TY - JOUR
T1 - Compliance with surgical antibiotic prophylaxis guidelines in pediatric surgery
AU - Klinger, Gil
AU - Carmeli, Idan
AU - Feigin, Elad
AU - Freud, Enrique
AU - Steinberg, Ran
AU - Levy, Itzhak
N1 - Publisher Copyright:
© 2015 Georg Thieme Verlag KG Stuttgart New York.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Introduction Surgical antibiotic prophylaxis (AP) guidelines balance the need to prevent infection with the risks of adverse drug effects. Our aim was to assess compliance with AP guidelines. Methods A retrospective study was performed in a pediatric medical center. Included were patients aged 0 to 18 years that underwent clean-contaminated surgery during a 1-year period (2008-2009) and required AP. Compliance with four AP bundle guidelines was evaluated. Risk factors for noncompliance were identified using univariate and multivariate analyses. Results AP was given to 239 of 247 (96.8%) of patients. Complete compliance with AP guidelines was achieved in 16 of 247 (6.5%) patients. Compliance with guidelines for appropriate antibiotic, drug dose, correct timing, and treatment duration were found in 97.1, 52.2, 31.9, and 35.9% of patients, respectively. Multivariable analysis showed that inappropriate timing was associated with age ≥ 4 years (p = 0.002), urgent surgery (p = 0.0018), surgical department AP administration (p = 0.0001), and night-time surgery (p = 0.015). Incorrect AP dose was associated with presence of comorbidities (p = 0.006). No risk factor was related to incorrect AP duration. Conclusions We have found a low rate of full compliance with AP guidelines. AP should only be given in the operating room. Increased awareness to AP guidelines is needed.
AB - Introduction Surgical antibiotic prophylaxis (AP) guidelines balance the need to prevent infection with the risks of adverse drug effects. Our aim was to assess compliance with AP guidelines. Methods A retrospective study was performed in a pediatric medical center. Included were patients aged 0 to 18 years that underwent clean-contaminated surgery during a 1-year period (2008-2009) and required AP. Compliance with four AP bundle guidelines was evaluated. Risk factors for noncompliance were identified using univariate and multivariate analyses. Results AP was given to 239 of 247 (96.8%) of patients. Complete compliance with AP guidelines was achieved in 16 of 247 (6.5%) patients. Compliance with guidelines for appropriate antibiotic, drug dose, correct timing, and treatment duration were found in 97.1, 52.2, 31.9, and 35.9% of patients, respectively. Multivariable analysis showed that inappropriate timing was associated with age ≥ 4 years (p = 0.002), urgent surgery (p = 0.0018), surgical department AP administration (p = 0.0001), and night-time surgery (p = 0.015). Incorrect AP dose was associated with presence of comorbidities (p = 0.006). No risk factor was related to incorrect AP duration. Conclusions We have found a low rate of full compliance with AP guidelines. AP should only be given in the operating room. Increased awareness to AP guidelines is needed.
KW - antibiotic prophylaxis
KW - pediatric surgery
KW - surgical site infection
UR - http://www.scopus.com/inward/record.url?scp=84897119403&partnerID=8YFLogxK
U2 - 10.1055/s-0034-1368798
DO - 10.1055/s-0034-1368798
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AN - SCOPUS:84897119403
SN - 0939-7248
VL - 25
SP - 199
EP - 202
JO - European Journal of Pediatric Surgery
JF - European Journal of Pediatric Surgery
IS - 2
ER -