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 language | English (US) |
|---|---|
| Pages (from-to) | 587-592 |
| Number of pages | 6 |
| Journal | Pediatric Surgery International |
| Volume | 30 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2014 |
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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 journal › Article
}
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 -