Advances in Pediatric Research
Open Access

Enhancing Perioperative Antibiotic Prophylaxis in Neonatal Surgery: The Benefits of Shorter Duration

Anthony Kopel^{* *}Correspondence: Anthony Kopel, Department of Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, USA, Email:

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Description

Surgical Site Infections (SSIs) are the most prevalent healthcareassociated infections worldwide, leading to substantial financial burdens, extended hospital stays and significant patient morbidity. In neonates, SSIs pose an even greater risk due to their underdeveloped immune systems, which makes them particularly vulnerable to infections following surgical procedures. These infections not only increase healthcare costs but also contribute to longer recovery times and more severe outcomes, further complicating neonatal care. The neonatal population's susceptibility to SSIs requires special consideration, as their small size, immature immune response and increased likelihood of undergoing invasive procedures all heighten the risk of infection.

Perioperative antibiotic prophylaxis has long been recognized as an effective strategy to reduce the incidence of SSIs, thereby improving patient outcomes and lowering the associated healthcare costs. The administration of antibiotics before and sometimes after surgery helps to minimize the risk of infection, particularly in surgeries where the chance of bacterial contamination is higher. However, despite the known benefits of prophylactic antibiotics, guidelines for their use in neonatal surgery remain sparse and are often based on data extrapolated from adult populations or informed by expert opinion rather than robust clinical evidence. This lack of neonatal-specific guidelines results in substantial variability in antibiotic prescribing practices, especially in terms of the duration and choice of antibiotics.

The absence of evidence-based recommendations is particularly pronounced in the context of clean-contaminated vs. contaminated surgeries. Clean surgeries, typically those involving non-infected tissue, have a lower risk of infection compared to contaminated surgeries, which may involve exposure to bacterial flora. However, despite these differences in risk, there is limited data guiding the appropriate use of antibiotics in neonates undergoing these varied types of surgeries. This knowledge gap has led to widespread variability in prescribing patterns, which may contribute to unexpected consequences, such as increased rates of SSIs, the development of antibiotic resistance and unnecessary healthcare expenditures.

The variation in antibiotic use within neonatal surgery is concerning for several reasons. Overuse of antibiotics can lead to the development of antibiotic resistance, which is a growing concern in Neonatal Intensive Care Units (NICUs) where antibiotics are commonly administered. Furthermore, prolonged antibiotic courses can expose neonates to unnecessary risks, including adverse reactions, alterations in the gut microbiome and potential disruption of normal development. On the other hand, underuse of antibiotics or insufficient prophylaxis may leave neonates vulnerable to infections, especially in high-risk surgeries where contamination is more likely.

Our study aimed to address this critical knowledge gap by investigating whether there is a correlation between the duration of perioperative antibiotic prophylaxis and the incidence of SSIs in neonates undergoing various types of surgical procedures, including clean, clean-contaminated and contaminated surgeries. We specifically examine to determine whether shorter or longer durations of antibiotic therapy impacted the likelihood of SSIs, as well as to identify factors that could influence the development of infections in this vulnerable population. Additionally, we aimed to examine variables such as gestational age, surgical technique, underlying health conditions and antibiotic choice, all of which may contribute to the risk of SSIs.

By focusing on the neonatal population, our study hopes to provide valuable insights into the optimal use of antibiotic prophylaxis in neonatal surgery. Through a better understanding of how the duration of antibiotic use influences infection rates, we aim to contribute to the development of more effective, evidence-based guidelines for antibiotic administration in neonates. Ultimately, we believe that our findings can help guide clinical decision-making, reduce unnecessary antibiotic use, prevent the development of SSIs and improve overall care for neonates undergoing surgery. Furthermore, our research could help standardize antibiotic practices across NICUs.

Conclusion

In conclusion, our study highlights the significant variability in perioperative antibiotic prophylaxis practices in neonatal surgery, particularly concerning the duration of administration. Given the lack of evidence-based guidelines, this variability may contribute to increased surgical site infections, antibiotic resistance and unnecessary healthcare costs. By establishing a correlation between the duration of antibiotic use and SSI incidence and identifying key factors influencing infection risk, our findings aim to provide critical insights. Ultimately, these insights could help guide more standardized, evidence-based antibiotic strategies, improving both outcomes and resource management in neonatal surgical care. Potentially reducing variability in treatment approaches and enhancing neonatal health outcomes.