Antimicrobial stewardship for surgical antibiotic prophylaxis and surgical site infections: a systematic review

Martinez-Sobalvarro, Joselin Valeska; Pereira-Júnior, Antônio Alves; Pereira, Lucas Borges; Baldoni, André Oliveira; Ceron, Carla S.; Reis, Tiago Marques dos

doi:10.1007/s11096-021-01358-4

Cited by 31 publications

(18 citation statements)

References 60 publications

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“…Here we also concentrate on the extent of inappropriate prescribing of antibiotics post-operatively to prevent SSIs. It is important that antibiotic prophylaxis is administered for the appropriate duration to prevent SSIs as they are responsible for an appreciable number of hospital-acquired infections, impacting on morbidity, mortality and costs [ 141 , 142 , 143 , 144 , 145 ]. However, as mentioned, extended prophylaxis increases AMR and adverse reactions with limited or no impact on further reducing SSIs [ 83 , 141 , 146 ].…”

Section: Introductionmentioning

confidence: 99%

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

et al. 2022

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There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These concerns have resulted in a plethora of initiatives globally and nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially with the highest rates of AMR globally. Key activities in NAPs include gaining a greater understanding of current antimicrobial utilization patterns through point prevalence surveys (PPS) and subsequently instigating antimicrobial stewardship programs (ASPs). Consequently, there is a need to comprehensively document current utilization patterns among hospitals across Africa coupled with ASP studies. In total, 33 PPS studies ranging from single up to 18 hospitals were documented from a narrative review with typically over 50% of in-patients prescribed antimicrobials, up to 97.6% in Nigeria. The penicillins, ceftriaxone and metronidazole, were the most prescribed antibiotics. Appreciable extended prescribing of antibiotics up to 6 days or more post-operatively was seen across Africa to prevent surgical site infections. At least 19 ASPs have been instigated across Africa in recent years to improve future prescribing utilizing a range of prescribing indicators. The various findings resulted in a range of suggested activities that key stakeholders, including governments and healthcare professionals, should undertake in the short, medium and long term to improve future antimicrobial prescribing and reduce AMR across Africa.

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Section: Introductionmentioning

confidence: 99%

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

et al. 2022

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“…La infección de herida quirúrgica puede ser ocasionada por factores tanto endógenos como exógenos (Martinez et al,2022). Los factores endógenos son propios o específicos del paciente, como la edad, la desnutrición y otras enfermedades base (hipertensión arterial, diabetes obesidad) (Moreno,2022).…”

Section: Resultsunclassified

“…Según Martinez et al, (2022), mencionan que para evitar infecciones no se debe depilar el sitio quirúrgico, y si la depilación es sumamente necesaria, se debe realizar minutos antes del procedimiento quirúrgico, teniendo cuidado de no comprometer la integridad cutánea y así, evitar la colonización microbiana en el sitio quirúrgico. Además, Braak et al, (2022) en su investigación realizada manifiestan que para prevenir infecciones en la herida quirúrgica se debe mantener una adecuada asepsia de las manos por parte del personal de salud y correcta desinfección del quirófano.…”

Section: Resultsunclassified

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

Chicaiza¹,

Guaita²,

Ocaña³

et al. 2023

LATAM

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La infección post quirúrgica en el sitio de incisión, se manifiesta por la aparición de una serie de microorganismos como staphilococcus aureus, enterococos, escherichia coli, entre otros. Es por ello, que el tratamiento dependerá de la magnitud de infección y del antibiograma, basándose en una terapia antimicrobiana sensible y de amplio espectro, mientras que la profilaxis antibiótica dependerá del tipo de cirugía y sitio quirúrgico a ser intervenido, es por ello que la presente investigación tuvo como objetivo conocer el tratamiento y profilaxis de infección de herida quirúrgica, mediante una revisión bibliográfica de tipo no experimental descriptivo, comparando diferentes investigaciones científicas, en donde se concluyó que la infección de herida quirúrgica es una de las complicaciones que se presenta con mayor frecuencia en las unidades operativas, que dependen de factores endógenos y exógenos, por ende, es necesario utilizar profilaxis antibiótica, y en caso de existir infección usar el antibiótico adecuado según los signos clínicos que se identifique en el paciente.

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“…In Pakistan, SSI rates can vary from 6.5% up to 33.7% of patients admitted to surgical wards [ 27 , 28 , 29 ]. Overall, SSIs can account for up to 60% of HAIs in LMICs [ 1 , 9 , 11 , 30 , 31 ]. In view of this, the management of surgical patients requires careful scrutiny to improve future care and reduce costs.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications

et al. 2023

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Antimicrobial prophylaxis is effective in reducing the rate of surgical site infections (SSIs) post-operatively. However, there are concerns with the extent of prophylaxis post-operatively, especially in low- and middle-income countries (LMICs). This increases antimicrobial resistance (AMR), which is a key issue in Pakistan. Consequently, we conducted an observational cross-sectional study on 583 patients undergoing surgery at a leading teaching hospital in Pakistan with respect to the choice, time and duration of antimicrobials to prevent SSIs. The identified variables included post-operative prophylactic antimicrobials given to all patients for all surgical procedures. In addition, cephalosporins were frequently used for all surgical procedures, and among these, the use of third-generation cephalosporins was common. The duration of post-operative prophylaxis was 3–4 days, appreciably longer than the suggestions of the guidelines, with most patients prescribed antimicrobials until discharge. The inappropriate choice of antimicrobials combined with prolonged post-operative antibiotic administration need to be addressed. This includes appropriate interventions, such as antimicrobial stewardship programs, which have been successful in other LMICs to improve antibiotic utilization associated with SSIs and to reduce AMR.

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Antimicrobial stewardship for surgical antibiotic prophylaxis and surgical site infections: a systematic review

Cited by 31 publications

References 60 publications

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

Antibiotic Utilization Patterns for Different Wound Types among Surgical Patients: Findings and Implications

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