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Antibiotics
Volume 14
Issue 2
10.3390/antibiotics14020125
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Article

Adherence to Perioperative Antimicrobial Prophylaxis in Children in the Settings of Neurosurgery, Otorhinolaryngology, and Orthopedics

by
Dimitra Dimopoulou
1,
Athina Tsakali
1,
Maria M. Berikopoulou
1,
Anastasia Dimopoulou
2,
Vasiliki Kamposou
3,
Dimitrios Panagopoulos
4,
Christos-Sotiris Papadakis
5,
Vasileios Tokis
5,
Konstantina Pouli
6,
Georgios Bozonelos
5,
John Anastasopoulos
6,
Konstantinos Antonis
5,
Nektarios Papapetropoulos
3 and
Athanasios Michos
7,*
1
2nd Department of Pediatrics, “Aghia Sofia” Children’s Hospital, 11527 Athens, Greece
2
Department of Pediatric Surgery, “Aghia Sofia” Children’s Hospital, 11527 Athens, Greece
3
Department of Otorhinolaryngology, “Aghia Sofia” Children’s Hospital, 11527 Athens, Greece
4
Department of Neurosurgery, “Aghia Sofia” Children’s Hospital, 11527 Athens, Greece
5
1st Department of Orthopedic Surgery, “Aghia Sofia” Children’s Hospital, 11527 Athens, Greece
6
2nd Department of Orthopedic Surgery, “Aghia Sofia” Children’s Hospital, 11527 Athens, Greece
7
Division of Infectious Diseases, 1st Department of Pediatrics, National and Kapodistrian University of Athens, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
Antibiotics 2025, 14(2), 125; https://doi.org/10.3390/antibiotics14020125
Submission received: 30 December 2024 / Revised: 21 January 2025 / Accepted: 23 January 2025 / Published: 24 January 2025
(This article belongs to the Special Issue Prevention and Antimicrobial Surveillance of Hospital-Associated Infections)
Versions Notes

Abstract

Introduction: Data about compliance with perioperative antimicrobial prophylaxis (PAP) guidelines in the pediatric population are limited. This study aims to evaluate PAP adherence in pediatric surgical subspecialty departments. Methods: A prospective cohort study was conducted from September 2023 to October 2024 at “Aghia Sophia” Children’s Hospital, Athens, Greece. Children <16 years old undergoing surgical procedures in the neurosurgery (NS), orthopedics (OP), and otolaryngology (ORL) departments were included. Data on demographics, surgical characteristics, and PAP practices (timing, agent, duration, and redosing) were collected and compliance with the international guidelines was evaluated. Results: A total of 301 children were included, with a median age (IQR) of 7 (8) years. PAP was received by 249/301 (82.7%) children (100% in the OP and NS, and 48% in the ORL). However, indications for PAP had 50.8% of children: 102/103 (99%) in the NS, 47/98 (47.9%) in the OP, and 4/48 (8.3%) in the ORL. Most children received broad-spectrum or combination of antimicrobials and/or antibiotics for longer duration. Appropriate PAP according to the guidelines was administered in 0% children in NS, 2% in OP, and 2.1% in ORL. Multivariable analysis in the ORL regarding the use of PAP revealed that shorter procedures (≤60 min; OR: 22.9, p = 0.003) and clean wounds (OR: 33.4, p < 0.001) were significantly associated with not using PAP. Conclusions: This study highlights gaps in the PAP guideline adherence in pediatric surgical departments, and the need for educational interventions to improve compliance and reduce antimicrobial use. Based on these findings, we plan to implement an educational intervention in order to optimize PAP practices in the pediatric population.
Keywords: perioperative antimicrobial prophylaxis; children; guidelines; compliance; adherence; neurosurgery; orthopedics; otorhinolaryngology; surgical site infections perioperative antimicrobial prophylaxis; children; guidelines; compliance; adherence; neurosurgery; orthopedics; otorhinolaryngology; surgical site infections

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MDPI and ACS Style

Dimopoulou, D.; Tsakali, A.; Berikopoulou, M.M.; Dimopoulou, A.; Kamposou, V.; Panagopoulos, D.; Papadakis, C.-S.; Tokis, V.; Pouli, K.; Bozonelos, G.; et al. Adherence to Perioperative Antimicrobial Prophylaxis in Children in the Settings of Neurosurgery, Otorhinolaryngology, and Orthopedics. Antibiotics 2025, 14, 125. https://doi.org/10.3390/antibiotics14020125

AMA Style

Dimopoulou D, Tsakali A, Berikopoulou MM, Dimopoulou A, Kamposou V, Panagopoulos D, Papadakis C-S, Tokis V, Pouli K, Bozonelos G, et al. Adherence to Perioperative Antimicrobial Prophylaxis in Children in the Settings of Neurosurgery, Otorhinolaryngology, and Orthopedics. Antibiotics. 2025; 14(2):125. https://doi.org/10.3390/antibiotics14020125

Chicago/Turabian Style

Dimopoulou, Dimitra, Athina Tsakali, Maria M. Berikopoulou, Anastasia Dimopoulou, Vasiliki Kamposou, Dimitrios Panagopoulos, Christos-Sotiris Papadakis, Vasileios Tokis, Konstantina Pouli, Georgios Bozonelos, and et al. 2025. "Adherence to Perioperative Antimicrobial Prophylaxis in Children in the Settings of Neurosurgery, Otorhinolaryngology, and Orthopedics" Antibiotics 14, no. 2: 125. https://doi.org/10.3390/antibiotics14020125

APA Style

Dimopoulou, D., Tsakali, A., Berikopoulou, M. M., Dimopoulou, A., Kamposou, V., Panagopoulos, D., Papadakis, C.-S., Tokis, V., Pouli, K., Bozonelos, G., Anastasopoulos, J., Antonis, K., Papapetropoulos, N., & Michos, A. (2025). Adherence to Perioperative Antimicrobial Prophylaxis in Children in the Settings of Neurosurgery, Otorhinolaryngology, and Orthopedics. Antibiotics, 14(2), 125. https://doi.org/10.3390/antibiotics14020125

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