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Prolonged antibiotic administration for surgical site infection in pediatric laryngotracheal surgery
Author(s) -
Torre Michele,
Paraboschi Irene,
Loy Anna,
Mesini Alessio,
Pistorio Angela,
Simonini Alessandro,
Mattioli Girolamo,
Mazzei Oscar,
Piro Liliana,
Bandettini Roberto,
Castagnola Elio
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27699
Subject(s) - medicine , incidence (geometry) , antibiotic prophylaxis , antibiotics , univariate analysis , retrospective cohort study , surgery , confidence interval , prospective cohort study , multivariate analysis , physics , microbiology and biotechnology , optics , biology
Objectives/Hypothesis Incidence of surgical site infection (SSI) after laryngotracheal (LT) surgery is relatively high, especially in children. Study Design Retrospective and prospective cohort study. Methods Clinical records of children who underwent open LT surgery at the Istituto Giannina Gaslini Children's Hospital from January 2008 to August 2017 were reviewed for development of SSI. Standard antibiotic prophylaxis was administered until February 2015. In March 2015, an antibiotic treatment tailored on pathogens isolated from surveillance cultures and prolonged until extubation was introduced. Incidence and risk factors for SSI before and after the new protocol implementation were analyzed by means of univariate and multivariable analyses. Results A total of 57 procedures were analyzed. SSI incidence was 36% in patients receiving standard prophylaxis and 4% in those treated with the new strategy ( P = .004), with an absolute benefit increase of 32% (95% confidence interval: 11%–52%), in absence of any difference in clinical conditions between the two groups. Conclusions The new management protocol had a highly favorable impact on the development of an SSI. Level of Evidence 2b Laryngoscope , 129:2634–2639, 2019