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Surgical antibiotic prophylaxis in children: adherence to indication, choice of agent, timing, and duration

Marta Ciofi degli Atti1, Stefania Spila Alegiani, Roberto Raschetti

  • 1Clinical Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, Rome, Italy, marta.ciofidegliatti@opbg.net.

European Journal of Clinical Pharmacology
|February 20, 2015
PubMed

Insights

Surgical antibiotic prophylaxis (SAP) in children is often not administered when indicated and rarely appropriate. Quality improvement is needed to ensure correct antibiotic use in pediatric surgery.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease Prevention
  • Clinical Pharmacy

Background:

  • Surgical antibiotic prophylaxis (SAP) in pediatric populations is not well-defined.
  • Elective surgical procedures in children require standardized antibiotic protocols.

Purpose of the Study:

  • To investigate the current practices of surgical antibiotic prophylaxis in children undergoing elective surgery.
  • To assess the adherence to and appropriateness of SAP in pediatric patients.

Main Methods:

  • Prospective study of elective pediatric surgeries across three Italian tertiary-care hospitals.
  • Data collected on antibiotic administration, timing, choice, and duration relative to international guidelines.
  • Multivariable logistic regression used to identify predictors of SAP adherence.

Main Results:

  • SAP was administered in 81% of procedures where indicated and 18% where not indicated.
  • Overall appropriateness of SAP (choice, timing, duration) was only 8% when indicated.
  • Procedure type and hospital were significant factors influencing SAP administration.

Conclusions:

  • Low rates of indicated SAP use and poor appropriateness highlight significant concerns in pediatric surgical care.
  • Urgent quality improvement initiatives are necessary to implement evidence-based SAP guidelines in children.
  • Hospital-level evaluation of interventions is crucial to improve SAP practices.
Abstract

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