Rationality of Prophylactic Antibiotic Use and Surgical Site Infection After Cesarean Section at a Jakarta Hospital

Abstract

Cesarean section (CS) is an obstetric surgical procedure associated with a risk of surgical site infection (SSI). The administration of prophylactic antibiotics aims to prevent postoperative infections; however, irrational antibiotic use can increase the risk of antimicrobial resistance. This study aims to evaluate the rationality of prophylactic antibiotic use based on the Gyssens method and to analyze the relationship between the rationality of antibiotic use and the incidence of SSI in cesarean section patients at X Regional Hospital in Jakarta in 2025. This study employed an analytical observational design with a retrospective cross-sectional approach. Data were obtained from the medical records of 310 cesarean section patients from January to December 2025, selected using simple random sampling based on the Slovin formula. The observed variables included patient characteristics, type of prophylactic antibiotic, rationality of antibiotic use based on the Gyssens method, and the incidence of SSI. Data analysis was performed descriptively and analytically using Fisher’s Exact Test, as well as odds ratio (OR) and 95% confidence interval (CI) analysis. The results showed that the majority of patients underwent emergency cesarean section, totaling 211 patients (68.1%). The most commonly used prophylactic antibiotic was ceftriaxone, administered to 242 patients (78.1%), while cefazolin was used in 68 patients (21.9%). Based on the Gyssens method, rational antibiotic use was found in 68 patients (21.9%), while irrational use was found in 242 patients (78.1%). ILO events were found in 7 patients (2.3%). The analysis results showed no significant association between the rationality of antibiotic use and the occurrence of ILO (p=0.704). Patients with irrational antibiotic use had a 1.70-fold higher risk of ILO compared to the rational group (OR=1.70; 95% CI=0.20–14.44). The study’s conclusion indicates that the use of prophylactic antibiotics in cesarean section patients at Hospital X in the Jakarta region in 2025 was still dominated by irrational use based on the Gyssens method, particularly regarding inappropriate antibiotic selection. However, no significant association was found between the rationality of antibiotic use and the incidence of ILO.