Prophylactic antibiotics in pediatric orthopedic surgery: current practices

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Infectious Disease Prevention

Background:

• Surgical site infections are a significant concern in pediatric orthopedic procedures.
• Prophylactic antibiotic use is a common strategy to mitigate infection risk.
• Understanding current practices in prophylactic antibiotic administration is crucial for evidence-based guidelines.

Purpose of the Study:

• To survey the current use of prophylactic antibiotics in pediatric orthopedic surgery across the U.S.A.
• To identify patterns in antibiotic selection, timing, and duration based on surgical procedure type.

Main Methods:

• A survey was distributed to 90 orthopedic surgery programs in the United States.
• Data collected focused on the administration of prophylactic antibiotics for various pediatric orthopedic operations.
• Specific procedures surveyed included Harrington rod procedures, hip and knee reconstruction, meniscus repairs, and Achilles tendon lengthening.

Main Results:

• Prophylactic antibiotics were most frequently used in Harrington rod procedures (80.7%) and less so in hip (64.2%) and knee (44.7%) reconstructive surgeries.
• Antibiotic use was rare for meniscus repairs (8.0%) and Achilles tendon lengthening (2.3%).
• Cephalosporins were the most common antibiotic class (85%), with the first dose typically given preoperatively (89.6%) and discontinuation within five days (96%).

Conclusions:

• A distinct pattern exists in the utilization of prophylactic antibiotics in pediatric orthopedic surgery, varying by procedure complexity and type.
• Cephalosporins are the predominant antibiotic choice, administered preoperatively and for short durations.
• These findings establish a baseline for current prophylactic antibiotic practices in pediatric orthopedic surgery.