Surgical Antimicrobial Prophylaxis in Abdominal Surgery for Neonates and Paediatrics: A RAND/UCLA Appropriateness Method Consensus Study
Sonia Bianchini,
Erika Rigotti,
Sara Monaco,
Laura Nicoletti,
Cinzia Auriti,
Elio Castagnola,
Giorgio Conti,
Luisa Galli,
Mario Giuffrè,
Stefania La Grutta,
Laura Lancella,
Andrea Lo Vecchio,
Giuseppe Maglietta,
Nicola Petrosillo,
Carlo Pietrasanta,
Nicola Principi,
Simonetta Tesoro,
Elisabetta Venturini,
Giorgio Piacentini,
Mario Lima,
Annamaria Staiano,
Susanna Esposito,
the Peri-Operative Prophylaxis in Neonatal and Paediatric Age (POP-NeoPed) Study Group
Affiliations
Sonia Bianchini
Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
Erika Rigotti
Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy
Sara Monaco
Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
Laura Nicoletti
Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
Cinzia Auriti
Neonatology and Neonatal Intensive Care Unit, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Elio Castagnola
Infectious Diseases Unit, IRCCS Giannina Gaslini, 16147 Genoa, Italy
Giorgio Conti
Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00165 Rome, Italy
Luisa Galli
Pediatric Infectious Disease Unit, Meyer Children’s Hospital, 50139 Florence, Italy
Mario Giuffrè
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90141 Palermo, Italy
Stefania La Grutta
Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy
Laura Lancella
Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Andrea Lo Vecchio
Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Via D. Montesano 49, 80131 Naples, Italy
Giuseppe Maglietta
Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy
Nicola Petrosillo
UniCampus University, 00125 Rome, Italy
Carlo Pietrasanta
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Mother, Child and Infant, NICU, 20122 Milan, Italy
Nicola Principi
Università degli Studi di Milano, 20122 Milan, Italy
Simonetta Tesoro
Division of Anesthesia, Analgesia and Intensive Care, Department of Surgical and Biomedical Sciences, University of Perugia, 06129 Perugia, Italy
Elisabetta Venturini
Pediatric Infectious Disease Unit, Meyer Children’s Hospital, 50139 Florence, Italy
Giorgio Piacentini
Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy
Mario Lima
Paediatric Surgery, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
Annamaria Staiano
Department of Translational Medical Science, Section of Pediatrics, University of Naples “Federico II”, Via D. Montesano 49, 80131 Naples, Italy
Susanna Esposito
Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
the Peri-Operative Prophylaxis in Neonatal and Paediatric Age (POP-NeoPed) Study Group
Surgical site infections (SSIs), i.e., surgery-related infections that occur within 30 days after surgery without an implant and within one year if an implant is placed, complicate surgical procedures in up to 10% of cases, but an underestimation of the data is possible since about 50% of SSIs occur after the hospital discharge. Gastrointestinal surgical procedures are among the surgical procedures with the highest risk of SSIs, especially when colon surgery is considered. Data that were collected from children seem to indicate that the risk of SSIs can be higher than in adults. This consensus document describes the use of preoperative antibiotic prophylaxis in neonates and children that are undergoing abdominal surgery and has the purpose of providing guidance to healthcare professionals who take care of children to avoid unnecessary and dangerous use of antibiotics in these patients. The following surgical procedures were analyzed: (1) gastrointestinal endoscopy; (2) abdominal surgery with a laparoscopic or laparotomy approach; (3) small bowel surgery; (4) appendectomy; (5) abdominal wall defect correction interventions; (6) ileo-colic perforation; (7) colorectal procedures; (8) biliary tract procedures; and (9) surgery on the liver or pancreas. Thanks to the multidisciplinary contribution of experts belonging to the most important Italian scientific societies that take care of neonates and children, this document presents an invaluable reference tool for perioperative antibiotic prophylaxis in the paediatric and neonatal populations.
