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Impact of prophylactic antibiotic duration on surgical site infection rate in neonatal surgery: a multicenter

Tomohiro Sunouchi¹, Jun Fujishiro², Koji Oba³

¹Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan.

Journal of Perinatology : Official Journal of the California Perinatal Association

|August 27, 2025

Abstract

Objective:

To evaluate the relationship between the incidence of surgical site infections (SSIs) and the duration of perioperative antibiotic prophylaxis (PAP) in neonatal surgery, and to identify risk factors for SSIs in neonates.

Methods:

Eligible patients were neonates who underwent surgical procedures-primarily in the respiratory and gastrointestinal fields-between January 2014 and December 2023 at seven institutions. All data were retrospectively retrieved from electronic patient records. We estimated the risk difference using a modified least-squares regression model.

Results:

Of the 983 patients included, 91 (9%) developed SSIs. A total of 735 patients (75%) received PAP for >24 h. There was no significant difference in risk when PAP duration was <24 h compared with ≥24 h. Independent risk factors for SSIs were an operative time exceeding 120 min, past surgical history, and open surgery.

Conclusion:

In neonatal surgery, a short duration (<24 h) of PAP may not increase the risk of SSI.

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