Inappropriate antibiotic surgical prophylaxis in pediatric patients: A national point-prevalence study

In the United States, surgical procedures account for up to 450,000 pediatric admissions each year,1,2 with antibiotic prophylaxis administered for >50% of surgeries.3–5 National guidelines provide procedure-specific recommendations for antimicrobial prophylaxis, including drug and dosing, in an effort to reduce surgical site infections.5 The 2017 Centers for Disease Control and Prevention (CDC) guideline recommends only a single dose of perioperative prophylaxis for clean and clean-contaminated cases.6 Despite these guidelines, inappropriate surgical prophylaxis use continues to be common. [...]categorizing an antibiotic as inappropriate or not was a perceived determination by ASP team members within each institution, which may have introduced some differential classification. [...]an operations manual was used to help standardize the definition of inappropriateness. [...]only a trained ASP physician and/or clinical pharmacist was permitted to make the determination. [...]a significant portion of surgical antibiotic prophylaxis is inappropriate.