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"ABSTRAKLatar belakangRestricted antibiotics adalah golongan antibiotik spektrum luas yang termasuk dalam kategori lini 3 kebijakan dan pedoman penggunaan antibiotik PPRA. Restricted antibiotics digunakan secara global terkait dengan banyaknya kejadian resistensi bakteri. Penggunaan restricted antibiotic yang tidak tepat dapat menimbulkan masalah resistensi hingga superinfeksi yang lebih besar, peningkatan mortalitas dan biaya pengobatan. Restriksi pemberian antibiotik ini didasarkan pada risiko resistensi yang lebih besar yang dapat ditimbulkannya, toksisitas dan pertimbangan farmakoekonomik.TujuanUntuk mengevaluasi penggunaan restricted antibiotic di IGD RSCM.MetodePenelitian dilakukan secara kohort prospektif, deskriptif dengan mengambil data pasien usia > 18 tahun yang mendapatkan restricted antibiotic di IGD RSCM selama periode 29 Juli-31 September 2015. Kuantitas penggunaan restricted antibiotic dievaluasi dengan metode ATC/DDD WHO (DDD/100 bed-days) dan kualitas penggunaan restricted antibiotic dievaluasi dengan metode Gyssen. Biaya penggunaan restricted antibiotic dihitung berdasarkan ketetapan biaya oleh RSCM. Penelitian ini juga melihat gambaran dan kesesuaian hasil kultur kuman dengan terapi yang diberikan serta menilai outcome klinik pasien yang mendapatkan restricted antibiotic di IGD RSCM.Hasil penelitianHasil penelitian menunjukkan kuantitas penggunaan restricted antibiotic mencapai 78,3 DDD/100 bed-days dengan penggunaan terbanyak adalah meropenem dan sefepim. Sebanyak 86,7% restricted antibiotic diberikan secara empirik. Hasil pemeriksaan kultur kuman dan uji kepekaan kuman menunjukkan Acinetobacter baumannii dan Pseudomonas aeruginosa merupakan isolat kuman yang menunjukkan resistensi terhadap beberapa restricted antibiotic. Berdasarkan kriteria Gyssen, penggunaan restricted antibiotic termasuk kategori tepat sebesar 45,7%. Biaya terbesar penggunaan restricted antibiotic terdapat pada meropenem dan sefepim. Sebanyak 34 pasien meninggal selama perawatan dengan hasil kultur yang tidak sesuai dengan restricted antibiotic yang digunakan.KesimpulanKuantitas penggunaan dan prevalensi ketidaktepatan penggunaan restricted antibiotic secara umum cukup tinggi di IGD RSCM. Beberapa bakteri menunjukkan resistensi terhadap beberapa restricted antibiotic.

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ABSTRACT

Background

Restricted antibiotics have been used globally due to high prevalence of bacterial resistance. The inappropriate use of restricted antibiotic contributes significantly to the increase of antimicrobial resistance with many consequence such as risk of toxicity, increase of mortality and cost of treatment. Restriction of these antibiotics based on risk of resistance, toxicity and pharmacoeconomics considerations.

Objective

To evaluate the use of restricted antibiotic in adult patients in emergency unit of Cipto Mangunkusumo hospital.

Methods

We performed descriptive, cohort prospective study of adult patients those admitted to the emergency unit of Cipto Mangunkusumo hospital. We reviewed the medical record and electronic health record every day. Subject were patients aged more than 18 years old who received restricted antibiotic from July 29 to September 31, 2015 and all patients were followed up every day until they discharged from hospital. The use of restricted antibiotics were quantitavely evaluated using the ATC/DDD system (DDD/100 bed-days) and qualitatively analyzed using the Gyssen method. All the cost of restricted antibiotic use were calculated using standard price in Cipto Mangunkusumo hospital. This study also assess the clinical outcome and the pattern of sensitivity test of patient those received restricted antibiotic in emergency unit of Cipto Mangunkusumo hospital.

