Gambaran Prokalsitonin, Skor SOFA, dan Rasionalitas Pemberian Antibiotik pada Pasien Luka Bakar Berat di RSUP Dr. Hasan Sadikin Bandung Periode Februari–Agustus 2021

Kurnia Ricky Ananta, Erwin Pradian, Nurita Dian Kestriani

Abstract


Sepsis masih menjadi penyebab utama kematian pada luka bakar berat karena dampak luka bakar yang luas pada sistem organ. Prokalsitonin dan skor sequential organ failure assessment (SOFA) memiliki kemampuan yang sama dalam menilai prognosis pada pasien sepsis untuk indikator mortalitas, terapi yang lebih awal dan mengevaluasi terapi yang diberikan, agar angka mortalitas dapat menurun. Penggunaan antibiotik yang tepat dan akurat juga dapat dianggap sebagai faktor penting dalam meningkatkan prognosis. Tujuan penelitian ini melihat gambaran prokalsitonin, skor SOFA, dan rasionalitas pemberian antibiotik pada pasien luka bakar berat di RSUP Dr Hasan Sadikin Bandung. Penelitian ini merupakan penelitian observasional analitik yang dilakukan pada 38 pasien yang dirawat di ULB dan ICU RSUP Dr. Hasan Sadikin Bandung Februari–Agustus 2021. Penelitian ini diperoleh hasil bahwa nilai prokalsitonin yang didukung skor SOFA dapat dijadikan acuan untuk mempertimbangkan keberhasilan pemberian antibiotik dan penghentian antibiotik pada pasien luka bakar berat. Pemberian antibiotik pada seluruh pasien luka bakar berat di RSUP Dr. Hasan Sadikin tidak rasional dikarenakan tidak didasari pemeriksaan kultur dan prokalsitonin pada hari pertama pasien terpapar. Pemberian antibiotik profilaksis secara rasional harus didukung oleh tanda-tanda infeksi yang jelas dilihat dari nilai prokalsitonin, skor SOFA, dan kultur untuk menghindari resistensi antibiotik


Overview of Procalcitonin, SOFA Score, and Rationality of Antibiotics Administration to Patients with Severe Burns at Dr. Hasan Sadikin General Hospital Bandung, February–August 2021


Sepsis is currently the leading cause of death in severe burns due to its wide-ranging effects on organ systems. Procalcitonin and sequential organ failure assessment (SOFA) scores can determine the prognosis of septic patients in terms of mortality indicators, early therapy, and evaluation of the therapy given to reduce mortality and morbidity. Correct and accurate use of antibiotics is also essential in improving the patient's prognosis. This study aimed to determine the procalcitonin, SOFA scores, and the rationality of antibiotics administration to patients with severe burns at Dr. Hasan Sadikin General Hospital Bandung. This analytic observational study was conducted on 38 patients hospitalized in the Burn Unit and ICU of Dr. Hasan Sadikin General Hospital Bandung during February–August in 2021. Procalcitonin values supported by SOFA scores may refer to successful antibiotic administration and ceasing therapy in severe burn injury patients. Antibiotic administration to all patients with severe burns in Dr. Hasan Sadikin General Hospital was irrational as it was not based on cultural examination and procalcitonin on the first day of exposure. Clear signs of infection seen from the procalcitonin value, SOFA score, and culture to avoid antibiotic resistance must support rational prophylactic antibiotic administration.


Keywords


Antibiotik, luka bakar berat, prokalsitonin, sepsis, skor SOFA

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DOI: https://doi.org/10.15851/jap.v9n3.2579

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