Antibiotic Prophylaxis for Pyloromyotomy in Children: An Opportunity for Better Stewardship

Kibileri Williams, Timothy Lautz, Richard J. Hendrickson, Tolulope A. Oyetunji*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Introduction: Surgical site infection is very uncommon after pyloromyotomy in children, and it is considered a “clean” procedure under the traditional wound classification system. This study aims to investigate prophylactic antibiotic administration for pyloromyotomy among children’s hospitals in the USA. Methods: The Pediatric Health Information System (PHIS) database was retrospectively reviewed from 2014 to 2015 including all patients less than 1 year old who had a principal diagnosis of pyloric stenosis and underwent pyloromyotomy. Patient demographics, hospital length of stay, and perioperative antibiotic administration were extracted. Results: A total of 4206 patients met study criteria. Most patients were male (84%) and Caucasian (70%). The median age at admission was 32 days (IQR 24–44 days), and median length of stay was 2 days (IQR 1–2 days). Antibiotics were administered perioperatively in 2153 (51%) patients with marked variation among children’s hospitals. Antibiotics were given to more than 10% of patients in more than 90% of hospitals, and only two of 49 hospitals gave no antibiotic prophylaxis. Conclusions: This study has shown that at several tertiary-level children’s hospitals in the USA, antibiotic prophylaxis is administered for pyloromyotomy, a “clean” procedure. This highlights the need for standardization of care and more effective antibiotic stewardship in pediatric surgery.

Original languageEnglish (US)
Pages (from-to)4107-4111
Number of pages5
JournalWorld journal of surgery
Volume42
Issue number12
DOIs
StatePublished - Dec 1 2018

ASJC Scopus subject areas

  • Surgery

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