Timing of antimicrobial prophylaxis and infectious complications in pediatric patients undergoing appendectomy

Cristen N. Litz, Jessica B. Asuncion, Paul D. Danielson, Nicole M. Chandler

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Antibiotic administration within one hour prior to incision is a common quality metric; however, antibiotics are typically started at the time of diagnosis in pediatric patients with acute appendicitis. The purpose was to determine if antibiotic administration within one hour prior to incision reduces the incidence of surgical site infections (SSI) in pediatric patients with acute appendicitis started on parenteral antibiotics upon diagnosis. Methods: A retrospective review was performed of 478 patients aged 0–18 years who underwent appendectomy for acute appendicitis from 7/2013 to 4/2015. Patients were categorized based on timing of antibiotic administration; there were 198 patients in Group A (< 60 min before) and 280 in Group B (> 60 min before). Results: Demographics and operative time (A: 30.5 ± 9.9 vs B: 30.8 ± 12.2 min, p = 0.51) were similar. Procedures were performed laparoscopically and the groups had similar proportions of single-incision operations (A: 53% vs B: 55%, p = 0.64). There was no difference in the incidence of superficial SSI (A: 2.0% vs B: 2.1%, p = 1.0) or intraabdominal abscess (A: 4.0% vs B: 3.6%, p = 0.81) and this remained true when stratified by intraoperative classification. Conclusion: Antibiotic administration within one hour of appendectomy in pediatric patients with acute appendicitis who receive antibiotics at diagnosis did not change the incidence of postoperative infectious complications. Type of study: Treatment study. Level of evidence: III.

Original languageEnglish (US)
Pages (from-to)449-451
Number of pages3
JournalJournal of pediatric surgery
Volume53
Issue number3
DOIs
StatePublished - Mar 2018

Keywords

  • Antimicrobial prophylaxis
  • Appendectomy
  • Infection prevention
  • Pediatric surgery
  • Quality improvement
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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