The identification of drug related problems (DRPs) using profilaxis antibiotics in orthopedic surgical patients at a Government Hospital in Yogyakarta

Abstract

Background: Antibiotic prophylaxis in orthopedic surgery cases aims to prevent surgery site infections (SSI). For antibiotic prophylaxis, it is recommended to use the first generation of cephalosporin, namely cefazolin which can kill the bacteria commonly found in orthopedic surgery infection. The prophylactic administration of cefotaxime is not the first line but is definitive for surgical prophylaxis. Objective: The aim of this study was to determine the rationale for the use of antibiotic prophylaxis for orthopedic surgery, the drug problems (DRPs) that occurred and their potential interactions. Method: This study was conducted using a cross sectional design with a total sampling technique of medical record samples from January to February 2019 at the Government Hospital in Yogyakarta. Observational analytical descriptive data processing by ensuring the appropriate of indications, route of administration, timing of administration and an appropriate of prophylactic doses as well as how to compare DPRs to the literature and analysis of potential co drug interaction with Drug Information Handbook (DIH), AHFS Clinical Drug Information, Drug Interaction Facts, and Interactions Stockley’s Drug Interaction. Results: All patients received appropriate therapy for indication, type of drug, routes of administration for pre and postoperative. All patients received an under dose of ranitidine and 1 patient (1,69%) received an over dose of piracetam. Potential interactions that occur include ketorolac-ranitidine, NSAIDs with other NSAIDs, NSAIDs-ranitidine, NSAIDs-ACEi, NSAIDs-bisoprolol, bisoprolol-calcium, calcium-vitamin C, and paracetamol-ranitidine. Conclusion: Pre and postoperative prophylactic antibiotics are rational. The accompanying drug, ranitidine and piracetam were not properly doses. Drug interactions in this study are potential. Keywords: prophylaxis antibiotic, orthopedic surgery, cefotaxim, DRPs