| dc.description.abstract | The development of resistance among bacteria due to the overuse and misuse of antibiotics is one of the major public health issues. Surgery is one of the medical areas where antibiotics are widely used to prevent post-operative infection and where the irrational use of antibiotics is reported frequently. Inadequate attention to standard recommendations for prescribing antibiotics by surgeons and other practitioners leads to unnecessary excessive antibiotic utilization, which can increase antimicrobial resistance, morbidity, mortality, and unneeded expenditure on both hospitals and patients. Particularly, this is a most common problem in developing countries where they either have no idea that there is a guideline to follow or if they are aware of it, they disregard it. Afghanistan one of the least developed countries and the heart of conflict and war in the last four decades has encountered lots of challenges within cultural, economic, social, political, and healthcare areas. Regime changes, lack of security, lack of infrastructure, a messy healthcare system, corruption, import of counterfeit drugs, geographical challenges for patients, hygienic conditions, and cultural obstacles related to gender are some factors affecting the quality of public health in this country in recent years. One of the major concerns within the healthcare sector in Afghanistan is the irrational use of antibiotics. To get an overview of the situation in the country, initiating studies was a logical starting point, but the situation in Afghanistan prevented us from conducting such studies. Due to the lack of local research in Afghanistan, articles from neighboring countries were collected to analyze. This is because of the similarity between neighboring countries and Afghanistan from several perspectives such as antibiotic resistance profile, antibiotics prescription culture, and social, economic, and cultural background, which were selected to analyze. In addition, designing a questionnaire, in which surgeons in Afghanistan were asked about their daily practice, was a supply to article analysis to show the real situation of prophylactic antibiotic use in this country. These studies revealed that even though there are several international guidelines available, they are not actively used, and this causes incorrect antibiotic utilization patterns. Guideline implementation led to a more proper selection, the timing of preoperative administration, and especially the duration of prophylactic antibiotics. Data from the questionaries in Afghanistan pointed out some of these findings and this means that initiatives should be taken to improve the surgical antibiotic prophylaxis practice. Preparing a national protocol adjusted to the local medical condition, antibiotics accessibility, local resistance profile, and cultural background should be prioritized. However, approaching such a guideline in Afghanistan requires better knowledge about the resistance profile of the pathogens in this country. This literature study can be used as a pre-study for further research in this field in the future. | eng |