Perioperative Antibiotic Use in Pediatric Solid Tumor Resection: A Two-center Retrospective Cohort Study

Abstract

Purpose

There is no consensus on the perioperative use of antibiotics in pediatric solid tumor resection. This study collected data from two pediatric centers that utilize perioperative antibiotics to varying degrees in pediatric solid tumor patients to investigate the occurrence of postoperative sepsis and infectious complications.

Methods

A two-institution, retrospective cohort study was performed. Charts of children who underwent solid tumor resection between July 2018–June 2021 were reviewed. Patient characteristics, diagnosis, operative data, perioperative antibiotic use, and postoperative infection/sepsis were analyzed within 30 days of surgery. The primary outcome was surgical site infection (SSI) or systemic sepsis within 30 days of surgery. Fisher's tests were performed to evaluate differences.

Results

250 patients underwent tumor resection between July 2018 and June 2021 at both centers. The median age was 4 years [Range: 0.02–26.1]. Seventy-five percent (N = 188) received perioperative antibiotics prophylaxis (AP), while 25 % of patients did not receive AP (N = 62). Only one patient in the AP group (0.5 %) developed postoperative sepsis, while 12 patients (19.4 %) in the non-AP group developed sepsis (p < 0.0001). There were 3 SSI in the AP group and none in the non-AP group (p = 1.0).

Conclusions

The administration of AP in children undergoing solid tumor resection is associated with a reduced rate of postoperative sepsis but no difference in SSI. This could possibly be related to bacterial translocation during surgery and the seeding of indwelling central venous access catheters. Our results support the standardized use of AP in this population.

Type of Study

Retrospective Cohort Study.

Level of Evidence

III.