Results

The study results showed that the quantity of restricted antibiotic were 78,3 DDD/100 bed-days during July 29 to September 31, 2015 in the emergency unit of Cipto Mangunkusumo hospital. The most frequently used restricted antibiotic were meropenem dan sefepim. Restricted antibiotic used as empiric therapy was 86.7%. The culture and sensitivity test results showed that Acinetobacter baumannii and Pseudomonas aeruginosa were isolate that have resistance to several restricted antibiotics. Only 45.7% restricted antibiotic use were considered to be definitely appropriate based on Gyssen method. Meropenem and cefepim contribute to the higher cost during hospitalization and 34 patients used restricted antibiotic died during treatment have non concurrent of sensitivity to restricted antibiotic used.

Conclusion

The quantity of restricted antibiotic and prevalence of inappropriate restricted antibiotic use in this emergency department of Cipto Mangunkusumo hospital was generally high. Some bacterias have been resistance to several restricted antibiotic."

"Angka kejadian bedah caesar di seluruh dunia terus meningkat setiap tahun. Namun, angka risiko kematian pasca bedah caesar sangat tinggi akibat infeksi. Pemakaian suatu jenis antibiotik profilaksis pada sebagian kasus bedah caesar telah terbukti dapat mengurangi kejadian infeksi luka operasi. Tujuan penelitian ini untuk mengetahui pola penggunaan antibiotik profilaksis serta kerasionalan antibiotik profilaksis yang digunakan pada pasien bedah caesar di RSUPN Dr. Cipto Mangunkusumo tahun 2015. Penelitian dilakukan secara observasional dengan menggunakan metode deskriptif dan data diperoleh dari rekam medis pasien secara retrospektif. Pengambilan data dilakukan dengan teknik purposive sampling. Evaluasi kerasionalan penggunaan antibiotik profilaksis dinilai dari ketepatan pasien, tepat indikasi, tepat obat, tepat dosis, tepat waktu pemberian dan tanpa infeksi luka operasi. Pasien yang memenuhi kriteria sebagai subjek penelitian sebanyak 245 pasien. Data yang diperoleh menunjukkan bahwa jenis antibiotik profilaksis yang paling banyak digunakan adalah sefazolin (72,66%). Pada penelitian terdapat pasien bedah caesar yang menerima antibiotik profilaksis 100% tepat pasien, 100% tepat indikasi, 98,78% tepat obat, 98,37% tepat dosis dan 72,24% tepat waktu pemberian, serta 98,37% tanpa infeksi luka operasi. Penggunaan antibiotik profilaksis pada pasien bedah sesar terbukti 72,24% pasien menunjukkan kerasionalan. The number of caesarean section in all over the world continue to increase each year. But the rate of post caesarean section risk of death is very high due to infection. The use of a type of antibiotics prophylaxis in some cases of caesarean section has been proven to reduce the occurrence of surgical site infection. The purpose of this study was to know the image of antibiotic prophylaxis and the rationality of antibiotic prophylaxis on caesarean section patients in RSUPN Dr. Cipto Mangunkusumo in 2015. This study was conducted in observation using descriptive method and the data is acquired from medical record investigation retrospectively. Data were collected using purposive sampling technique. Rational use of antibiotics assessed evaluation of the appropriate patient, appropriate indication, appropriate drug, appropriate dose, appropriate time and without the provision of surgical site infection. Eligible patients as subjects of research were 245 patients. Data obtained showed that the most common kind of antibiotic prophylaxis that being used is cefazoline (72.66%). In this study were caesarean patients who received antibiotic prophylaxis showed 100% appropriate patient, 100% appropriate indication, 98.78% appropriate drug, 98.37% appropriate dose, 72.24% appropriate time and 98.37% no surgical site infection. The usage of antibiotic prophylaxis in patients with proven 72.24% caesarean section patients showed rationality."

