Antibiotics for Groin Hernia Repair According to Evidence-Based Guidelines: Time for Action in Ghana.
Antibiotics for Groin Hernia Repair According to Evidence-Based Guidelines: Time for Action in Ghana.
复制标题
根据循证指南使用抗生素修复腹股沟疝气:加纳采取行动的时间到了。
DOI:
10.1016/j.jss.2019.01.040
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发表时间:
2019
期刊:
影响因子:
--
通讯作者:
Mock,Charles
中科院分区:
文献类型:
--
作者:
Gyedu,Adam;Katz,Micah;Agbedinu,Kwabena;Donkor,Peter;Mock,Charles
BackgroudGroin hernia repairs (GHR), though classified as clean surgeries, are associated with varying rates of surgical site infections. We assessed the practices of surgeons in Ghana regarding antibiotic use for GHR in comparison to evidence-based international guidelines (EBIG).MethodsWe interviewed surgeons trained by the Ghana College of Physicians and Surgeons (GCPS), from inception (2003) through 2016, about their use of antibiotics for GHR. We defined the outcome variable of consistently following EBIG in antibiotics use for GHR. Logistic regression was used to examine howa prioriselected covariates contributed to the outcome.ResultsEighty-two of 117 surgeons reported performing/supervising at least one GHR per week. They performed/supervised a mean of five GHR per week. Thirty-two (40%) reported using mesh for at least 50% of GHR. For primary GHR, 75% of surgeons administered antibiotics according to EBIG, whereas for GHR with mesh only, 45% did so. Predictors of consistently following EBIG were increasing number of GHR performed per week (adjusted odds ratio 1.44, 95% CI 1.07-1.96) and increasing time spent for clinical work (adjusted odds ratio 0.95, 95% CI 0.91-0.99). Years of practice since GCPS graduation, total operations performed per week, and hospital level of practice were not predictive of the outcome variable.ConclusionsTwo-thirds of Ghanaian surgeons interviewed do not consistently administer antibiotics for GHR per EBIG, raising the need to improve access to evidence-based medical information overall to guide practice. Determining local surgical site infections rates to guide antibiotic use in GHR will be useful in Ghana and other LMICs.
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