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Published on: August 30, 2018
Antibiotic stewardship in pediatric head and neck surgery
Mary Grace Robichaux1, Zhide Fang2, Jill N D'Souza3
1LSUHSC School of Medicine, New Orleans, LA, USA.
Insights
This study on pediatric head and neck surgeries found no significant difference in surgical site infections (SSI) between patients who received perioperative antibiotics and those who did not. Further research is needed to confirm these findings on antibiotic prophylaxis.
Area of Science:
- Pediatric Surgery
- Infectious Disease Prevention
- Antibiotic Prophylaxis
Background:
- Surgical site infections (SSI) are a concern in pediatric head and neck surgeries.
- Evidence-based guidelines for perioperative antibiotic use in these procedures are lacking.
- Understanding infection rates and antibiotic practices is crucial for optimizing patient care.
Purpose of the Study:
- To determine the rate of postoperative SSI in clean pediatric head and neck surgeries.
- To review perioperative antibiotic administration practices in this patient population.
- To evaluate the impact of perioperative antibiotics on SSI rates.
Main Methods:
- A retrospective review of pediatric patients (ages 0-18) undergoing clean head and neck surgery from 2013-2023.
- Comparison of SSI rates between a control group (no antibiotics) and a study group (received antibiotics).
- Statistical analysis using Chi-square test and Binomial proportion confidence intervals.
Main Results:
- 99 patients in the control group had an SSI rate of 3.03%.
- 93 patients in the study group had an SSI rate of 0%.
- No statistically significant difference in SSI rates was observed between the two groups (p=0.2468).
Conclusions:
- Empiric perioperative antibiotic use may not significantly alter SSI development in pediatric clean head and neck surgeries.
- This study highlights the need for larger, prospective research to establish evidence-based antibiotic prophylaxis guidelines.
- Current findings suggest a potential re-evaluation of routine antibiotic use in select pediatric head and neck procedures.
Objective:
This study seeks to determine the rate of postoperative surgical site infections (SSI) among clean head and neck surgeries and review perioperative antibiotic administration practices.
Study Design:
Retrospective review.
Setting:
Pediatric tertiary care institution in New Orleans over a ten-year period.
Methods:
A retrospective review was undertaken to identify clean head and neck surgical procedures performed at Manning Family Children's between 2013 and 2023. EPIC SlicerDicer™ was used to identify patients between ages 0-18 who underwent clean head and neck surgeries. Each chart was reviewed for perioperative antibiotic administration and occurrence of postoperative SSI. Rates of SSI were compared between the control group that received no perioperative antibiotics and the study group that received perioperative antibiotics using Chi-square test. Exact Binomial proportion confidence intervals were obtained.
Results:
99 patients were identified for the control group, while 93 patients were included in the study group. In the control group, the infection rate was determined to be 3.03 %, with 95 % CI = (0.0063, 0.086). In the study group, the infection rate was found to be 0 with 95 % CI = (0, 0.0389). There was no statistically significant difference in infection rate between the groups (p = 0.2468).
Conclusion:
There are no current pediatric studies to guide evidence-based antibiotic prophylaxis in clean head and neck procedures. This small study did not find a statistically significant difference in infection rate between groups, and that empiric perioperative antibiotic treatment may not change the rate of SSI development in pediatric clean head and neck surgeries. Further studies with larger sample sizes are needed to confirm these findings.
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