MedicalResearch.com Interview with:
Thomas J. Sandora, M.D., M.P.H.
Senior Associate Physician in Medicine; Hospital Epidemiologist; Medical Director, Infection Control
Boston Children’s Hospital
Associate Professor of Pediatrics, Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sandora: Giving antibiotics before certain types of operations results in lower rates of surgical site infections. However, there are limited data about which pediatric operations require antibiotic prophylaxis. We examined national variability in antibiotic prophylaxis for the 45 most commonly performed pediatric operations at children’s hospitals in the U.S. We found that antibiotic use was considered appropriate for only 64.6% of cases, with a high degree of variability within procedures and between hospitals.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Sandora: There does not appear to be uniform agreement about whether certain types of operations for children require antibiotic prophylaxis. The biggest issue is that many children are receiving antibiotics for operations which may not require prophylaxis. This practice can be associated with adverse events related to antibiotic use, such as allergic reactions and Clostridium difficile infection.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Sandora: In order to inform the optimal use of surgical antibiotic use for children, we need more data regarding the impact of prophylactic antibiotics for specific operations in children. This type of research would help to define the set of operations for which pediatric surgeons should be administering antibiotic prophylaxis. This information could be used to create a national guideline about when to give children antibiotics before surgery.
National Variability and Appropriateness of Surgical Antibiotic Prophylaxis in US Children’s Hospitals
JAMA Pediatr. Published online April 18, 2016. doi:10.1001/jamapediatrics.2016.0019.