone fractures at the Haji General Hospital Surabaya, Indonesia. Methods: This study was a descriptive observational study conducted on 89 samples. Data were collected retrospectively through medical records in the period January-December 2019. Antibiotic use data were then analysed qualitatively and quantitatively using the Gyssen and DDD methods. Results: In this study, the antibiotic that was widely used as a prophylactic and therapeutic antibiotic in patients with bone fractures was ceftriaxone. Quantitative analysis using the DDD method showed that the value of ceftriaxone was 45.6/100 patient-days and cefazoline was 3.1/100 patient-days. Analysis of antibiotic use in bone fracture patients using the Gyssen method showed that the rational use of antibiotics was 84.3%, the use of antibiotics was not timely as much as 4.5%, and the interval of antibiotic administration was not appropriate as much as 11.2%. Conclusion: the use of antibiotics in fracture surgery patients is classified as rational use of antibiotics but the use of antibiotics still exceeds WHO standards. Furthermore, it is necessary to conduct a similar study with prospective data collection so that it can observe the incidence of surgical wound infection.