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Antibiotic Prophylaxis Use and Outcomes in Children Undergoing Laparoscopic Orchiopexy

Kerri A McKie1, Anoosha Moturu2, Dionne A Graham3

  • 1Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

The Journal of Urology
|August 14, 2025
PubMed

Insights

Routine antimicrobial prophylaxis does not significantly improve outcomes for pediatric laparoscopic orchiopexy. This study found similar surgical site infection rates, reoperation, and readmission rates with or without antibiotic use.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease Prevention
  • Surgical Quality Improvement

Background:

  • Antimicrobial prophylaxis is commonly used in pediatric surgery to prevent surgical site infections (SSIs).
  • The necessity and impact of routine antimicrobial prophylaxis in laparoscopic orchiopexy for children remain under investigation.

Purpose of the Study:

  • To compare clinically relevant outcomes, specifically 30-day postoperative surgical site infection (SSI) rates, in children undergoing laparoscopic orchiopexy with and without antimicrobial prophylaxis.

Main Methods:

  • A multicenter cohort study utilized data from the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database.
  • Patient-level analysis employed propensity score matching, while hospital-level analysis examined the correlation between prophylaxis rates and observed-to-expected SSI ratios.

Main Results:

  • No significant difference in SSI rates was observed between prophylaxis and no-prophylaxis groups in the patient-level analysis (1.3% vs 1.3%).
  • Hospital-level analysis revealed no correlation between prophylaxis rates and SSI rates (Spearman ρ = -0.081; P = 0.3).
  • Reoperation and readmission rates were also similar between the groups.

Conclusions:

  • This study found no significant evidence to support the routine use of antimicrobial prophylaxis for improving outcomes in pediatric laparoscopic orchiopexy.
  • Current evidence does not support routine antibiotic prophylaxis in this specific pediatric surgical population.
Abstract

Keywords:
antimicrobial prophylaxisinfection preventionorchiopexysurgical site infection

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