Review of antibiotic prophylaxis for the prevention of surgical site infection in low and middle income countries (LMICs)

LATEST ARTICLES
SEARCH INDEX
SUGGEST ARTICLE
THE OSI COLLECTIONS
ABOUT THE OSI

OSI STATISTICS

Total abstracts indexed:
534
Audio abstracts:
101
Open access articles:
474
Pending review:
115
Annotations added:
2
Countries represented:
91
No. of contributors:
10
Bookmarks made:
12
Specialities covered:
19

Review of antibiotic prophylaxis for the prevention of surgical site infection in low and middle income countries (LMICs)


JournalAccess Microbiology
Publication date – Feb – 2020
Authors – Lesley Cooper, Jacqueline Sneddon
KeywordsLMICs, ssi, surgery
Open access – Yes
SpecialityGeneral surgery
World region Global

Language – English
Submitted to the One Surgery Index on May 20, 2020 at 8:23 am
Abstract:

Background
The Scottish Antimicrobial Prescribing Group (SAPG) is supporting two hospitals in Ghana via a Fleming Fund healthcare partnership to develop antimicrobial stewardship. Initial intelligence gathering suggests that antibiotic prophylaxis to prevent surgical site infection (SSI) is suboptimal. To inform a quality improvement programme we have reviewed the evidence for use of surgical prophylaxis in LMICs including staff behaviours and attitudes.

Methods
MEDLINE, Embase, Cochrane, CINHAL and Google Scholar were searched from inception to 22 July 2019 for trials, audits, guidelines and systematic review in English. Grey literature, websites and reference lists of included studies were searched. The following data were extracted; study characteristics, interventions, outcomes and recommendations. In view of heterogeneity between studies descriptive analysis was conducted.

Results
Of 185 records screened, 26 studies related to SSI and timing of antibiotic prophylaxis in LMICs were included. The incidence of SSI is significantly higher in LMICs compared with high income countries, recording of infection surveillance data is poor and a lack of local guidelines for antibiotic prophylaxis. Several projects in Africa have reported reduction in SSI with single dose preoperative antibiotic use compared with post-operative prophylaxis and a reduction in cost and nurse time. Despite evidence to the contrary, many surgeons continue to use post-operative antibiotic prophylaxis.

Conclusion
Education to improve incidence of SSI in LMICs through appropriate antibiotic prophylaxis can be successful. Interventions must include local context and address strongly held beliefs. The establishment of local multidisciplinary teams will promote ownership and sustainability of change.

OSI Number – 20387

Public annotations on this article:
No public annotations yet