Systematic Review on Effectiveness of Antimicrobial Use for Prevention of Surgical Site Infections and the Use of Antimicrobials Perioperatively in Veterinary Practices in Kenya

Abstract

Antimicrobials are often administered indiscriminately in veterinary surgical patients to prevent surgical site infection and improve the overall surgical outcome. Guidelines for using antimicrobials perioperatively in veterinary patients have been developed in many countries but are unavailable in Kenya. However, conflicting results remain concerning the beneficial effects of antimicrobial prophylaxis perioperatively. As such, the study was developed to gather evidence on the effectiveness of prophylactic antimicrobials on surgical site infections in veterinary patients and further determine the knowledge and practices on perioperative antibacterial use among veterinarians in Kenya. A mixed-design study comprising a systematic review and a cross-sectional study was adopted. Systematic searches in PubMed, Science Direct, and Google Scholar were conducted for peer-reviewed articles. The key search words were surgical procedure, antimicrobial prophylaxis, surgical site infection, and surgical wound infection. Two reviewers performed the inclusion and exclusion of studies and data extraction independently. In the cross-sectional study, a questionnaire was administered to registered veterinarians in Kenya to evaluate their knowledge, attitude, and practices towards antimicrobial use perioperatively. The information gathered included Veterinarians' demographics, surgical practices perioperatively, antimicrobial use in different surgical procedures, and occurrence of surgical site infections. Descriptive statistics that included proportions were determined for categorical variables, while mean, median, standard deviation, and range were calculated for continuous variables. A multilevel mixed-effects logistic regression analysis was performed to identify factors associated with antimicrobial use and surgical site infection.