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Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better

Pediatric cardiac surgery requires perioperative antibiotic prophylaxis (PAP) to reduce the risk of surgical site infections. However, the complexity of these procedures and the metabolic immaturity of children impede the establishment of PAP regimens that are both efficacious and in line with antim...

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Autores principales: Burzyńska, Julia, Jaworski, Radoslaw, Maruszewski, Bohdan, Kansy, Andrzej, Dzierżanowska-Fangrat, Katarzyna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854416/
https://www.ncbi.nlm.nih.gov/pubmed/36671267
http://dx.doi.org/10.3390/antibiotics12010066
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author Burzyńska, Julia
Jaworski, Radoslaw
Maruszewski, Bohdan
Kansy, Andrzej
Dzierżanowska-Fangrat, Katarzyna
author_facet Burzyńska, Julia
Jaworski, Radoslaw
Maruszewski, Bohdan
Kansy, Andrzej
Dzierżanowska-Fangrat, Katarzyna
author_sort Burzyńska, Julia
collection PubMed
description Pediatric cardiac surgery requires perioperative antibiotic prophylaxis (PAP) to reduce the risk of surgical site infections. However, the complexity of these procedures and the metabolic immaturity of children impede the establishment of PAP regimens that are both efficacious and in line with antimicrobial stewardship (AMS). In this study, we compared two PAP regimens: cefazolin with gentamicin (in a retrospective group) and cefazolin only (prospectively) in children undergoing elective cardiac surgery. In the prospective group, additional elements of AMS were introduced, i.e., restricted access to cefazolin and more diligent use of empirical antibiotics proceeded by consultation with an AMS team. The rate of surgical site infections (SSI), the scope of PAP deviations, and the postoperative use of antibiotics other than PAP within 30 days after surgery were analyzed. There were no significant differences in the rate of SSIs between the groups (3.9% vs. 1.2% in the prospective and retrospective groups, respectively (p = 0.35)). However, in the prospective group, the PAP violation was significantly reduced compared with the retrospective group (full compliance with the PAP regimen was 45.5% vs. 4.8%, p < 0.001, respectively). In addition, a reduction of postoperative antibiotic use was observed in the prospective group (0.991 vs. 1.932 defined daily doses, respectively).
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spelling pubmed-98544162023-01-21 Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better Burzyńska, Julia Jaworski, Radoslaw Maruszewski, Bohdan Kansy, Andrzej Dzierżanowska-Fangrat, Katarzyna Antibiotics (Basel) Article Pediatric cardiac surgery requires perioperative antibiotic prophylaxis (PAP) to reduce the risk of surgical site infections. However, the complexity of these procedures and the metabolic immaturity of children impede the establishment of PAP regimens that are both efficacious and in line with antimicrobial stewardship (AMS). In this study, we compared two PAP regimens: cefazolin with gentamicin (in a retrospective group) and cefazolin only (prospectively) in children undergoing elective cardiac surgery. In the prospective group, additional elements of AMS were introduced, i.e., restricted access to cefazolin and more diligent use of empirical antibiotics proceeded by consultation with an AMS team. The rate of surgical site infections (SSI), the scope of PAP deviations, and the postoperative use of antibiotics other than PAP within 30 days after surgery were analyzed. There were no significant differences in the rate of SSIs between the groups (3.9% vs. 1.2% in the prospective and retrospective groups, respectively (p = 0.35)). However, in the prospective group, the PAP violation was significantly reduced compared with the retrospective group (full compliance with the PAP regimen was 45.5% vs. 4.8%, p < 0.001, respectively). In addition, a reduction of postoperative antibiotic use was observed in the prospective group (0.991 vs. 1.932 defined daily doses, respectively). MDPI 2022-12-30 /pmc/articles/PMC9854416/ /pubmed/36671267 http://dx.doi.org/10.3390/antibiotics12010066 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Burzyńska, Julia
Jaworski, Radoslaw
Maruszewski, Bohdan
Kansy, Andrzej
Dzierżanowska-Fangrat, Katarzyna
Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
title Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
title_full Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
title_fullStr Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
title_full_unstemmed Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
title_short Perioperative Antibiotic Prophylaxis in Pediatric Cardiac Surgery—Simple Is Better
title_sort perioperative antibiotic prophylaxis in pediatric cardiac surgery—simple is better
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854416/
https://www.ncbi.nlm.nih.gov/pubmed/36671267
http://dx.doi.org/10.3390/antibiotics12010066
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