"Penggunaan antibiotika yang tidak rasional dapat meningkatkan angka kejadian infeksi Enterobacteriaceae penghasil extended spectrum beta-lactamase (ESBL). Prevalensi Enterobacteriaceae penghasil ESBL berbeda di berbagai rumah sakit, dan dapat mempersulit pengobatan, memperpanjang lama rawat, dan meningkatkan angka kematian. Penelitian ini bertujuan untuk mengetahui prevalensi Enterobacteriaceae penghasil ESBL di ICU Pusat RSCM dan hubungannya dengan penggunaan antibiotika. Penelitian merupakan studi cross sectional menggunakan 111 data sekunder hasil uji resistensi ESBL dari pemeriksaan mikrobiologi kultur sesuai standar The Clinical and Laboratory Standards Institute (CLSI) dan rekam medik pasien ICU Pusat RSCM dalam tahun 2011. Hasil uji laboratorium menunjukkan 8 dari 111 sampel (7,2%) mengalami infeksi Enterobacteriaceae penghasil ESBL. Data dianalisis dengan uji chi-square, p=0,05. Hasil analisis statistik menunjukkan bahwa RP>1 dengan nilai kemaknaan p=1.000 dan IK95% 1.039; 1.179. Berdasarkan hasil tersebut, dapat disimpulkan bahwa tidak terdapat hubungan bermakna antara penggunaan antibiotika dengan kejadian infeksi Enterobacteriaceae penghasil ESBL di ICU Pusat RSCM pada tahun 2011.;

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Irrational use of antibiotics can increase the incidence of infection by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. Prevalence of ESBL-producing Enterobacteriaceae varies among hospitals, and which its resistance could complicate the treatment, extend hospital length of stay, and increase the mortality.

The aim of this study is to determine the prevalence of ESBL-producing Enterobacteriaceae and its association with antibiotic use. This study was a cross sectional study, involving 111 secondary data derived from ESBL resistance test of culture examinations which used the standardized method according to The Clinical and Laboratory Standards Institute (CLSI) and patients? medical records in Central ICU RSCM in 2011.

Laboratory test results showed that 8 from 111 samples (7,2%) were infected with Enterobacteriaceae producing ESBL. Data were analyzed using chi-square test, p=0,05. Statistical analysis results were RP>1 with the value of significance p=1.000 and 95% CI 1.039; 1.179. It is concluded that there is no association between antibiotic use and ESBL-producing Enterobacteriaceae infection in Central ICU RSCM in 2011."

"[Tingginya tingkat infeksi nosokomial di ICU menyebabkan penggunaan antibiotik ICU cenderung lebih tinggi dari ruang rawat yang lain. Penggunaan antibiotik ini sering kali tidak menunggu hasil uji kepekaan bakteri. Hal ini menyebabkan resistensi terhadap antibiotika semakin cepat terjadi. Tujuan penelitian ini adalah mengetahui jenis antibiotik yang banyak digunakan di ICU RSCM dan mengetahui jumlah penggunaan antibiotik berdasarkan perhitungan Defined Daily Dose (DDD) WHO di ICU RSCM periode Januari hingga Maret 2015. Penelitian ini merupakan penelitian deskriptif observasional dengan menggunakan rekam medis pasien. Dari 167 rekam medis yang diikutkan dalam penelitian ini, tiga antibiotik dengan frekuensi pemakaian terbanyak adalah meropenem (15.31%), seftriakson (14.43%), dan fosfomisin (11.57%). Hasil penilaian kuantitas penggunaan antibiotik berdasarkan metode DDD menunjukkan tiga antibiotik dengan DDD tertinggi adalah meropenem (433.51 DDD/1000 hari rawat), dilanjutkan dengan seftriakson (268.04 DDD/1000 hari rawat dan amikasin (180.41 DDD/1000 hari rawat). Hasil ini cukup tinggi jika dibandingkan dengan kuantitas penggunaan antibiotik rumah sakit lain, The high incidence nosocomial infection in Intensive Care Unit could increase the antibiotics administration. Furthermore, the administration of antibiotics often not based on the results of bacterial susceptibility test. This phenomenon cause the high level of bacterial resistance in ICU. The aim of this study was to determine the most frequent antibiotics used in ICU and to evaluate antibiotic consumption quantitatively using ACT/DDD method in ICU RSCM. This research is a descriptive-observasional study using medical record of the patient. From 167 medical records, three antibiotics with the highest frequency administration were meropenem (15.31%), ceftriaxone (14.43%), dan fosfomycin (11.57%). By using DDD method, three antibiotics with the highest DDD were meropenem (433.51 DDD/1000 bed days), ceftriaxone (268.04 DDD/1000 bed days), and amikacin (180.41 DDD/1000 bed days). This result is quite high when compared with antibiotic consumpsion in another hosp]"

