{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:58:55Z","timestamp":1789473535810,"version":"build-2803163510"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T00:00:00Z","timestamp":1496620800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec id=\"S0899823X17000794_abs1\" sec-type=\"objectives\"><jats:title>OBJECTIVES<\/jats:title><jats:p>Appropriate use of surgical antibiotic prophylaxis (SAP) reduces intraoperative wound contamination in pediatric surgery, thus minimizing the risk of surgical site infection (SSIs). Conversely, inappropriate use of SAP exposes patients to the risk of antibiotic side effects and contributes to the emergence of antimicrobial resistance. Our aims were to describe SAP administration and to analyze factors associated with nonadherence in pediatric patients.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000794_abs2\" sec-type=\"general\"><jats:title>DESIGN<\/jats:title><jats:p>Descriptive study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000794_abs3\" sec-type=\"general\"><jats:title>SETTING<\/jats:title><jats:p>Overall, 955 pediatric patients underwent 1,038 surgical procedures.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000794_abs4\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>We assessed adherence to SAP international guidelines for surgical procedures performed on children aged &lt;18 years in 2015 in 4 randomly selected hospitals in Calabria (Italy). The clinical records of these patients were retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000794_abs5\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>Appropriate SAP administration or nonadministration pertained to 754 surgical procedures (72.6%). Surgical antibiotic prophylaxis was administered in 88.5% of 358 procedures with an SAP indication. Adherence to guidelines for appropriate drug choice were followed in 5.7% of cases, for route of administration in 76.7% of cases, for timing in 48.6% of cases, for duration in 14.5% of cases, and for dose in 91.5% of cases, and for all components in only 5 cases (1.6%). Among 680 procedures without SAP indication, 35.7% case patients received antibiotics. Inappropriate administration of antibiotics in procedures without SAP indication was associated with surgical specialty wards (<jats:italic>P<\/jats:italic>=.008), ordinary admission (<jats:italic>P<\/jats:italic>&lt;.001), head and neck surgical procedures (<jats:italic>P<\/jats:italic>=.020), clean surgery (<jats:italic>P<\/jats:italic>=.017), and surgical duration (<jats:italic>P<\/jats:italic>=.010).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X17000794_abs6\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>Discrepancies between SAP guidelines and actual practice behavior more frequently indicate excessive use of antibiotics than underuse. Increased awareness of SAP guidelines is required.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic> 2017;38:823\u2013831<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2017.79","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T05:34:56Z","timestamp":1496640896000},"page":"823-831","source":"Crossref","is-referenced-by-count":26,"title":["Appropriateness of Surgical Antibiotic Prophylaxis in Pediatric Patients in Italy"],"prefix":"10.1017","volume":"38","author":[{"given":"Mariavalentina","family":"Giordano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Squillace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pavia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,6,5]]},"reference":[{"key":"S0899823X17000794_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-015-1816-0"},{"key":"S0899823X17000794_ref10","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2015.195"},{"key":"S0899823X17000794_ref35","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810002505"},{"key":"S0899823X17000794_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq309"},{"key":"S0899823X17000794_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31821175f8"},{"key":"S0899823X17000794_ref13","unstructured":"Antibioticoprofilassi perioperatoria nell\u2019adulto. Sistema nazionale per le linee guida (SNLG) website. http:\/\/www.snlg-iss.it\/cms\/files\/LG_AntibioticoP_Unico_2008.pdf. Published 2008. Accessed September 15, 2015."},{"key":"S0899823X17000794_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530270074035"},{"key":"S0899823X17000794_ref34","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00562-11"},{"key":"S0899823X17000794_ref14","unstructured":"Antibiotic prophylaxis in surgery. SIGN, Edinburgh. Scottish Intercollegiate Guidelines Network (SIGN) website. http:\/\/www.sign.ac.uk\/pdf\/sign104.pdf. Published 2008. Accessed September 15, 2015."},{"key":"S0899823X17000794_ref25","doi-asserted-by":"publisher","DOI":"10.12927\/hcq.2008.19664"},{"key":"S0899823X17000794_ref19","volume-title":"Stata: Release 14. 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Italian Ministry of Health website. http:\/\/www.rssp.salute.gov.it\/rssp\/paginaMenuDownloadRssp.jsp?lingua=english. Published 2011. Accessed March 15, 2017."},{"key":"S0899823X17000794_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2010.11.004"},{"key":"S0899823X17000794_ref29","unstructured":"Summary of the latest data on antibiotic resistance in the European Union. European Centre for Disease Prevention and Control (ECDC) website. http:\/\/ecdc.europa.eu\/en\/eaad\/Documents\/antibiotic-resistance-in-EU-summary.pdf. Published 2016. 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