The use of surgical antibiotic prophylaxis (AP) in children is poorly characterized. The aims of this study were to examine (1) trends in the use of antibiotic prophylaxis for commonly performed operations, (2) appropriateness in the context of available guidelines, and (3) adverse events potentially attributable to AP.
The group conducted a 5-year retrospective analysis of 22 children's hospitals for all patients younger than 18 years who underwent 1 of the 40 commonly performed general and urological procedures. Indications for AP were defined by published specialty-specific guidelines. Clostridium difficile infection and surrogate events for drug allergy (diphenhydramine and epinephrine administrations) were examined as potential antibiotic-associated adverse events. Eighty-two percent of the children received antibiotics during procedures when AP was indicated and 40% of the patients received antibiotics when there was no indication. The likelihood of receiving ap was significantly different between hospitals for all procedures examined. Adverse events were significantly more frequent in children receiving AP than in those who did not.
Significant variation exists in the use of AP in the Pediatric surgical population. Many children do not receive AP when indicated, and an even greater proportion may receive antibiotics when there is no indication. These findings may have profound implications from a public health perspective when extrapolated to all children undergoing surgical procedures.
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