"ABSTRAKNama : Echa AisyahProgram Studi : Ilmu Kesehatan MasyarakatJudul : Evaluasi Ekonomi Penggunaan Antibiotika Profilaksis CefotaximeDan Ceftriaxone Pada Pasien Operasi Seksio Sesarea Di RumahSakit X Tahun 2017Pemberian antibiotik profilaksis pada operasi seksio sesarea sangat dianjurkan.Menurut pedoman umum penggunaan antibiotik obat dipilih atas dasar keamanan danefektivitas biaya. Evaluasi ekonomi ini menggunakan metode alongside observationalstudy, data dikumpulkan selama bulan April ndash;Mei 2017 secara prospektif mencakup 60pasien dengan operasi seksio sesarea yang mendapatkan antibiotik profilaksis,membandingkan efektivitas biaya antara Cefotaxime dan Ceftriaxone. Hasil ujistatistik menunjukkan bahwa tidak ada perbedaan karakteristik pada 60 pasien tersebut.Analisis menggunakan perspektif rumah sakit, dilaksanakan di rumah sakit milikPemerintah di Jawa Barat. Hasil Systematic Review menunjukkan bahwa tidak adaperbedaan efikasi pada penggunaan kedua obat tersebut. Hasil penelitian inimenkonfirmasi bahwa tidak ada perbedaan outcome klinis berupa infeksi luka operasibaik pada pasien yang mendapatkan antibiotik profilaksis Ceftriaxone maupunCefotaxime. Komponen biaya terbesar adalah biaya operasional 84,79 , diikutibiaya alokasi dari unit penunjang 13,68 , lalu biaya investasi 1,2 dan biayapemeliharaan 0,32 . Analisis memberikan hasil biaya inkremental sebesar Rp.342.535,00 pada satu episode rawat inap. Rumah sakit memiliki potensi untukmenghemat sebesar Rp. 317.529.945,00 setahun dengan memilih antibiotik profilaksisCefotaxime pada pasien operasi seksio sesarea.Kata Kunci : Antibiotik Profilaksis; Operasi Seksio Sesarea; Efektivitas Biaya.

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ABSTRACTName Echa AisyahProgram of Study Public HealthTitle Economic Evaluation on The Use of Prophylaxis AntibioticCefotaxime and Ceftriaxone in Caesarean Section SurgeryPatients at X Hospital in The Year 2017.Prophylactic antibiotic for patients with caesarean section surgery is highlyrecommended in the clinical guideline. The use of antibiotics is selected by usingcriteria safety and cost effectiveness. This economic evaluation was using alongsideobservational study method, prospective data was collected from April to May 2017covering 60 patients with cesarean section surgery who received prophylaxisantibiotics, comparing cost effectiveness between Cefotaxime and Ceftriaxone. Thestatistical test showed that there was no differences of characteristics in the 60 patients.The analysis based on hospital perspective, carried out in a public hospital in WestJava. The Systematic Review showed that there were no difference in the efficacy ofthe drugs. This study confirmed that there was no difference in clinical outcome onsurgical wound infections either in patient who received Ceftriaxone prophylaxis orCefotaxime. The greatest component of the cost was the operational cost 84,79 ,followed by the indirect cost 13,68 , investment cost 1,2 , and maintenance cost 0,32 . The analysis suggested the incremental cost was IDR 342.535 in one episodeof treatment. Hospital would save cost of IDR 317.529.945 a year by choosingCefotaxime prophylactic antibiotics for patients with cesarean section surgery.Keywords Prophylaxis Antibiotic Cesarean Section Surgery Cost Effectiveness"

