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Area of Science:

  • Pediatric Surgery
  • Infectious Disease
  • Antimicrobial Stewardship

Background:

  • National guidelines recommend surgical antibiotic prophylaxis (SAP) duration of 24 hours or less.
  • Antibiotic overuse is a significant concern in healthcare settings, contributing to antimicrobial resistance.

Purpose of the Study:

  • To evaluate the duration of SAP in a pediatric hospital.
  • To identify opportunities for standardizing SAP practices and reducing antibiotic overuse.

Main Methods:

  • Retrospective analysis of 12,895 surgical procedures performed in 2017.
  • Procedures were categorized by SAP duration: none, single dose, multiple doses within 24 hours, and >24 hours.
  • Calculated cumulative days of potentially excess prophylaxis.

Main Results:

  • 55% of procedures received SAP; 11% received prophylaxis for >24 hours.
  • 14% received multiple doses within 24 hours, also considered potential excess.
  • A total of 5,733 cumulative days of potentially excess surgical prophylaxis were administered.

Conclusions:

  • Up to 25% of pediatric surgical procedures received potentially unnecessary perioperative prophylaxis in 2017.
  • Developing pediatric-specific national guidance for SAP could significantly impact antibiotic overuse.
  • Standardization of SAP duration is crucial for antimicrobial stewardship in pediatric surgery.