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Updated: Jul 13, 2026

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
[Surgical antibiotic prophylaxis's usage review in a mother-child university hospital]
A Bleuse1, H Roy1, P Ovetchkine2
1Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte Sainte-Catherine, H3T 1C5 Montréal, Québec, Canada.
Insights
Surgical antibiotic prophylaxis compliance was evaluated in pediatric patients. Key areas for improvement include standard order sets and preoperative timing to reduce surgical site infections.
Area of Science:
- Infectious Diseases
- Surgical Safety
- Healthcare Quality Improvement
Context:
- Pediatric surgical patients require standardized antibiotic prophylaxis protocols.
- Compliance with current guidelines for surgical antibiotic prophylaxis is crucial for patient outcomes.
- University hospitals face challenges in consistently implementing antibiotic prophylaxis protocols.
Purpose:
- To assess compliance rates for surgical antibiotic prophylaxis in pediatric surgery.
- To evaluate the effectiveness of tools aiding antibiotic prophylaxis prescription.
- To determine the surgical site infection rate in pediatric surgical patients.
Summary:
- A retrospective study of 125 pediatric surgical patients found an 87% compliance rate for surgical antibiotic prophylaxis indication.
- Compliance with standard order sets (15%) and preoperative timing (30%) was suboptimal.
- The surgical site infection rate was 4%, highlighting areas for protocol improvement.
Impact:
- Suboptimal use of standard order sets and preoperative timing necessitates improved administrative tools and inter-departmental coordination.
- Implementing a digital perioperative document is planned to enhance surgical antibiotic prophylaxis.
- Improving compliance can lead to reduced surgical site infections and better patient safety in pediatric surgery.
Objectives:
The main objective was to evaluate the surgical antibiotic prophylaxis's compliance rate. The secondary objectives were to evaluate the tools designed to help the surgical antibiotic prophylaxis's prescription, and evaluate the surgical site infection rate.
Methods:
This retrospective study was done in a university hospital on a random selection of 125 pediatric patients having undergone a surgery (cardiac, general, neurological, ENT, orthopedic or plastic). Compliance to the current recommendations has been assessed.
Results:
Out of the 125 studied patients (2 exclusions), the indication was compliant at 87% (107/123). The perioperative document included an intention to use antibiotic prophylaxis in 24% of cases (29/123). The compliance for the presence of the standard order set for antibiotic prophylaxis was only 15% (19/123). The compliance for the preoperative administration varied: antibiotic choice (94%, 63/67), dose (91%, 61/67), route (99%, 66/67), timing (30%, 20/67). The compliances for intra- and postoperative administrations were respectively 75% (57/76) and 89% (68/76). The surgical site infection rate was 4% (5/123).
Conclusions:
The use of a standard order set for antibiotic prophylaxis and the timing of the preoperative administration were sub-optimal. A better dissemination and use of the administrative tools and the implementation of a coordination system with the members of anesthesia services would improve these important aspects of the surgical antibiotic prophylaxis. The establishment of a digital perioperative document is planned.
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