"Antibiotik merupakan obat yang digunakan pada infeksi yang disebabkan oleh bakteri. Penggunaan antibiotik perlu dimonitoring karena penggunaan yang berlebihan dapat meningkatkan terjadinya resistensi. Evaluasi penggunaan obat secara kuantitatif dapat dilakukan menggunakan metode ATC/DDD (ATC/Anatomical Therapeutic Chemical, DDD/Defined Daily Dose) yang merupakan sistem klasifikasi dan pengukuran penggunaan obat. Tujuan penelitian ini adalah mengetahui lima antibiotik yang paling banyak digunakan di Puskesmas Kecamatan Matraman dan di seluruh jaringan Puskesmas wilayah Kecamatan Matraman pada tahun 2022 dengan metode ATC/DDD. Data pemakaian antibiotik didapatkan dari Laporan Penggunaan dan Lembar Permintaan Obat (LPLPO). Lima antibiotik yang paling banyak digunakan di Puskesmas Kecamatan Matraman tahun 2022 yaitu amoksisilin kaplet 500 mg (59.2%), ciprofloxacine tablet 500 mg (10.7%), cefadroxil kapsul 500 mg (7.6%), amoksisilin sirup kering 125 mg/5 mL (5.6%), dan thiamfenikol kapsul 500 mg (4.6%). Sementara lima antibiotik yang paling banyak digunakan di seluruh jaringan Puskesmas wilayah Kecamatan Matraman tahun 2022 yaitu amoksisilin kaplet 500 mg (58.0%), ciprofloxacine tablet 500 mg (11.0%), cefadroxil kapsul 500 mg (6.8%), amoksisilin sirup kering 125 mg/5 mL (4.8%), dan isoniazid tablet 300 mg (3.1%).

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Antibiotics are drugs used to treat infections caused by bacteria. The use of antibiotics needs to be monitored because excessive use can increase the occurrence of resistance. Quantitative evaluation of drug use can be done using the ATC/DDDD (ATC = Anatomical Therapeutic Chemical; DDD = Defined Daily Dose) method, which is a classification and measurement system for drug use. The purpose of this study is to find out the five most widely used antibiotics in the Matraman District Health Center and in the entire Matraman District Health Center network in 2022 using the ATC/DDDD method. Antibiotic usage data is obtained from the Drug Use Report and Request Sheet. The five most widely used antibiotics at the Matraman District Health Center in 2022 are amoxicillin capsules 500 mg (59.2%), ciprofloxacine tablets 500 mg (10.7%), cefadroxil capsules 500 mg (7.6%), amoxicillin dry syrup 125 mg/5 mL (5.6%), and thiamphenicol capsules 500 mg (4.6%). Meanwhile, the five most widely used antibiotics in the entire Puskesmas network in Matraman District in 2022 are amoxicillin caplets 500 mg (58.0%), ciprofloxacine tablets 500 mg (11.0%), cefadroxil capsules 500 mg (6.8%), amoxicillin dry syrup 125 mg/5 mL (4.8%), and isoniazid tablets 300 mg (3.1%)."

