title: Analysis of antibiotic surgical prophylaxis in hospitalized children suffering upper and lower extremity injuries.
abstract: BACKGROUND
  Surgical prophylaxis may account for one-third of all antibiotic use in paediatric hospitals.
  
  
  OBJECTIVE
  To evaluate the appropriateness of surgical prophylaxis and to analyse adherence of surgeons to surgical prophylaxis guidelines.
  
  
  METHODS
  Retrospective study at a university paediatric hospital. Patients younger than 18 years with injuries of lower and upper extremities were included. The study period was from January 1st 2011-December 31st 2013 and January 1st 2001-December 31st 2003. The appropriateness of the antibiotic use was analysed in accordance with international and local guidelines.
  
  
  RESULTS
  Antibiotic prophylaxis was needed by 1125 (55.0 %) patients in 2011-2013 and by 816 (44.4 %) patients in 2001-2003. However, it was administered to only 66.0 % of those in need of prophylaxis in 2011-2013 and to 70.8 % of those in 2001-2003. A single antibiotic dose was administered to 73.8 % of those who received antibiotics in 2011-2013 and to 34.1 % of those in 2001-2003. The timing of the first dose was correct in 370 (52.9 %) prescriptions in 2011-2013 and in 10 (20.4 %) prescriptions in 2001-2003. The most often used antibiotics for prophylaxis were cefazolin in 2011-2013 and cefuroxime in 2001-2003.
  
  
  CONCLUSIONS
  Overall adherence rate to the international and hospital guidelines was low, indicating that in order to improve this situation, there is a need for multiple interventions.
authors.affiliation: University Children's Hospital, Vienibas gatve 45, Riga, 1004, Latvia. inese.sviestina@gmail.com.|Faculty of Pharmacy, Riga Stradins University, Riga, Latvia. inese.sviestina@gmail.com.
authors.forename: Inese
authors.initials: I
authors.lastname: Sviestina
authors.affiliation: Faculty of Medicine, Riga Stradins University, Riga, Latvia.
authors.forename: Janis
authors.initials: J
authors.lastname: Mozgis
authors.affiliation: Public Health and Epidemiology Department, Riga Stradins University, Riga, Latvia.
authors.forename: Dzintars
authors.initials: D
authors.lastname: Mozgis
mesh_terms: D000293:Adolescent; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D007223:Infant; D035002:Lower Extremity / Q000293:injuries / Q000601:surgery*; D008297:Male; D010607:Pharmacy Service, Hospital / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D034941:Upper Extremity / Q000293:injuries / Q000601:surgery*
keywords: Antibiotics; Extremities; Injuries; Latvia; Paediatrics; Surgical prophylaxis