Pediatric Surgery International

, Volume 30, Issue 6, pp 587–592

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
Original Article

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.

Keywords

Surgical site infections Neonates Infants Antibiotic prophylaxis Propensity score analysis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Lan T. Vu
    • 1
  • Eric Vittinghoff
    • 2
  • Kerilyn K. Nobuhara
    • 3
  • Diana L. Farmer
    • 4
  • Hanmin Lee
    • 1
  1. 1.Department of SurgeryUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoUSA
  3. 3.Washington State Health Care AuthorityOlympiaUSA
  4. 4.Department of SurgeryUniversity of CaliforniaDavisUSA

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