"Surgical site infections are the second most frequent nosocomial infection after catheter infection. They are associated with increase morbidity and mortality, iength of stay in hospital and cost of care. Antibiotic prophylaxis use is addressed to reduce incidence of surgical site infection. The aim of this research was to find out the pattern of antibiotic prophylaxis use; incidence of surgical site infection; association between antibiotic prophylaxis use and incidence of surgical site infection; and other factors that influence the incidence of surgical site infection. This research was carried out in Dr. Cipto Mangunkusumo Hospital Jakarta and it was a retrospective study with cross-sectional design. A total of 220 samples had been taken proportional randomly according to the type of surgery division from 1,841 medical records in 2005. The result showed that the most antibiotic prophylaxis frequently used was cephalosporin (first and third generation). followed by phosphomycin and metronidazole. Most of the patients were given antibiotic prophylaxis in inappropriate time and the duration of use was more than one day. This study found that the incidence of surgical site infection was 8.6% with the highest percentage occurred at orthopedic surgery (23.3%). Statistically, there was no relationship of class. Timing and duration of antibiotic prophylaxis use with incidence of surgical site infection. Adherence of antibiotic prophylaxis use to hospital guideline was not influenced the incidence of surgical site infection. Multivariate analysis with logistic regression analysis showed that the incidence of surgical site infection were influenced by the type of surgery (OR=2.6) and the use of antibiotics during hospitalization prior to surgery (OR=3.2). The conclusion of this research were the incidence of surgical site infection relatively high and class. timing, duration and adherence to hospital guideline of antibiotic prophylaxis use did not influence it. The wound contaminated and the use antibiotics during hospitalization prior to surgery were risk factors for surgical site infection. It was recommended that the hospital management revise the currently used surgical antibiotic prophylaxis guideline which is no longer relevant to the current situation."

"Praktik Kerja Profesi Apoteker di RSUP Fatmawati bertujuan untuk menganalisis profil penggunaan antibiotik meropenem pada bulan Mei tahun 2023 di RSUP Fatmawati. Kajian dilakukan dengan menggunakan metode deskriptif. Tahapan kajian meliputi pengumpulan data pasien dari sistem informasi rumah sakit (ISIMRS), SIMGOS dan Open Labs, penyajian data dalam bentuk tabel deskriptif dan penarikan kesimpulan. Hail kajian menunjukkan arakteristik pasien antibiotik meropenem di RSUP Fatmawati pada Bulan Mei Tahun 2023 mencakup 184 pasien, dengan mayoritas berjenis kelamin laki-laki dan berasal dari kelompok pasien geriatri (61-70 tahun) dengan kesudahan pasien pulang dari rumah sakit. Karakteristik peresepan antibiotik meropenem di RSUP Fatmawati pada Bulan Mei Tahun 2023 sebanyak 5669 vial meropenem dengan regimen dosis paling banyak yaitu 3x1 gram dan asal ruangan pasien yang diberikan antibiotik paling banyak yaitu gedung bougenville, lantai 4 - ICU. Hasil biakan kultur menunjukkan resistensi terhadap Acinetobacter baumannii

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Pharmacist Professional Work Practices at Fatmawati Hospital aims to analyze the profile of use of the antibiotic meropenem in May 2023 at Fatmawati Hospital. The study was carried out using descriptive methods. The study stages include collecting patient data from the hospital information system (ISIMRS), SIMGOS and Open Labs, presenting the data in the form of descriptive tables and drawing conclusions. The results of the study show that the characteristics of meropenem antibiotic patients at Fatmawati General Hospital in May 2023 included 184 patients, the majority of whom were male and came from the geriatric patient group (61-70 years) with the patients later returning home from the hospital. Characteristics of meropenem antibiotic prescriptions at Fatmawati General Hospital in May 2023 were 5669 vials of meropenem with the highest dose regimen being 3x1 gram and the room where the most antibiotics were given was the Bougainville building, 4th floor - ICU. Culture results showed resistance to Acinetobacter baumannii."

