Oleh Admin Kalbe Medical pada November 19, 2013 06:30

Kombinasi Ceftriaxone-Metronidazole Efektif sebagai Antibiotik Profilaksis pada Tindakan Obstetrik-Ginekologik

Pemberian antibiotik profilaksis pada tindakan obstetri dan ginekologi adalah untuk mencegah terjadinya infeksi pasca-operasi dan menurunkan morbiditas dan mortalitas akibat infeksi pasca-operasi sehingga biaya pengobatan pasca-operasi berkurang. Studi penggunaan antibiotik profilaksis, salah satunya dilakukan oleh Dr. Anand dan rekan-rekan melakukan studi retrospektif di the Obstetrics and Gynecology Department, Guru Gobind Singh  Hospital, Jamnagar (terdapat di India) yang membandingkan efektivitas ceftriaxone-metronidazole dan ciprofloxacin-metronidazole dalam mencegah infeksi pasca-pembedahan obstetri ginekologi.

Dalam studi ini, sejumlah 1.084 rekam medik pasien yang menjalani histerektomi vaginal atau abdominal, laparoskopi, laparotomi, atau cesarean section elektif/emergensi dikumpulkan dari bulan Juni 2010 sampai Desember 2010. Pasien dibagi menjadi 2 kelompok yaitu grup 1 (ciprofloxacin infus 200 mg setiap 12 jam dan metronidazole infus 500 mg setiap 8 jam, selama 48 jam atau sampai dapat diberikan oral dilanjutkan dengan ciprofloxacin 500 mg setiap 12 jam dan metronidazole 400 mg setiap 8 jam) dan grup 2 (ceftriaxone 1 g, 1 kali sehari dan metronidazole infus 500 mg setiap 8 jam, selama 48 jam atau sampai dapat diberikan oral dilanjutkan dengan cefixime 200 mg setiap 12 jam dan metronidazole 400 mg setiap 8 jam). 

Dalam studi ini, diperoleh hasil bahwa kelompok yang mendapatkan antibiotik profilaksis kombinasi ciprofloxacin/ metronidazole injeksi yang dilanjutkan dengan pemberian ciprofloxacin dan metronidazole oral (group 1) versus ceftriaxone dan metronidazole injeksi  yang dilanjutkan dengan cefixime dan metronidazole oral (group 2) menujukkan bahwa angka kejadian infeksi pasca operasi lebih sering pada kelompok group 1 daripada group 2, yaitu masing-masing sebesar 5,8% vs 0,7% dengan p=0,0001. Kedua regimen tersebut ditoleransi dengan baik. Efek samping mual dan muntah ringan dijumpai sebanyak 13 kasus pada grup 1 dan 9 kasus pada grup 2.

Kesimpulan dari studi ini adalah regimen ceftriaxone-metronidazole lebih superior dibandingkan ciprofloxacin-metronidazole dalam mengontrol infeksi pada luka operasi pada pembedahan obstetri dan ginekologi. (HLA)



Image: Ilustration
Referensi: Anand NI, Parmar DM, Sukhlecha A. Comparison of combinations of ciprofloxacin-metronidazole and ceftriaxone-metronidazole in controlling operative site infections in obstetrics and gynecological surgeries: A retrospective study. J Pharmacol Pharmacother.2011;2(3):170-3.


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