Antimicrobial surgical prophylaxis: Still an issue in paediatrics

Objectives: Antimicrobial prophylaxis (AP) is an important means of reducing surgical site infections. The goal of this study was to evaluate the perioperative AP in paediatric practice and its compliance with surgical prophylaxis guidelines.

Methods: A prospective study was conducted at Gazi University Faculty of Medicine, between September 2015 and April 2016. Paediatric patients who underwent surgical procedures were included in the study. Surgical AP was evaluated.

Results: During the entire study period, 466 children underwent surgery at our centre; 433 (92.7%) received antimicrobial prophylaxis. Overall adherence to the guidelines regarding surgical prophylaxis was 22.1%. The rate of administration of surgical prophylaxis was significantly lower, and the duration was shorter when the surgical procedure was clean (P = 0.002). When the duration of the procedure was longer, the rate of administration of prophylaxis was higher (P = 0.000). The duration of postoperative prophylaxis was longer than recommended in 72.2% of the patients. In the multivariate analysis, application errors increased with longer surgical time (P = 0.01, OR 2.18, 95% CI 1.19-4.03).

Conclusions: High rates of misapplication of antimicrobial surgical prophylaxis were observed in this study. Awareness and usage of guidelines should be encouraged. The education of clinicians should be supported by studies regarding surgical prophylaxis in children.