No abstract

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In patients who underwent appendicectomy for uncomplicated appendicitis is the use of postoperative antibiotics associated with lower rates of surgical site infections? The search has been devised and 6 studies were deemed to be suitable to answer the question. The outcome assessed was the efficiency of postoperative antibiotic therapy in decreasing the rate of surgical site infections in uncomplicated appendicitis. Authors recommend against the use of postoperative antibiotics based on the supported evidence. Hence, its usage was not associated with lower rates of surgical site infections. On the contrary, it might increase the cost, postoperative morbidity and length of stay.

Many concerns have been expressed in the field of clinical practice regarding antimicrobial resistance since many infections with severe complications and bad prognosis have been described since the end of the last century. In primary healthcare facilities, the risks for developing high rates of antibiotic resistance is high, probably due to the high prevalence of bacterial infections in these places, and due to the overuse of antibiotics without any relevance of evidence of bacterial infections. For instance, people usually administer high doses of broad-spectrum antibiotics for non-severe, self-limiting respiratory tract infections. Moreover, for fighting bacterial infections, patients usually discontinue the treatment course once the symptoms of the disease were relieved. These factors among many others had led to the high prevalence of antibiotic resistance which may lead to serious complications. Many approaches are being made to reduce the resistance that has been reviewed in this review. These include optimizing the dosage and timing of antibiotics administration which can be achieved by more understanding of the pharmacology of the antibiotics. Moreover, training and education programs that target the prescribers and patients have been proven to be efficient in reducing the rates. These efforts are encouraged to last and target more people for more favorable outcomes.