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Peri-Operative Prophylaxis in Patients of Neonatal and Pediatric Age Subjected to Cardiac and Thoracic Surgery: A
Sonia Bianchini1, Laura Nicoletti1, Sara Monaco1
1Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Insights
This consensus provides guidelines for peri-operative antibiotic prophylaxis in pediatric and neonatal cardiac and thoracic surgery patients. It aims to standardize care and prevent antibiotic misuse in high-risk surgical site infection (SSI) scenarios.
Area of Science:
- Pediatric Surgery
- Infectious Disease Prevention
- Thoracic Surgery
Background:
- Surgical site infections (SSIs) are a significant risk in pediatric cardiac and thoracic surgery.
- These infections increase mortality, morbidity, and healthcare costs.
- Standardized antibiotic prophylaxis is crucial for high-risk pediatric populations.
Purpose of the Study:
- To establish consensus-based recommendations for peri-operative antibiotic prophylaxis.
- To cover a wide range of pediatric and neonatal cardiac and non-cardiac thoracic surgical procedures.
- To guide physicians in managing antibiotic use and preventing resistance.
Main Methods:
- Consensus document development.
- Review of current literature and clinical practice.
- Inclusion of diverse surgical scenarios from congenital heart disease repair to trauma.
Main Results:
- Defined clear indications for antibiotic prophylaxis across 11 specific scenarios.
- Provided comprehensive, up-to-date practice recommendations.
- Addressed antibiotic management for procedures including cardiac catheterization, ECMO, and chest drains.
Conclusions:
- The consensus offers a standardized approach to antibiotic prophylaxis in pediatric cardiac and thoracic surgery.
- Aims to optimize patient management and reduce antibiotic abuse.
- Represents a vital resource for physicians in high-risk pediatric surgical settings.
Abstract:
Surgical site infections (SSIs) represent a potential complication of surgical procedures, with a significant impact on mortality, morbidity, and healthcare costs. Patients undergoing cardiac surgery and thoracic surgery are often considered patients at high risk of developing SSIs. This consensus document aims to provide information on the management of peri-operative antibiotic prophylaxis for the pediatric and neonatal population undergoing cardiac and non-cardiac thoracic surgery. The following scenarios were considered: (1) cardiac surgery for the correction of congenital heart disease and/or valve surgery; (2) cardiac catheterization without the placement of prosthetic material; (3) cardiac catheterization with the placement of prosthetic material; (4) implantable cardiac defibrillator or epicardial pacemaker placement; (5) patients undergoing ExtraCorporal Membrane Oxygenation; (6) cardiac tumors and heart transplantation; (7) non-cardiac thoracic surgery with thoracotomy; (8) non-cardiac thoracic surgery using video-assisted thoracoscopy; (9) elective chest drain placement in the pediatric patient; (10) elective chest drain placement in the newborn; (11) thoracic drain placement in the trauma setting. This consensus provides clear and shared indications, representing the most complete and up-to-date collection of practice recommendations in pediatric cardiac and thoracic surgery, in order to guide physicians in the management of the patient, standardizing approaches and avoiding the abuse and misuse of antibiotics.
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