Strengthening surgical antibiotic stewardship in low-resource settings: a multicentre, prospective, quality improvement study - Summary - MDSpire

Strengthening surgical antibiotic stewardship in low-resource settings: a multicentre, prospective, quality improvement study

  • By

  • Clean Cut Investigators Group

  • John Ibyishaka

  • Yvonne Uwabagira

  • Mediatrice Cyuzuzo

  • Celine Tuyishime

  • Florentine Uwingabire

  • Pierre Celestin Ukobizaba

  • Jean Paul Niyigena

  • Jean Yves Shyrirakera

  • Marie Chantal Umurerwa

  • Gaudence Kabagwira

  • Vestine Musabende

  • Abraham Kwizera

  • Innocent Byamungu

  • Deborah Mukantibaziyaremye

  • Leontine Neema

  • Pierrine Nyirangeri

  • Valens Majyambere

  • Emmanuel Nsengimana

  • Andrew Oryono

  • Fabrice Habarugira

  • Valens Dusabimana

  • Diane Senga

  • Gerard Harerimana

  • Aloys Hakizimana

  • Yves Berard Niyomugabo

  • Senait Bitew Alemu

  • Sara Taye Hale

  • Barnabas Alayende

  • Maia R Nofal

  • Alype Rwamatwara

  • Roda Uwayesu

  • David Tuyisenge

  • Justin Bayisenga

  • Ronald Tubasiime

  • Febronie Muhorakeye

  • Assefa Tesfaye

  • Samantha Steeman

  • Hillena Kebede

  • Natnael Gebeyehu

  • Abebe Bekele

  • Tihitena Negussie Mammo

  • Thomas G Weiser

  • December 10, 2025

  • 0 min

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Objective:

To reduce overprescribing of surgical antibiotic prophylaxis and improve infection prevention and control (IPC) practices in low-resource settings.

Key Findings:
  • Prolonged prophylaxis decreased from 40.7% pre-intervention to 14.1% post-intervention (P < 0.001).
  • Compliance with IPC standards improved from a mean of 2.6 to 5.0 out of 6.0 (P < 0.001).
  • Early cessation of antibiotics did not increase SSI rates (8.9% vs. 17.2% for prolonged prophylaxis).
  • No significant difference in SSI rates after risk adjustment (RR: 1.37, P = 0.107).
Interpretation:

The integrated quality improvement programme effectively reduced prolonged antibiotic prophylaxis without increasing SSI rates, highlighting the importance of strengthening IPC systems for antimicrobial stewardship.

Limitations:
  • Study conducted in a limited number of hospitals in Rwanda, which may affect generalizability.
  • Short duration of the intervention may not capture long-term outcomes.
Conclusion:

Strengthening infection prevention systems rather than relying on prolonged prophylaxis can improve surgical safety and combat antimicrobial resistance in low-income countries.

Original Source(s)

Strengthening surgical antibiotic stewardship in low-resource settings: a multicentre, prospective, quality improvement study

  • by Clean Cut Investigators Group, John Ibyishaka, Yvonne Uwabagira, Mediatrice Cyuzuzo, Celine Tuyishime, Florentine Uwingabire, Pierre Celestin Ukobizaba, Jean Paul Niyigena, Jean Yves Shyrirakera, Marie Chantal Umurerwa, Gaudence Kabagwira, Vestine Musabende, Abraham Kwizera, Innocent Byamungu, Deborah Mukantibaziyaremye, Leontine Neema, Pierrine Nyirangeri, Valens Majyambere, Emmanuel Nsengimana, Andrew Oryono, Fabrice Habarugira, Valens Dusabimana, Diane Senga, Gerard Harerimana, Aloys Hakizimana, Yves Berard Niyomugabo, Senait Bitew Alemu, Sara Taye Hale, Barnabas Alayende, Maia R Nofal, Alype Rwamatwara, Roda Uwayesu, David Tuyisenge, Justin Bayisenga, Ronald Tubasiime, Febronie Muhorakeye, Assefa Tesfaye, Samantha Steeman, Hillena Kebede, Natnael Gebeyehu, Abebe Bekele, Tihitena Negussie Mammo, Thomas G Weiser

  • December 10, 2025

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