OBJECTIVE: To evaluate body mass index (BMI) and antimicrobial dose as risk factors for surgical site infections in pediatric patients.
PATIENTS AND METHODS: Children between 2 and 19 years of age undergoing clean orthopedic procedures and receiving at least one dose of perioperative antibiotics (cefazolin, vancomycin, or clindamycin) were studied. The retrospective case-controlled study was conducted at the Alfred I. duPont Hospital for Children, a 180-bed tertiary-care academic pediatric hospital in Wilmington, DE. Data were collected from January 1, 2002, to December 31, 2005.
RESULTS: Underweight children had a higher risk for SSIs than overweight and normal-weight children. American Society of Anesthesiologists classes II and greater were associated with a greater risk of SSI. Longer procedures were also associated with a higher risk of SSI, specifically, duration of surgery >2 h. Children weighing ≥70 kg who received a standard dose of cefazolin (maximum of 1 g) had a higher risk of SSI caused by methicillin-sensitive Staphylococcus aureus (MSSA).
CONCLUSIONS: Being underweight and undergoing an operation lasting >2 h created significant risks for SSI. Children weighing ≥70 kg receiving a standard 1-g dose of cefazolin had a greater risk of MSSA SSIs than children weighingantibiotic.
Cies, Jeffrey J; Chan, Shannon; Hossain, Jobayer; Brenn, B Randall; and Di Pentima, M Cecilia, "Influence of body mass index and antibiotic dose on the risk of surgical site infections in pediatric clean orthopedic surgery." (2012). Department of Anesthesiology Faculty Papers. Paper 21.