EFEKTIVITAS PENGGUNAAN IMPLANT BERLAPIS ANTIBIOTIK PADA TERAPI OSTEOMIELITIS
DOI:
https://doi.org/10.23917/ujp.v2i1.118Keywords:
osteomielitis, implant antibiotik, gentamisin, efektivitas.Abstract
Osteomielitis merupakan komplikasi yang umum terjadi dan menjadi tantangan bagi ahli bedah. Pengobatan osteomielitis biasanya melalui pemberian secara sistemik, namun antibiotik ketika diberikan secara sistemik kadar antibiotik yang sampai pada jaringan rendah karena pemberian secara sistemik. Implant dengan lapisan antibakteri telah dikembangkan sebagai alternatif pengganti pengobatan antibiotik secara sestemik. Dari beberapa artikel ilmiah membuktikan bahwa tingkat kesembuhan keseluruhan pasien osteomielitis adalah 65,5% hingga 95% dengan terapi lokal menggunakan implant berlapis antibiotik. Pada penelitian ini dilakukan uji meta analisis dengan tujuan untuk mengetahui efektivitas implant berlapis antibiotik yang digunakan secara monoterapi atau terapi kombinasi pada pasien osteomielitis. Metode yang digunakan pada literature review ini adalah metode boolean. Sumber informasi didapatkan dari database Science Direct dan PubMed. Data yang digunakan untuk dilakukan meta analisis yaitu sebanyak 9 data yang memenuhi kriteria dilakukannya meta analisis. Pada meta analisis dilakukan analisa pada forrest plot untuk mengetahui efektifitas penggunaan implant berlapis antibiotik gentamisin sebagai monoterapi ataupun biterapi serta dilakukan analisa pada hasil funnel plot untuk mengetahui apakah terdapat bias publikasi pada hasil meta-analisis. Hasil forrest plot menunjukkan nilai random effect model (RE model) (0,86) dimana pada penelitian terdahulu mensyaratakan bahwa nilai size effect (0,88) yang paling mendekati nilai RE model dengan estimasi yang paling akurat. Pada funnel plot menunjukkan hasil yang simetris dimana nilai p-value pada egger’s test (0,667) dan nilai fail-safe N (10373) maka hasil meta analisis ini tidak memiliki makna bias. Sehingga dari hasil meta analisis tersebut telah dibuktikan bahwa antibiotik gentamisin efektif digunakan bersamaan dengan antibiotik vankomisin pada implant berlapis antibiotik pada pasien osteomielitis.
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