"Infeksi daerah operasi (IDO) merupakan infeksi pada sayatan atau organ yang terjadi setelah pembedahan. Upaya pencegahan terhadap infeksi ini menjadi semakin penting dengan jumlah operasi yang semakin meningkat. Pemberian antibiotik profilaksis seringkali dianggap sebagai pencegahan IDO yang paling mudah dilakukan. Namun ketidaktepatan dalam penggunaannya dapat menjadi faktor risiko penyebab terjadinya IDO. Tujuan penelitian ini adalah untuk menganalisis ketidaktepatan penggunaan antibiotik profilaksis pada pasien bedah di RSUD Kota Depok pada periode Januari-Maret 2020. Penelitian ini dilakukan secara observasional dengan disain penelitian deskriptif cross sectional dan pengambilan data dilakukan secara retrospektif. Analisis dilakukan pada sampel sebanyak 139 menggunakan metode Gyssens. Hasil analisis ketidaktepatan penggunaan antibiotik profilaksis dengan metode Gyssens yaitu pada kategori VI sebanyak 138 sampel (99,28%), kategori V sebanyak 83 sampel (60,14%) kategori IVa sebanyak 52 sampel (94,54%). Untuk kategori IVb sampai IIc memiliki nilai yang sama yaitu sebanyak 0 sampel. Kategori I semua sampel tidak tepat waktu pemberian sehingga analisa berakhir pada kategori I dengan jumlah 3 sampel.(100%). Sedangkan angka kejadian infeksi daerah operasi pada pasien bedah di RSUD Kota Depok periode 1 Januari -19 Maret 2020 sebanyak 2,87%. Faktor penyebab terjadinya infeksi daerah operasi karena ketidaktepatan penggunaan antibiotik profilaksis pada waktu pemberian, kepatuhan pasien dan penyakit penyerta (komorbid).

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Surgery area infection (SSI) is an infection of the incision or organ that occurs after surgery. prevention against this infection is becoming increasingly important with an increasing number of operations. Treatment of prophylactic antibiotics as the easiest prevention of SSIs. However, inaccuracy in its use can be a factor in causing SSI. The purpose of this study was to analyze the inaccuracy of prophylactic use in surgical patients at RSUD Kota Depok in the period January-March 2020. This study was conducted observational with a cross-sectional descriptive study and data collection was carried out retrospectively. The analysis was carried out on a sample of 139 using the Gyssens method. The results of the inaccuracy analysis of prophylactic antibiotics using the Gyssens method were 138 samples (99.28%) in category VI, 83 samples (60.14%) in category IVa as many as 52 samples (94.54%). For categories IVb to IIc, there are 0 samples. Category I all samples are not presented on time so that the analysis ends in category I with a total of 3 samples. (100%). Meanwhile, the incidence of infection in the surgical area in surgical patients at the Depok City Hospital for the period January 1-March 19 2020 was 2.87%. Factors causing regional infection due to inappropriate use of prophylactic antibiotics at the specified time, patient and comorbidities (comorbid)."

"Tidur merupakan salah satu kebutuhan dasar manusia, umumnya kebutuhan tidur seseorang terpenuhi pada malam hari dengan waktu tidur 7 - 8 jam. Tidur bermanfaat untuk mengembalikan kondisi fisik dan emosional namun perawatan di rumah sakit dapat rnempengaruhi pemenuhan tidur dimalam hari, salah satunya adalah pemberian antibiotik empat kali sehari sebagai fungsi kalaboratif perawat.Permasalahan dalam penelitian ini adalah apakah pemberian antibiotik empat kali sehari mempengaruhi kebutuhan tidur. Tujuan dari penelitian ini ingin mendapatkan gambaran yang jelas tentang pengaruh pemberian antibiotik empat kali sehari terhadap pemenuhan tidur. Hasil penelitian ini menggunakan desain eksploratif dengan uji statistik tendensi sentral (mean), disimpulkan bahwa ada pengaruh yang signifikan Pemberian dosis antibiotik empat kali sehari terhadap pemenuhan kebutuhan tidur klien yang dirawat di rumah sakit, dilihat dari data 15 responden (71%) dari 21 responden menyatakan kebutuhan tidurnya tidak terpenuhi."