Oki Nugraha Putra,, Oki and Iswinarno Doso Saputro, Iswinarno and Affan Yuniar Nur Hidayatullah, Affan (2021) A retrospective surveillance of the prophylactic antibiotics for debridement surgery in burn patients. International Journal of Burns and Trauma, 11 (2). ISSN 2160-2026

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Abstract

Abstract Burn injury is trauma with a high risk of infection. A method that can be used to prevent and decrease the incidence of infection and accelerate wound healing is debridement. The use of prophylactic antibiotics was considered in debridement to minimize surgical site infection. This study's objective was to characterize the usage of prophylactic antibiotics for debridement in burn patients, including the selection, dose, and route of administration. The second objective was to quantitatively calculate the use of prophylactic antibiotics using ATC/DDD. This was a retrospective study in burn patients admitted to the Dr. Soetomo Hospital's burn unit between 2017 and 2020. Ninety burn patients meet the inclusion criteria enrolled in this study. There were eight prophylactic antibiotics for debridement in this study. Only four from eight antibiotics met the guidelines for prophylactic antibiotics before surgery. All prophylactic antibiotics were given intravenously. The most common prophylactic antibiotics were cefazolin (39%) and followed by ceftazidime (31%) and ceftriaxone (11%). Ceftazidime, cefoperazone, amikacin, and meropenem were used as therapeutic antibiotics to treat burn infection and continued as prophylactic before debridement surgery. Cefazolin and ceftriaxone were the most antibiotics that comply their dose with the guideline. The total of DDD/100 operations was 6.23 and cefazolin was the highest consumed, 3.10 DDD/100 operations. The mortality rate in our study was 33%. For those who survived, there was a significant correlation between % TBSA and length of stay also debridement frequency. Our study concluded there was a difference between daily practice in the hospital and in the guidelines. Improvements were needed to use prophylactic antibiotics more precisely regarding quantity and choice of the type of antibiotics. Keywords: ATC/DDD; Prophylactic antibiotics; burns; debridement.

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