title: Compliance with surgical antibiotic prophylaxis guidelines in pediatric surgery.
abstract: BACKGROUND
  Surgical antibiotic prophylaxis (AP) guidelines balance the need to prevent infection with the risks of adverse drug effects. Our aim was to assess compliance with AP guidelines.
  
  
  METHODS
  A retrospective study was performed in a pediatric medical center. Included were patients aged 0 to 18 years that underwent clean-contaminated surgery during a 1-year period (2008-2009) and required AP. Compliance with four AP bundle guidelines was evaluated. Risk factors for noncompliance were identified using univariate and multivariate analyses.
  
  
  RESULTS
  AP was given to 239 of 247 (96.8%) of patients. Complete compliance with AP guidelines was achieved in 16 of 247 (6.5%) patients. Compliance with guidelines for appropriate antibiotic, drug dose, correct timing, and treatment duration were found in 97.1, 52.2, 31.9, and 35.9% of patients, respectively. Multivariable analysis showed that inappropriate timing was associated with age ≥ 4 years (p = 0.002), urgent surgery (p = 0.0018), surgical department AP administration (p = 0.0001), and night-time surgery (p = 0.015). Incorrect AP dose was associated with presence of comorbidities (p = 0.006). No risk factor was related to incorrect AP duration.
  
  
  CONCLUSIONS
  We have found a low rate of full compliance with AP guidelines. AP should only be given in the operating room. Increased awareness to AP guidelines is needed.
authors.affiliation: Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
authors.affiliation: Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
authors.forename: Idan
authors.initials: I
authors.lastname: Carmeli
authors.affiliation: Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Feigin
authors.affiliation: Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Enrique
authors.initials: E
authors.lastname: Freud
authors.affiliation: Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Steinberg
authors.affiliation: Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*