儿科头颈外科的抗生素管理

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-07-28 DOI:10.1016/j.ijporl.2025.112503

Mary Grace Robichaux , Zhide Fang , Jill N. D'Souza

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引用次数: 0

摘要

目的探讨清洁头颈部手术术后手术部位感染（SSI）的发生率，并回顾围手术期抗生素的使用情况。研究设计：回顾性研究。在新奥尔良建立儿科三级医疗机构十年。方法回顾性分析2013年至2023年在曼宁家庭儿童医院进行的清洁头颈部手术。EPIC SlicerDicer™用于识别年龄在0-18岁之间接受清洁头颈部手术的患者。每个图表回顾围手术期抗生素的使用和术后SSI的发生。采用卡方检验比较对照组围手术期未使用抗生素与研究组围手术期使用抗生素的SSI发生率。得到了精确的二项比例置信区间。结果对照组99例，研究组93例。对照组感染率为3.03%,95% CI =(0.0063, 0.086)。研究组感染率为0,95% CI =(0,0.0389)。两组间感染率比较，差异无统计学意义（p = 0.2468）。结论目前尚无儿科研究指导清洁头颈部手术的循证抗生素预防。这项小型研究没有发现组间感染率有统计学意义的差异，并且经年累月的围手术期抗生素治疗可能不会改变儿科清洁头颈部手术中SSI的发生率。需要更大样本量的进一步研究来证实这些发现。

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Antibiotic stewardship in pediatric head and neck surgery

Objective

This study seeks to determine the rate of postoperative surgical site infections (SSI) among clean head and neck surgeries and review perioperative antibiotic administration practices.

Study design

Retrospective review.

Setting

Pediatric tertiary care institution in New Orleans over a ten-year period.

Methods

A retrospective review was undertaken to identify clean head and neck surgical procedures performed at Manning Family Children's between 2013 and 2023. EPIC SlicerDicer™ was used to identify patients between ages 0–18 who underwent clean head and neck surgeries. Each chart was reviewed for perioperative antibiotic administration and occurrence of postoperative SSI. Rates of SSI were compared between the control group that received no perioperative antibiotics and the study group that received perioperative antibiotics using Chi-square test. Exact Binomial proportion confidence intervals were obtained.

Results

99 patients were identified for the control group, while 93 patients were included in the study group. In the control group, the infection rate was determined to be 3.03 %, with 95 % CI = (0.0063, 0.086). In the study group, the infection rate was found to be 0 with 95 % CI = (0, 0.0389). There was no statistically significant difference in infection rate between the groups (p = 0.2468).

Conclusion

There are no current pediatric studies to guide evidence-based antibiotic prophylaxis in clean head and neck procedures. This small study did not find a statistically significant difference in infection rate between groups, and that empiric perioperative antibiotic treatment may not change the rate of SSI development in pediatric clean head and neck surgeries. Further studies with larger sample sizes are needed to confirm these findings.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.