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Programs in Seed Grants

Using an “antibiotic timeout” to reduce unnecessary perioperative antibiotic use in Ethiopia, Malawi, and Rwanda

A prospective quality improvement study

Research Team: Maia Nofal, MD, MPH, Boston Medical Center Department of Surgery and Stanford/Fogarty Global Health Equity Scholar; Thomas Weiser, MD, MPH, Stanford Surgery; Tihitena Negussie Mammo, MD, Addis Ababa University and Lifebox Foundation

Funders: Department of Surgery, Center for Innovation in Global Health

With antimicrobial resistance on the rise, reducing the overuse of antibiotics is critical. This project will examine whether a simple, low-tech, and low-cost intervention, Lifebox’s Clean Cut program, can improve antibiotic stewardship after surgery in hospitals with low resources.

“In low- and middle-income countries, routine antibiotic prescribing after surgery to prevent surgical infections is commonly taught and reinforced by beliefs that international recommendations against such practices do not apply in LMICs where sterility practices are variable and surgical site infections are more common,” said Primary Investigator Maia Nofal. “By engaging surgical teams in antimicrobial stewardship practices in collaboration with pharmacists and microbiologists through an “antibiotic timeout”, we hope to create a simple, low-cost, and accessible intervention for resource-constrained hospitals to address antibiotic overprescribing after surgery.”

Learn more about Dr. Nofal and her work to prevent post-surgical infection in low-and-middle-income countries here.

Photo credit: Jafar Ahmed,