Antibiotic Prophylaxis for Elective Pediatric Laparoscopic Cholecystectomies
Topic overview
NSQIP analysis of 3,959 low-risk pediatric laparoscopic cholecystectomy patients found that antibiotic prophylaxis reduced surgical site infections by 65%, challenging current SIS guidelines recommending against prophylaxis. Findings suggest pediatric-specific guidelines may be needed.
Key takeaways
- 90% of low-risk pediatric lap chole patients received SAP despite SIS guidelines recommending against it in this population.
- Patients without SAP had significantly higher SSI rates: superficial 2.1% vs 0.8%, organ space 0.8% vs 0.1% (p<0.05).
- SAP reduced odds of any postoperative SSI by 65% (OR=0.35) after controlling for demographics in multivariable analysis.
- No difference in C. diff colitis rates between SAP and no-SAP groups (0.1% vs 0.0%, p=1.0).
- Current SIS guidelines may not apply to pediatric patients; reassessment needed given protective effect of prophylaxis.
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