Surgical site infections in neonates and infants: Is antibiotic prophylaxis needed for longer than 24 h?

Lan T. Vu, Eric Vittinghoff, Kerilyn K. Nobuhara, Diana L Farmer, Hanmin Lee

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: The purpose is to determine whether use of perioperative antibiotics for more than 24 h decreases the incidence of SSI in neonates and infants. Methods: We studied neonates and infants who had clean-contaminated or contaminated gastrointestinal operations from 1996 to 2006. Patient- and operation-related variables, duration of perioperative antibiotics, and SSI within 30 days were ascertained by retrospective chart review. In assessing the effects of antibiotic duration, we controlled for confounding by indication using standard covariate adjustment and propensity score matching. Results: Among 732 operations, the incidence of SSI was 13 %. Using propensity score matching, the odds of SSI were similar (OR 1.1, 95 % CI 0.6-1.9) in patients who received ≥24 h of postoperative antibiotics compared to >24 h. No difference was also found in standard covariate adjustment. This multivariate model identified three independent predictors of SSI: preoperative infection (OR 3.9, 95 % CI 1.4-10.9) and re-operation through the same incision, both within 30 days (OR 3.5, 95 % CI 1.7-7.4) and later (OR 2.3, 95 % CI 1.4-3.8). Conclusion: In clean-contaminated and contaminated gastrointestinal operations, giving >24 h of postoperative antibiotics offered no protection against SSI. An adequately powered randomized clinical trial is needed to conclusively evaluate longer duration antibiotic prophylaxis.

Original languageEnglish (US)
Pages (from-to)587-592
Number of pages6
JournalPediatric Surgery International
Volume30
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Surgical Wound Infection
Antibiotic Prophylaxis
Newborn Infant
Anti-Bacterial Agents
Propensity Score
Incidence
Randomized Controlled Trials
Infection

Keywords

  • Antibiotic prophylaxis
  • Infants
  • Neonates
  • Propensity score analysis
  • Surgical site infections

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Medicine(all)

Cite this

Surgical site infections in neonates and infants : Is antibiotic prophylaxis needed for longer than 24 h? / Vu, Lan T.; Vittinghoff, Eric; Nobuhara, Kerilyn K.; Farmer, Diana L; Lee, Hanmin.

In: Pediatric Surgery International, Vol. 30, No. 6, 2014, p. 587-592.

Research output: Contribution to journalArticle

Vu, Lan T. ; Vittinghoff, Eric ; Nobuhara, Kerilyn K. ; Farmer, Diana L ; Lee, Hanmin. / Surgical site infections in neonates and infants : Is antibiotic prophylaxis needed for longer than 24 h?. In: Pediatric Surgery International. 2014 ; Vol. 30, No. 6. pp. 587-592.
@article{48ad95ad6e444d899d0aae2ea5a4c876,
title = "Surgical site infections in neonates and infants: Is antibiotic prophylaxis needed for longer than 24 h?",
abstract = "Purpose: The purpose is to determine whether use of perioperative antibiotics for more than 24 h decreases the incidence of SSI in neonates and infants. Methods: We studied neonates and infants who had clean-contaminated or contaminated gastrointestinal operations from 1996 to 2006. Patient- and operation-related variables, duration of perioperative antibiotics, and SSI within 30 days were ascertained by retrospective chart review. In assessing the effects of antibiotic duration, we controlled for confounding by indication using standard covariate adjustment and propensity score matching. Results: Among 732 operations, the incidence of SSI was 13 {\%}. Using propensity score matching, the odds of SSI were similar (OR 1.1, 95 {\%} CI 0.6-1.9) in patients who received ≥24 h of postoperative antibiotics compared to >24 h. No difference was also found in standard covariate adjustment. This multivariate model identified three independent predictors of SSI: preoperative infection (OR 3.9, 95 {\%} CI 1.4-10.9) and re-operation through the same incision, both within 30 days (OR 3.5, 95 {\%} CI 1.7-7.4) and later (OR 2.3, 95 {\%} CI 1.4-3.8). Conclusion: In clean-contaminated and contaminated gastrointestinal operations, giving >24 h of postoperative antibiotics offered no protection against SSI. An adequately powered randomized clinical trial is needed to conclusively evaluate longer duration antibiotic prophylaxis.",
keywords = "Antibiotic prophylaxis, Infants, Neonates, Propensity score analysis, Surgical site infections",
author = "Vu, {Lan T.} and Eric Vittinghoff and Nobuhara, {Kerilyn K.} and Farmer, {Diana L} and Hanmin Lee",
year = "2014",
doi = "10.1007/s00383-014-3506-x",
language = "English (US)",
volume = "30",
pages = "587--592",
journal = "Pediatric Surgery International",
issn = "0179-0358",
publisher = "Springer Verlag",
number = "6",

