Reduction of Surgical Site Infections in Pediatric Patients with Complicated Appendicitis: Utilization of Antibiotic Stewardship Principles and Quality Improvement Methodology

Quality improvement initiative at a children's hospital reduced surgical site infections after complicated appendectomy from 35% to 15% through standardized protocols including intraoperative cultures and targeted antibiotic therapy. The clinical practice guideline led to culture-guided antibiotic selection in 29% of cases and decreased overall morbidity significantly.