Kibileri Williams1, Timothy Lautz2,3, Richard J Hendrickson4, Tolulope A Oyetunji5. 1. Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20001, USA. 2. Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 63, Chicago, IL, 60611, USA. 3. Northwestern University Feinberg School of Medicine, 420 E. Superior St, Chicago, IL, 60611, USA. 4. Department of Surgery, Children's Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO, 64108, USA. 5. Department of Surgery, Children's Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO, 64108, USA. taoyetunji@cmh.edu.
Abstract
INTRODUCTION: Surgical site infection is very uncommon after pyloromyotomy in children, and it is considered a "clean" procedure under the traditional wound classification system. This study aims to investigate prophylactic antibiotic administration for pyloromyotomy among children's hospitals in the USA. METHODS: The Pediatric Health Information System (PHIS) database was retrospectively reviewed from 2014 to 2015 including all patients less than 1 year old who had a principal diagnosis of pyloric stenosis and underwent pyloromyotomy. Patient demographics, hospital length of stay, and perioperative antibiotic administration were extracted. RESULTS: A total of 4206 patients met study criteria. Most patients were male (84%) and Caucasian (70%). The median age at admission was 32 days (IQR 24-44 days), and median length of stay was 2 days (IQR 1-2 days). Antibiotics were administered perioperatively in 2153 (51%) patients with marked variation among children's hospitals. Antibiotics were given to more than 10% of patients in more than 90% of hospitals, and only two of 49 hospitals gave no antibiotic prophylaxis. CONCLUSIONS: This study has shown that at several tertiary-level children's hospitals in the USA, antibiotic prophylaxis is administered for pyloromyotomy, a "clean" procedure. This highlights the need for standardization of care and more effective antibiotic stewardship in pediatric surgery.
INTRODUCTION: Surgical site infection is very uncommon after pyloromyotomy in children, and it is considered a "clean" procedure under the traditional wound classification system. This study aims to investigate prophylactic antibiotic administration for pyloromyotomy among children's hospitals in the USA. METHODS: The Pediatric Health Information System (PHIS) database was retrospectively reviewed from 2014 to 2015 including all patients less than 1 year old who had a principal diagnosis of pyloric stenosis and underwent pyloromyotomy. Patient demographics, hospital length of stay, and perioperative antibiotic administration were extracted. RESULTS: A total of 4206 patients met study criteria. Most patients were male (84%) and Caucasian (70%). The median age at admission was 32 days (IQR 24-44 days), and median length of stay was 2 days (IQR 1-2 days). Antibiotics were administered perioperatively in 2153 (51%) patients with marked variation among children's hospitals. Antibiotics were given to more than 10% of patients in more than 90% of hospitals, and only two of 49 hospitals gave no antibiotic prophylaxis. CONCLUSIONS: This study has shown that at several tertiary-level children's hospitals in the USA, antibiotic prophylaxis is administered for pyloromyotomy, a "clean" procedure. This highlights the need for standardization of care and more effective antibiotic stewardship in pediatric surgery.
Authors: Alan P Ladd; Shari A Nemeth; Anna N Kirincich; L R Scherer; Scott A Engum; Frederick J Rescorla; Karen W West; Thomas M Rouse; Deborah F Billmire; Jay L Grosfeld Journal: J Pediatr Surg Date: 2005-06 Impact factor: 2.545
Authors: Katherine H Chan; Benjamin M Whittam; Elizabeth A S Moser; Mark P Cain; William E Bennett Journal: J Pediatr Urol Date: 2016-11-22 Impact factor: 1.830
Authors: Justin B Mahida; Lindsey Asti; Katherine J Deans; Peter C Minneci; Jonathan I Groner Journal: J Pediatr Surg Date: 2016-05-31 Impact factor: 2.545
Authors: Jeffrey S Gerber; Matthew P Kronman; Rachael K Ross; Adam L Hersh; Jason G Newland; Talene A Metjian; Theoklis E Zaoutis Journal: Infect Control Hosp Epidemiol Date: 2013-10-24 Impact factor: 3.254
Authors: Sonia Bianchini; Erika Rigotti; Sara Monaco; Laura Nicoletti; Cinzia Auriti; Elio Castagnola; Giorgio Conti; Luisa Galli; Mario Giuffrè; Stefania La Grutta; Laura Lancella; Andrea Lo Vecchio; Giuseppe Maglietta; Nicola Petrosillo; Carlo Pietrasanta; Nicola Principi; Simonetta Tesoro; Elisabetta Venturini; Giorgio Piacentini; Mario Lima; Annamaria Staiano; Susanna Esposito Journal: Antibiotics (Basel) Date: 2022-02-21