{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T18:49:29Z","timestamp":1769798969465,"version":"3.49.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5T32AI007641-17"],"award-info":[{"award-number":["5T32AI007641-17"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite guidelines recommending narrow-spectrum perioperative antibiotics (NSPA) as prophylaxis for most children undergoing congenital heart disease (CHD) surgery, broad-spectrum perioperative antibiotics (BSPA) are variably used, and their impact on postoperative outcomes is poorly understood.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used administrative data from U.S. hospitals participating in the Vizient Clinical Data Base. Admissions from 2011 to 2018 containing a qualifying CHD surgery in children 0\u201317 years old were evaluated for exposure to BSPA versus NSPA. Propensity score-adjusted models were used to compare postoperative length of hospital stay (PLOS) by exposure group, while adjusting for confounders. Secondary outcomes included subsequent antimicrobial treatment and in-hospital mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 18 088 eligible encounters from 24 U.S. hospitals, BSPA were given in 21.4% of CHD surgeries, with mean BSPA use varying from 1.7% to 96.1% between centers. PLOS was longer for BSPA-exposed cases (adjusted hazard ratio 0.79; 95% confidence interval [CI]: 0.71\u20130.89, P &amp;lt; .0001). BSPA was associated with higher adjusted odds of subsequent antimicrobial treatment (odds ratio [OR] 1.24; 95% CI: 1.06\u20131.48), and there was no significant difference in adjusted mortality between exposure groups (OR 2.06; 95% CI: 1.0\u20134.31; P = .05). Analyses of subgroups with the most BSPA exposure, including high-complexity procedures and delayed sternal closure, also did not find (but could not exclude) a measurable benefit from BSPA on PLOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>BSPA use was common in high-risk populations, and varied substantially between centers. Standardizing perioperative antibiotic practices between centers may reduce unnecessary broad-spectrum antibiotic exposure and improve clinical outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piad022","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T18:41:46Z","timestamp":1680720106000},"page":"205-213","source":"Crossref","is-referenced-by-count":5,"title":["Broad- Versus Narrow-Spectrum Perioperative Antibiotics and Outcomes in Pediatric Congenital Heart Disease Surgery: Analysis of the Vizient Clinical Data Base"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9991-1282","authenticated-orcid":false,"given":"Peter B","family":"Cooch","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases and Global Health, University of California San Francisco , San Francisco, California , USA"},{"name":"Department of Pediatrics, Kaiser Permanente Northern California , Oakland, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi-Ok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California San Francisco , San Francisco, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naveen","family":"Swami","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Cardiothoracic Surgery, University of California San Francisco , San Francisco, California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranita D","family":"Tamma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Tabbutt","sequence":"additional","affiliation":[{"name":"Department of 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