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All Journal Eduvest - Journal of Universal Studies Journal of Indonesian Health Policy and Administration
Nurjaman, Evelina Endang
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Aerospace Engineering Computer Science & IT Decision Sciences, Operations Research & Management Health Professions Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Analysis of Prophylactic Antibiotic Administration in Obstetrics, Gynecology, Orthopedics, and Gastrointestinal Surgery at Pondok Indah Bintaro Jaya Hospital January-March 2024 Nurjaman, Evelina Endang; Andriani, Helen
Eduvest - Journal of Universal Studies Vol. 5 No. 11 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i11.52237

Abstract

The use of presurgical antibiotics is common, but adherence to guideline is low. Improper use can lead to antibiotic resistance. A preliminary study was conducted at RSPI Bintaro Jaya hospital between October and December 2023. The study found that the correct type of antibiotic and the timing of administration (30-60 minutes before incision) were both below 60% adherence. Research objectives is to analyze the appropriateness and rationality of pre-surgical antibiotics prescriptions and to evaluaste the causes of noncompliance. The research used a mixed-methods approach. Descriptive statistics to analyze prescribing patterns. Semi-structured interviews to understand the reasons behind prescribing practices. Research finding: Adherence to prescribing guidelines for antibiotic prophylaxis was less than 60%. While doctors had the capability and opportunity to prescribe correctly, concerns about infection risk and surgical outcomes influenced their motivation, leading to potentially less judicious use of antibiotics.
Prophylactic Antibiotic Analysis in Obs-Gyn, Orthopedics, Gastrointestinal Surgery at a South Tangerang Hospital, January-March 2024 Nurjaman, Evelina Endang; Andriani, Helen
Journal of Indonesian Health Policy and Administration Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality was assessed based on four criteria: indication, agent type, timing, and duration. Univariate analysis was used to examine the relationship between physician characteristics and compliance. The qualitative findings were analyzed using the Capability, Opportunity, Motivation – Behavior (COM-B) behavioral model. Overall compliance with all four PA criteria was poor, at only 9% (18 of 208 surgeries). Low adherence was particularly noted in agent selection (33%) and administration timing (42%). Orthopedic surgery showed the lowest compliance in terms of indication and duration. Univariate analysis indicated that only surgical procedure type significantly influenced compliance (p = 0.039). Qualitative analysis revealed that non-adherence was primarily driven by the fear of surgical site infection (SSI) and the belief that broad-spectrum agents are more effective. Notably, despite poor compliance, no incidence of SSI (0%) was reported during the 30–90-day post-procedure follow-up. Consistently poor compliance highlights significant gaps in procedural implementation and physician motivation regarding reasonable PA use. Targeted interventions focusing on standardized procedures, evidence-based education, and systemic monitoring are essential to improve prescription practices and mitigate the risk of AMR development.
Co-Authors Andriani, Helen