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Prolonged antibiotic administration for surgical site infection in pediatric laryngotracheal surgery

Michele Torre1, Irene Paraboschi2, Anna Loy3

  • 1Pediatric Surgery and Airway Team Unit, Scientific Institute for Research, Hospitalization, and Health Care, Istituto Giannina Gaslini, Genoa, Italy.

The Laryngoscope
|December 28, 2018
PubMed

Insights

A new antibiotic protocol significantly reduced surgical site infections (SSI) in pediatric laryngotracheal (LT) surgery. This tailored approach lowered SSI incidence from 36% to 4%, improving patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease Management
  • Otolaryngology

Background:

  • Surgical site infections (SSI) pose a significant risk following laryngotracheal (LT) surgery, particularly in pediatric patients.
  • High incidence rates necessitate improved strategies to prevent SSIs in this vulnerable population.

Purpose of the Study:

  • To evaluate the impact of a new antibiotic management protocol on SSI incidence in children undergoing open LT surgery.
  • To compare SSI rates before and after the implementation of a tailored antibiotic strategy.

Main Methods:

  • Retrospective and prospective cohort study analyzing clinical records of 57 pediatric patients.
  • Comparison of SSI incidence between standard antibiotic prophylaxis and a new protocol involving pathogen-tailored, prolonged antibiotic treatment.
  • Univariate and multivariable analyses were used to identify risk factors and assess protocol effectiveness.

Main Results:

  • SSI incidence decreased dramatically from 36% with standard prophylaxis to 4% with the new protocol (P=.004).
  • The new strategy demonstrated an absolute benefit increase of 32% (95% CI: 11%-52%) in SSI prevention.
  • No significant differences in clinical conditions were observed between the groups, highlighting the protocol's specific impact.

Conclusions:

  • The implemented antibiotic management protocol significantly reduced the incidence of surgical site infections in pediatric laryngotracheal surgery.
  • This tailored, prolonged antibiotic approach represents a highly effective strategy for preventing SSIs in this surgical context.
Abstract

Keywords:
Antibiotic therapychildrenlaryngotracheal surgerymanagement protocolsurgical site infections

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