[Comparison between two antibiotic schemes in relation to surgical site infection in children: a randomized clinical trial].
BACKGROUND
There are few randomized clinical trials that prove the effectiveness of antibiotic prophylaxis (AP) to prevent pediatric surgical site infections (SSI). We undertook this study to determine the effectiveness of AP vs. traditional scheme of antibiotics.


METHODS
We carried out a randomized clinical trial at the General Surgery Department of a Tertiary Care Children's Hospital in Mexico City. There were 187 consecutive patients, age 18 years or less, with clean or clean-contaminated procedures performed between January 2005 and December 2006. Exclusion criteria included previous scar on operated site, receiving antibiotics, or no informed consent. Cefalotin or clindamycin plus amikacin was administered 2 h before incision, continued for just 24 h in the experimental group (EG) vs. cefalotin or clindamycin plus amikacin administered just before, during or after incision and continuing for 5 days (control group, CG).


RESULTS
Sixteen patients were excluded. EG included 26 clean and 54 clean-contaminated procedures, and in the CG there were 27 and 64 procedures, respectively. EG had a lower incidence of SSI (1/80 [1.2 %] vs. 10/91 [10.9 %], RR 9.7, (95% CI: 1.2-77.9, p = 0.009). The difference is based mainly on the clean-contaminated procedures.


CONCLUSIONS
AP administered 2 h before incision and continuing for 24 h significantly decreases the risk of SSI compared to CG in clean-contaminated procedures.
Bracho-Blanchet
Eduardo
E
Departamento de Cirugía General, Hospital Infantil de México "Federico Gómez", México, D.F., Mexico. eduardo@fambracho.org
Porras-Hernández
Juan
J
Dávila-Pérez
Roberto
R
Coria-Lorenzo
José
J
Gómez-Inestrosa
Alex
A
Nieto-Zermeño
Jaime
J
D000583:Amikacin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002512:Cephalothin / Q000008:administration & dosage*; D002675:Child, Preschool; D002981:Clindamycin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D016037:Single-Blind Method; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D000583:Amikacin; D002512:Cephalothin