Microbiology testing capacity and antimicrobial drug resistance in surgical-site infections: a post-hoc, prospective, secondary analysis of the FALCON randomised trial in seven low-income and middle-income countries

Surgical-site infection (SSI) is a common health-care-associated infection, contributing to antibiotic use. A study in seven low-income and middle-income countries (LMICs) found that targeted antibiotic prophylaxis is insufficient in preventing SSIs and controlling antimicrobial resistance (AMR). The FALCON trial involved 5788 patients, with 1163 diagnosed with SSIs. Of these, 77.8% received prophylactic antibiotics before surgery. Of 228 patients swabbed, 88.5% had microorganisms detected, with Escherichia coli being the most common. MDR was found in 69.4% of patients. The study suggests that expanding testing capacity, developing local guidelines, and implementing infection control teams could help prevent SSIs through directed antibiotic prophylaxis and reduce MDR burden.