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Abstract

A prophylactic antibiotic for patients with cesarean section surgery is highly recommended in the clinical guideline. The use of antibiotics is selected by using criteria safety and cost-effectiveness. This partial economic evaluation in the form of cost and outcome analysis was using alongside observational study method, prospective data were collected from April to May 2017 covering 60 patients with cesarean section surgery who received prophylaxis antibiotics, comparing cost-effectiveness between Cefotaxime and Ceftriaxone. The statistical test showed that there were no differences of characteristics in the 60 patients. The analysis based on the hospital perspective carried out in a public hospital in West Java. The Systematic Review showed that there was no difference in the efficacy of the drugs. This study confirmed that there was no difference in clinical outcome on surgical wound infections either in the patient who received Ceftriaxone prophylaxis or Cefotaxime. The greatest component of the cost was the operational cost (84.79%), followed by indirect cost (13.68%), investment cost (1.2%), and maintenance cost (0.32%). The analysis suggested the incremental cost was IDR342,535 in one episode of treatment. The hospital would save the cost of IDR317,529,945 a year by choosing Cefotaxime prophylactic antibiotics for patients with cesarean section surgery.

Bahasa Abstract

Pemberian antibiotik profilaksis pada operasi seksio sesarea sangat dianjurkan. Menurut pedoman umum penggunaan antibiotik obat dipilih atas dasar keamanan dan efektivitas biaya. Evaluasi ekonomi parsial berupa analisis biaya dan luaran ini menggunakan metode alongside observational study, data dikumpulkan selama bulan April–Mei 2017 secara prospektif mencakup 60 pasien dengan operasi seksio sesarea yang mendapatkan antibiotik profilaksis, membandingkan efektivitas biaya antara Cefotaxime dan Ceftriaxone. Hasil uji statistik menunjukkan bahwa tidak ada perbedaan karakteristik pada 60 pasien tersebut. Analisis menggunakan perspektif rumah sakit, dilaksanakan di rumah sakit milik Pemerintah di Jawa Barat. Hasil Systematic Review menunjukkan bahwa tidak ada perbedaan efikasi pada penggunaan kedua obat tersebut. Hasil penelitian ini menkonfirmasi bahwa tidak ada perbedaan outcome klinis (berupa infeksi luka operasi) antara pasien yang mendapatkan antibiotik profilaksis Ceftriaxone dengan antibiotik Cefotaxime. Komponen biaya terbesar adalah biaya operasional (84,79%), diikuti biaya alokasi dari unit penunjang (13,68%), biaya investasi (1,2%) dan biaya pemeliharaan (0,32%). Analisis biaya satuan memberikan hasil biaya inkremental sebesar Rp. 342.535 pada satu episode rawat inap. Rumah sakit memiliki potensi untuk menghemat sebesar Rp. 317.529.945 setahun dengan memilih antibiotik profilaksis Cefotaxime pada pasien operasi seksio sesarea.

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