{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:51:23Z","timestamp":1791258683837,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perioperative antibacterial prophylaxis in pediatric solid organ transplantation varies by center in regimen, add\u2010on agents, and stop dates. We used institutional protocols as a unified reference standard to establish baseline stewardship measures and targets for future quality\u2010improvement work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated 164 pediatric transplants from 2010 to 2021. Using anesthesia timing and medication\u2010administration data, we assessed on\u2010time dosing, regimen selection, MRSA\u2010 and VRE\u2010directed add\u2010on agents, double anaerobic coverage, Gram\u2010negative broadening during the protocol window, and discontinuation at organ\u2010specific stop targets. We also used transplant\u2010day anchoring and protocol\u2010defined windows to describe whether primary\u2010admission broad\u2010spectrum exposure represented protocol\u2010linked prophylaxis or later exposure. The audit measured protocol concordance and exposure patterns, not the appropriateness of deviations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prophylaxis was given on time in 95.7% of procedures. Overall, 87.2% received the recommended initial regimen, 7.3% the protocol\u2010defined beta\u2010lactam allergy regimen, and 4.3% another broad Gram\u2010negative regimen. Only 61.0% stopped the main regimen by the intended cutoff; stop performance was best in kidney transplantation and poorest in intestinal and multivisceral transplantation. MRSA\u2010directed add\u2010ons clustered in intestinal and multivisceral procedures and often extended beyond the intended duration. A secondary descriptive analysis identified contiguous protocol\u2010linked continuation beyond the intended window in 8.6% of primary\u2010admission broad\u2010spectrum days of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Timing and initial regimen selection were strong. The main baseline process measure requiring prospective review was continuation of protocol\u2010linked antibiotics beyond cutoffs in abdominal transplantation. This audit shows how routine electronic data can be used to create reproducible measures and organ\u2010specific targets for future stewardship and quality\u2010improvement studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70266","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:49:54Z","timestamp":1782406194000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Prophylaxis in Pediatric Solid Organ Transplantation: A Baseline Stewardship Audit Using Routine Electronic Data"],"prefix":"10.1111","volume":"28","author":[{"given":"Charles B.","family":"Foster","sequence":"first","affiliation":[{"name":"Section of Pediatric Infectious Diseases Cleveland Clinic Children's  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Rivard","sequence":"additional","affiliation":[{"name":"Pharmacy Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatraman A.","family":"Arakoni","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca E.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Section of Pediatric Infectious Diseases Cleveland Clinic Children's  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13938"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13895"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13928"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13922"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13883"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12733"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13589"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010164.pub2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001848"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000004932"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2013.9999"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13538"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12020292"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.70069"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13903"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13905"},{"key":"e_1_2_9_18_1","unstructured":"\u201cAntimicrobial Use and Resistance (AUR) Module \u201dNational Healthcare Safety Network accessed October 4 2024 https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/11pscaurcurrent.pdf."},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"}],"container-title":["Transplant Infectious 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