| Autor: |
Clean Cut Investigators Group, Nofal, Maia R., Zhuang, Alex Y., Gebeyehu, Natnael, Starr, Nichole, Haile, Sara Taye, Woldeamanuel, Habtamu, Tesfaye, Assefa, Alemu, Senait Bitew, Bekele, Abebe, Mammo, Tihitena Negussie, Weiser, Thomas G., Abdukadir, Abdi Amin, Abebe, Belay Mellese, Admasu, Ananya K., Alito, Tibebu Abebe, Ambulkar, Reshma, Arimino, Sedera, Arusi, Muhudin, Aynalem, Nardos |
| Předmět: |
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| Zdroj: |
British Journal of Surgery; Jan2024, Vol. 111 Issue 1, p1-8, 8p |
| Abstrakt: |
Background: Worldwide, approximately one in six inpatient antibiotic prescriptions are for surgical-infection prophylaxis, including postoperative prophylaxis. The WHO recommends against prolonged postoperative antibiotics to prevent surgical-site infection. However, in many low- and middle-income countries, postoperative antibiotic prophylaxis is common due to perceptions that it protects against surgical-site infection and data informing recommendations against antibiotic administration are largely derived from high-income countries. The aim of this study was to describe postoperative antibiotic-prescribing patterns and related surgical-site infection rates in hospitals in low- and middle-income countries. Methods: Patients from 19 hospitals in Ethiopia, Madagascar, India, and Bolivia with wound class I and II operations were included. Data on antibiotic administration, indication, surgical-site infection, length of hospital stay, and adherence to perioperative infection-prevention standards were collected by trained personnel. The association between postoperative antibiotic prophylaxis for greater than or equal to 24 h and surgical-site infection was analysed via modified robust Poisson regression, controlling for patient and procedural factors and degree of adherence to perioperative infection-prevention practices. Results: Of 8714 patients, 92.9% received antibiotics for prophylaxis after surgery and 27.7% received antibiotics for greater than or equal to 24 h. Patients receiving postoperative prophylaxis for greater than or equal to 24 h did not have lower surgical-site infection rates (Relative risk 1.09 (95% c.i. 0.89 to 1.33); P = 0.399), but the length of hospital stay was 1.4 days longer (P < 0.001). Conclusion: Prolonged postoperative antibiotics did not reduce surgical-site infection, but pervasive use was associated with a longer length of hospital stay, in resource-limited healthcare systems. With the growing threat of antimicrobial resistance, surgical initiatives to implement antimicrobial stewardship programmes in low- and middle-income countries are critical. This cohort study evaluated whether postoperative antibiotic prophylaxis decreased the risk of surgical-site infections in 19 hospitals in low- and middle-income countries, where postoperative prophylaxis is common. Administering postoperative prophylaxis for greater than or equal to 24 h was not associated with a lower risk of surgical-site infection. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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