Is the use of antibiotic prophylaxis in pediatric laparoscopic inguinal hernia repair necessary?

•What is currently known about this topic.•In the adult population, international guidelines for the management of inguinal hernia with laparoscopic repair do not recommend the routine use of surgical antibiotic prophylaxis.•What new information is contained in this article.•The use of prophylactic antibiotics did not significantly decrease the rate of surgical site infection after laparoscopic inguinal hernia repair in children. The use of surgical antibiotic prophylaxis (SAP) in pediatric laparoscopic inguinal hernia repair is controversial. The aim of this study was to evaluate the impact of SAP on the surgical site infection (SSI) rate after laparoscopic inguinal hernia repair in pediatric patients. We conducted a retrospective review of pediatric patients who underwent laparoscopic inguinal hernia repair between January 2017 and June 2022. Patient characteristics, intraoperative characteristics, antibiotic use and SSI within 30 days after the operation were collected via chart reviews. All patients underwent laparoscopic percutaneous extraperitoneal closure. SSI was defined by the Centers for Disease Control and Prevention criteria. Fisher's exact test was used to determine the association between SAP and SSI. In total, 365 patients were included in this study. Forty-nine percent (n = 179) received antibiotics, and 51% (n = 186) did not. There were five infection cases (1.4%) in this study. Two (1.1%) were in the SAP group and three (1.6%) were in the no SAP group (p = 1.0). All infections were superficial. There were no adverse events due to antibiotic use. A low percentage of SSI after laparoscopic inguinal hernia repair in the pediatric population was found, with no significant difference between the SAP group and the no SAP group. Therefore, the routine use of SAP for pediatric inguinal laparoscopic inguinal hernia repair is not recommended.