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Analysis of antibiotic surgical prophylaxis in hospitalized children suffering upper and lower extremity injuries
Inese Sviestina1,2, Janis Mozgis3, Dzintars Mozgis4
1University Children's Hospital, Vienibas gatve 45, Riga, 1004, Latvia. inese.sviestina@gmail.com.
Insights
Adherence to surgical antibiotic prophylaxis guidelines in pediatric hospitals is low. Interventions are needed to improve the appropriate use of antibiotics for surgical prophylaxis in children.
Area of Science:
- Pediatric Surgery
- Infectious Disease Management
- Antibiotic Stewardship
Background:
- Surgical prophylaxis constitutes a significant portion of antibiotic use in pediatric hospitals.
- Optimizing antibiotic use is crucial for combating antimicrobial resistance.
Purpose of the Study:
- To assess the appropriateness of antibiotic use for surgical prophylaxis in pediatric patients.
- To evaluate surgeon adherence to established prophylaxis guidelines.
Main Methods:
- A retrospective analysis of pediatric patients (<18 years) with extremity injuries was conducted.
- Data were collected from two distinct periods: 2001-2003 and 2011-2013.
- Antibiotic use appropriateness was evaluated against international and local guidelines.
Main Results:
- Antibiotic prophylaxis was indicated for 55.0% of patients in 2011-2013, an increase from 44.4% in 2001-2003.
- Prophylaxis administration rates were 66.0% (2011-2013) and 70.8% (2001-2003).
- Appropriate single-dose administration and correct timing of the first dose showed improvements in the later period but remained suboptimal.
Conclusions:
- Adherence to surgical antibiotic prophylaxis guidelines was low in both study periods.
- Significant improvements are necessary to enhance the appropriate use of antibiotics in pediatric surgical prophylaxis.
- Multifaceted interventions are recommended to improve guideline adherence.
Background:
Surgical prophylaxis may account for one-third of all antibiotic use in paediatric hospitals.
Objective:
To evaluate the appropriateness of surgical prophylaxis and to analyse adherence of surgeons to surgical prophylaxis guidelines.
Method:
Retrospective study at a university paediatric hospital. Patients younger than 18 years with injuries of lower and upper extremities were included. The study period was from January 1st 2011-December 31st 2013 and January 1st 2001-December 31st 2003. The appropriateness of the antibiotic use was analysed in accordance with international and local guidelines.
Results:
Antibiotic prophylaxis was needed by 1125 (55.0 %) patients in 2011-2013 and by 816 (44.4 %) patients in 2001-2003. However, it was administered to only 66.0 % of those in need of prophylaxis in 2011-2013 and to 70.8 % of those in 2001-2003. A single antibiotic dose was administered to 73.8 % of those who received antibiotics in 2011-2013 and to 34.1 % of those in 2001-2003. The timing of the first dose was correct in 370 (52.9 %) prescriptions in 2011-2013 and in 10 (20.4 %) prescriptions in 2001-2003. The most often used antibiotics for prophylaxis were cefazolin in 2011-2013 and cefuroxime in 2001-2003.
Conclusion:
Overall adherence rate to the international and hospital guidelines was low, indicating that in order to improve this situation, there is a need for multiple interventions.
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