Login to Access Video or Poster Abstract: MP66-06
Sources of Funding: None

Introduction

Surgeons frequently use surgical antibiotic prophylaxis (SAP) despite limited evidence to support its efficacy. We hypothesized that children who received SAP prior to orchiopexy would have no reduction in surgical site infection (SSI) risk but an increased risk of antibiotic-associated adverse events.

Methods

We performed a retrospective cohort study of all males between 30 days and 18 years of age who underwent an orchiopexy (ICD-9 CM 62.5) with or without herniorraphy (ICD-9 CM 53.0 or 53.1) in an ambulatory or observation setting from January 2004 to December 2015 using the Pediatric Health Information System database. We excluded inpatients and those with any concomitant procedures. We used Chi-square or Fisher's exact tests to determine the association between SAP and allergic reaction (defined as a charge for epinephrine or ICD-9 diagnosis code for allergic reaction on the date of surgery) and any of the following within 30 days: SSI, hospital readmission or any repeat hospital encounter. We performed mixed effects logistic regression controlling for age, race, insurance and clustering of similar practice patterns by hospital.

Results

A total of 71,767 patients were included: median age 4.6 years; 61.4% white; 49.3% with public insurance. 33.5% received SAP. A total of 1.4% of patients had a perioperative allergic reaction and <0.1% of patients were diagnosed with a SSI. On mixed effects logistic regression, patients who received SAP had 1.2 times the odds of a perioperative allergic reaction compared to those who did not receive SAP (p=0.005). SAP was not associated with SSI, hospital readmission, or any repeat encounter within 30 days.

Conclusions

In patients undergoing orchiopexy we found that SAP did not reduce the risk of postoperative SSI, readmissions or hospital visits. Patients who received SAP, however, had significantly increased odds of perioperative allergic reaction. This suggests that the risks of SAP may outweigh the benefits in children undergoing orchiopexy.

Funding

None