}

TY - JOUR

T1 - Surgical site infections in neonates and infants

T2 - Is antibiotic prophylaxis needed for longer than 24 h?

AU - Vu, Lan T.

AU - Vittinghoff, Eric

AU - Nobuhara, Kerilyn K.

AU - Farmer, Diana L

AU - Lee, Hanmin

PY - 2014

Y1 - 2014

N2 - Purpose: The purpose is to determine whether use of perioperative antibiotics for more than 24 h decreases the incidence of SSI in neonates and infants. Methods: We studied neonates and infants who had clean-contaminated or contaminated gastrointestinal operations from 1996 to 2006. Patient- and operation-related variables, duration of perioperative antibiotics, and SSI within 30 days were ascertained by retrospective chart review. In assessing the effects of antibiotic duration, we controlled for confounding by indication using standard covariate adjustment and propensity score matching. Results: Among 732 operations, the incidence of SSI was 13 %. Using propensity score matching, the odds of SSI were similar (OR 1.1, 95 % CI 0.6-1.9) in patients who received ≥24 h of postoperative antibiotics compared to >24 h. No difference was also found in standard covariate adjustment. This multivariate model identified three independent predictors of SSI: preoperative infection (OR 3.9, 95 % CI 1.4-10.9) and re-operation through the same incision, both within 30 days (OR 3.5, 95 % CI 1.7-7.4) and later (OR 2.3, 95 % CI 1.4-3.8). Conclusion: In clean-contaminated and contaminated gastrointestinal operations, giving >24 h of postoperative antibiotics offered no protection against SSI. An adequately powered randomized clinical trial is needed to conclusively evaluate longer duration antibiotic prophylaxis.

AB - Purpose: The purpose is to determine whether use of perioperative antibiotics for more than 24 h decreases the incidence of SSI in neonates and infants. Methods: We studied neonates and infants who had clean-contaminated or contaminated gastrointestinal operations from 1996 to 2006. Patient- and operation-related variables, duration of perioperative antibiotics, and SSI within 30 days were ascertained by retrospective chart review. In assessing the effects of antibiotic duration, we controlled for confounding by indication using standard covariate adjustment and propensity score matching. Results: Among 732 operations, the incidence of SSI was 13 %. Using propensity score matching, the odds of SSI were similar (OR 1.1, 95 % CI 0.6-1.9) in patients who received ≥24 h of postoperative antibiotics compared to >24 h. No difference was also found in standard covariate adjustment. This multivariate model identified three independent predictors of SSI: preoperative infection (OR 3.9, 95 % CI 1.4-10.9) and re-operation through the same incision, both within 30 days (OR 3.5, 95 % CI 1.7-7.4) and later (OR 2.3, 95 % CI 1.4-3.8). Conclusion: In clean-contaminated and contaminated gastrointestinal operations, giving >24 h of postoperative antibiotics offered no protection against SSI. An adequately powered randomized clinical trial is needed to conclusively evaluate longer duration antibiotic prophylaxis.

KW - Antibiotic prophylaxis

KW - Infants

KW - Neonates

KW - Propensity score analysis

KW - Surgical site infections

UR - http://www.scopus.com/inward/record.url?scp=84901628240&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901628240&partnerID=8YFLogxK

U2 - 10.1007/s00383-014-3506-x

DO - 10.1007/s00383-014-3506-x

M3 - Article

C2 - 24805114

AN - SCOPUS:84901628240

VL - 30

SP - 587

EP - 592

JO - Pediatric Surgery International

JF - Pediatric Surgery International

SN - 0179-0358

IS - 6

ER -