Factors Contributing to the Misuse of Antimicrobial Prophylaxis in Preventing Pediatric Surgical Site Infections

Abstract

Surgical site infections (SSIs) can disturb the healthcare systems, patients, and their families. In the pediatric population, adequate preventive measures, including appropriate surgical antibiotic prophylaxis (SAP), are essential to avoid the social, economic, and health concerns related to these infections. To describe the causes of inappropriate usage of SAP among pediatric patients, we used two databases, PubMed and Google Scholar, to conduct this review. We also manually screened the references of the articles reporting SSIs and SAP. The included articles were related to microorganisms associated with pediatric SSIs, causes of inappropriate SAP, and recommendations to improve their use. We excluded articles published in languages other than English and those beyond the scope of our review. Common causative microorganisms of pediatric SSIs are bacteria, mainly Staphylococcus aureus, and fungi, mainly Candida albicans. The appropriate use of SAP was based on three aspects: time and duration of administration, dose, and chosen antibiotics. The unavailability of international guidelines and fear of infectious factors force healthcare providers to administer SAP inappropriately. Other factors were related to the type of surgical operation, surgical wound classification, and weight of pediatric patients. Continuing education on guidelines for using antibiotics correctly and support from healthcare institutions by adopting adequate preventive measures can help ensure the appropriate use of SAP.