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

12 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

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

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