JOOTRH Study warns rising antibiotic resistance is undermining wound care treatment

KENYA—A new study by Dr. Silas O. Awuor has raised fresh concerns over the escalating threat of antimicrobial resistance (AMR) in wound care, warning that current treatment practices in Kenya could worsen the problem if urgent changes are not made.

The research, conducted at Jaramogi Oginga Odinga Teaching and Referral Hospital, shows that many wound infections are still treated empirically, with clinicians prescribing antibiotics without first conducting laboratory tests to identify the specific bacteria causing the infection.

According to the findings, this practice has significantly contributed to rising levels of drug resistance.

The study found that resistance to commonly prescribed antibiotics, including ampicillin and cotrimoxazole, now exceeds 90% in some wound infection cases.

In addition, researchers reported an increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug-resistant organisms that are becoming increasingly difficult to treat.

Dr. Awuor noted that many healthcare facilities continue to rely heavily on antibiotic treatment without microbiological confirmation.

This practice accelerates the emergence of resistant pathogens and reduces the effectiveness of standard therapies.

Biofilms complicate healing in chronic wounds

The study also highlights the growing role of biofilms in delaying wound healing.

These protective bacterial communities commonly form in chronic wounds such as diabetic foot ulcers, post-surgical infections, and pressure sores.

Because biofilms shield bacteria from both antibiotics and the body’s natural immune response, they make infections significantly harder to eliminate.

 As a result, conventional antibiotic treatment often fails unless clinicians combine it with physical interventions such as wound debridement to remove infected tissue.

Researchers found that chronic wounds increasingly host multiple bacterial strains simultaneously, many of which show resistance to available antibiotics.

This complexity has widened the gap between laboratory evidence and routine clinical decision-making.

Call for laboratory-guided treatment

Although Kenyan healthcare workers have introduced innovative low-cost wound care solutions, including honey-based dressings, acetic acid applications for Pseudomonas infections, and improvised negative pressure wound therapy systems, the study emphasizes that these approaches alone cannot address the growing microbiological challenge.

A major concern remains the limited use of diagnostic tools such as culture and sensitivity testing, which help identify the exact bacteria present and determine the most effective treatment.

The researchers are now calling for a nationwide shift toward microbiological stewardship, an approach that prioritizes laboratory-guided treatment over empirical prescribing.

Key recommendations include conducting early diagnostic testing before prescribing antibiotics, strengthening collaboration between clinicians and microbiologists, and using hospital-specific resistance data to guide treatment protocols.

The study warns that without these interventions, antimicrobial resistance could drive longer hospital stays, increase healthcare costs, and worsen patient outcomes across Kenya’s healthcare system, particularly in resource-limited settings where access to advanced diagnostics remains limited.