A prospective comparison of antibiotic usage in pediatric surgical patients: the safety, advantage, and effectiveness of the Surgical Infection Society guidelines versus a common practice.
BACKGROUND
The Surgical Infection Society (SIS) guidelines for antibiotic (Ab) usage minimally changed the surgical practice. The authors believed that clinical evidence of the safety, advantage, and effectiveness of SIS guidelines may improve inappropriate usage of Ab.


METHODS
A group of dedicated surgeons attempted to use Ab appropriately to SIS guidelines in their patients (group A). A comparison was made with a concurrent cohort of patients (group B), treated by surgeons who were nonsupporters of SIS guidelines. The trial was conducted in 378 children between March 1999 and May 2000. The outcome measures were morbidity and mortality rates, Ab treatment duration, timing of administration, unjustified spectrum, and switch of Ab. Analysis of variance and Chi2 test were used in statistics. P value less than.05 was considered significant (s).


RESULTS
Group A included 124 patients and Group B, 254. There were no intergroup differences in age, sex, and clean/contaminated/dirty ratio of procedures. The mean duration of Ab treatment was 3.9 days in group A, versus 7.1 days in group B (s), with overall rate of appropriateness of 77% versus 36% (s) and no differences in mortality and morbidity rates.


CONCLUSIONS
Perhaps these results may change Ab usage in pediatric surgery.
Górecki
Wojciech
W
Department of Pediatric Surgery, Children's Hospital, Jagiellonian University, Kraków, Poland.
Grochowska
Elzbieta
E
Krysta
Miroslaw
M
Wojciechowski
Piotr
P
Taczanowska
Anna
A
Stanek
Beata
B
D000293:Adolescent; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000592:standards*; D001424:Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004333:Drug Administration Routes; D017723:Drug Utilization Review; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007239:Infections / Q000188:drug therapy*; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy* / Q000517:prevention & control; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods / Q000592:standards*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control; D016896:Treatment Outcome