ArticleJAC-antimicrobial resistance2020
Supporting global antimicrobial stewardship: antibiotic prophylaxis for the prevention of surgical site infection in low- and middle-income countries (LMICs): a scoping review and meta-analysis.
Article in JAC-antimicrobial resistance, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Synthesizing evidence to guide the design and implementation of effective strategies for discontinuing postoperative antibiotic prophylaxis in surgical settings: an umbrella review post-WHO 2018 recommendations.Systematic reviews · 2025Pooled it
- The impact of antimicrobial stewardship interventions on appropriate use of surgical antimicrobial prophylaxis in low- and middle-income countries: a systematic review.Systematic reviews · 2024Pooled it
- The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis.World journal of surgery · 2021Pooled it
- Antimicrobial resistance in Noma control: a costly neglect within existing neglect.Tropical medicine and health · 2026Review
- Antimicrobial stewardship in practice: determinants of prescription behaviour and developing interventions to improve surgical prophylaxis in a Rwandan tertiary hospital-a mixed methods study using the behaviour change wheel.Antimicrobial resistance and infection control · 2026Article
- Article
- Prevalence and distribution of surgical site infection in Cape Coast Teaching Hospital, Ghana.BMC infectious diseases · 2025Article
- Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future.Frontiers in pharmacology · 2025Review
- Multipronged interventions to reduce surgical site infections: A multicenter implementation research protocol.PloS one · 2025Article
- Qualitative drivers of postoperative prophylactic antibiotics use and resistance in Ethiopia.BMC health services research · 2024Article
- An observational cohort study on the effects of extended postoperative antibiotic prophylaxis on surgical-site infections in low- and middle-income countries.The British journal of surgery · 2024Observational
- Antimicrobial Use Among Hospitalized Neonates and Children; Findings and Implications from a Comprehensive Point Prevalence Survey Among General Tertiary Hospitals in Pakistan.Infection and drug resistance · 2024Article
- Antimicrobial stewardship program for gastrointestinal surgeries at a Vietnamese tertiary hospital.Frontiers in medicine · 2024Article
- Impact of antibiotic prophylaxis on gut microbiota in colorectal surgery: insights from an Eastern European stewardship study.Frontiers in cellular and infection microbiology · 2024Article
- Point prevalence survey of antibiotics use among hospitalised neonates and children in Saudi Arabia: findings and implications.Journal of pharmaceutical policy and practice · 2024Article
- Using Culture Sensitivity Reports to Optimize Antimicrobial Therapy: Findings and Implications of Antimicrobial Stewardship Activity in a Hospital in Pakistan.Medicina (Kaunas, Lithuania) · 2023Observational
- Review
- Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications.Antibiotics (Basel, Switzerland) · 2023Article
- Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications.Antibiotics (Basel, Switzerland) · 2023Article
- Etiquette of the antibiotic decision-making process for surgical prophylaxis in Ethiopia: a triangulated ethnographic study.Frontiers in public health · 2023Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Scottish Antimicrobial Prescribing Group is supporting two hospitals in Ghana to develop antimicrobial stewardship. Early intelligence gathering suggested that surgical prophylaxis was suboptimal. We reviewed the evidence for use of surgical prophylaxis to prevent surgical site infections (SSIs) in low- and middle-income countries (LMICs) to inform this work.
methodsMEDLINE, Embase, Cochrane, CINAHL and Google Scholar were searched from inception to 17 February 2020 for trials, audits, guidelines and systematic reviews in English. Grey literature, websites and reference lists of included studies were searched. Randomized clinical trials reporting incidence of SSI following Caesarean section were included in two meta-analyses. Narrative analysis of studies that explored behaviours and attitudes was conducted.
resultsThis review included 51 studies related to SSI and timing of antibiotic prophylaxis in LMICs. Incidence of SSI is higher in LMICs, infection surveillance data are poor and there is a lack of local guidelines for antibiotic prophylaxis. Education to improve appropriate antibiotic prophylaxis is associated with reduction of SSI in LMICs. The random-effects pooled mean risk ratio of SSI in Caesarean section was 0.77 (95% CI: 0.51-1.17) for pre-incision versus post-incision prophylaxis and 0.89 (95% CI: 0.55-1.14) for short versus long duration. Reduction in cost and nurse time was reported in shorter-duration surgical antibiotic prophylaxis.
conclusionsThere is scope for improvement, but interventions must include local context and address strongly held beliefs. Establishment of local multidisciplinary teams will promote ownership and sustainability of change.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.