Antibiotic Prophylaxis to Prevent Surgical Site Infections in Children. Issue 2 (August 2015)

• Record Type: Journal Article
• Authors: Khoshbin, Amir; So, Jeannette P.; Aleem, Ilyas S.; Stephens, Derek; Matlow, Anne G.; Wright, James G.
• Is Part Of: Annals of surgery. Volume 262:Issue 2(2015:Aug.)
• Publication Date: 2015-08
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000000938
• Languages: English
• ISSNs: 0003-4932

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>To investigate the association between antibiotic prophylaxis (AP) and surgical-site infection in pediatric patients.</p> </sec> <sec> <title>Background:</title> <p>Surgical-site infections (SSIs) are a major cause of postoperative morbidity and mortality. Despite numerous studies in adults, benefit of AP in preventing SSIs in children is uncertain.</p> </sec> <sec> <title>Methods:</title> <p>Patients aged 0 to 21 years who underwent surgical procedures at a pediatric acute care hospital from April 1, 2009, to December 31, 2010, were assessed. Antibiotic prophylaxis indication and administration according to an evidence-based guideline were recorded. Complete compliance was defined as AP given, when indicated, within 60 minutes before incision. Surgical-site infections were identified using the Centers for Disease Control and Prevention criteria and documented in the medical records using the <italic>International Classification of Diseases, Tenth Revision</italic>. Multiple logistic regressions adjusting for age, sex, American Society of Anesthesiologists status, wound classification, admission status, surgical discipline, and surgical duration evaluated association of AP compliance and SSI.</p> </sec> <sec> <title>Results:</title> <p>Of 5309 patients for whom antibiotics were indicated, 3901 (73.5%) with complete compliance had an infection rate of 3.0%, whereas 1408 (26.5%) who were not compliant had an infection rate of 4.3% (adjusted relative risk: 0.7; 95% confidence interval: 0.5–0.9; <italic>P</italic> = 0.02). Of 4156 patients for whom antibiotics were not indicated, the 895 (21.5%) who received antibiotics had an infection rate of 1.7% compared with 0.7% in the 3261 (78.5%) who did not receive antibiotics (adjusted relative risk: 1.6; 95% confidence interval: 0.8–3.1; <italic>P</italic> = 0.18).</p> </sec> <sec> <title>Conclusions:</title> <p>In pediatric surgery, complete compliance with AP was associated with 30% decreased risk of SSI.</p> </sec> </abstract>