ReviewInternational journal of general medicine2021
Key Issues Surrounding Appropriate Antibiotic Use for Prevention of Surgical Site Infections in Low- and Middle-Income Countries: A Narrative Review and the Implications.
Review in International journal of general medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 4 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- From water to wards: status of integrated preventive strategies to break the chain of infection and antimicrobial resistance in Pakistan.Frontiers in pharmacology · 2026Pooled 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
- Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- A meta-analysis of the effects of preoperative mechanical intestinal preparation and oral antibiotics on surgical site infection after rectal tumor resection.Updates in surgery · 2026Article
- Antibiotic utilization in outpatient and inpatient hospitals in Zambia: a systematic review, key findings and public health implications.Infection prevention in practice · 2026Review
- Epidemiology of Surgical Site Infections: Incidence and Risk Factors at Jimma University Specialized and Comprehensive Hospital, Ethiopia.Antibiotics (Basel, Switzerland) · 2026Article
- Antibiotic Use in Pediatric Care in Ghana: A Call to Action for Stewardship in This Population.Antibiotics (Basel, Switzerland) · 2025Article
- Non-adherence to surgical antibiotic prophylaxis guidelines: findings from a mixed-methods study in a developing country.Antimicrobial resistance and infection control · 2025Article
- Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- "Why must I get an infection, especially after surgery?" opportunities for patient engagement in infection care.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Progress on the Global Research Agenda for Antimicrobial Resistance in Human Health in Pakistan: Findings and Implications.Infection and drug resistance · 2025Review
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- Article
- 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
- Point prevalence survey of antibiotics use among hospitalised neonates and children in Saudi Arabia: findings and implications.Journal of pharmaceutical policy and practice · 2024Article
- A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications.Medicina (Kaunas, Lithuania) · 2023Review
- Knowledge and Perceptions of Final-Year Nursing Students Regarding Antimicrobials, Antimicrobial Resistance, and Antimicrobial Stewardship in South Africa: Findings and Implications to Reduce Resistance.Antibiotics (Basel, Switzerland) · 2023Article
- Antimicrobial stewardship: knowledge, attitudes and practices regarding antimicrobial use and resistance among non-healthcare students at the University of Zambia.JAC-antimicrobial resistance · 2023Article
- Antibiotic point prevalence survey and antimicrobial resistance in hospitalized patients across Peruvian reference hospitals.Journal of infection and public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 8 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a concern with the growing use of antimicrobials across countries increasing antimicrobial resistance (AMR) rates. A key area within hospitals is their use for the prevention of surgical site infections (SSI) with concerns with timing of the first dose, which can appreciably impact on effectiveness, as well as duration with extended prophylaxis common among low- and middle-income countries (LMICs). This is a concern as extended duration increases utilization rates and AMR as well as adverse events. Consequently, there is a need to document issues of timing and duration of surgical antibiotic prophylaxis (SAP) among LMICs together with potential ways forward to address current concerns.
methodsNarrative review of timings and duration of SAP among LMICs combined with publications documenting successful approaches to improve SAP to provide future direction to all key stakeholder groups.
resultsThere were documented concerns with the timing of the first dose of antibiotics, with appropriate timing as low as 6.7% in Egypt, although as high as 81.9% in Turkey. There was also an extensive duration of SAP, ranging from long duration times in all patients in a study in Nigeria with a mean of 8.7 days and 97% of patients in Egypt to 42.9% of patients in Pakistan and 35% in Turkey. Successful interventions to improve SAP typically involved multiple approaches including education of all key stakeholder groups, monitoring of usage against agreed guidelines,as well as quality targets. Multiple approaches typically improved timing and duration as well as reduced costs. For instance, in one study appropriateness increased from 30.1% to 91.4%, prolonged duration reduced to 5.7% of patients, and mean costs of antibiotics decreased 11-fold.
conclusionThere are considerable concerns with the timing and duration of SAP among LMICs. Multiple interventions among LMICs can address this providing future directions.
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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 Socratic graph.