ArticleJournal of pediatric orthopedics
Compliance With a Comprehensive Antibiotic Protocol Improves Infection Incidence in Pediatric Spine Surgery.
Article in Journal of pediatric orthopedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the power of standardization in pediatric neurosurgery.Neurosurgical review · 2023Pooled it
- Impact of a Multidisciplinary Approach on Surgical Site Infections (SSIs) in Pediatric Posterior Spine Fusions (PSF): Insights From a Ten-Year Cohort Study (2012-2022).Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Institution-Based Quality and Safety Improvement Initiatives in Spine Surgery: A Scoping Review.JBJS reviews · 2025Article
- Evaluating compliance with the 2013 best practice guidelines for preventing surgical site infection in high-risk pediatric spine surgery.Spine deformity · 2024Article
- Recurrent Infections After Percutaneous Pinning of a Proximal Radius and Ulna Fracture.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Current Antimicrobial Use in Horses Undergoing Exploratory Celiotomy: A Survey of Board-Certified Equine Specialists.Animals : an open access journal from MDPI · 2023Article
- Does the Microflora of Surgery Site Infection Change After Prophylactic Use of Vancomycin Powder in the Spine Surgery.Infection and drug resistance · 2023Article
- Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample.JAMA network open · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundA multidisciplinary task force, designated Target Zero, has developed protocols for prevention of surgical site infection (SSI) for spine surgery at our institution. The purpose of this study was to evaluate how compliance with an antibiotic bundle impacts infection incidences in pediatric spine surgery.
methodsAfter institutional review board approval, a consecutive series of 511 patients (517 procedures) who underwent primary spine procedures from 2008 to 2012 were retrospectively reviewed to identify patients who developed SSI. Patients were followed for a minimum of 90 days postoperatively. Compliance data were collected prospectively in 511 consecutive patients and a total of 517 procedures. Three criteria were required for antibiotic bundle compliance: appropriate antibiotics completely administered within 1 hour before incision, antibiotics appropriately redosed intraoperatively for blood loss and time, and antibiotics discontinued within 24 hours postoperatively. A multivariable logistic regression analysis was used to test the association between compliance and the development of an infection.
resultsOverall antibiotic bundle compliance rate was 85%. After adjusting for risk category, estimated blood loss, and study year, the likelihood of an infection was increased in the noncompliant group compared with the compliant group (adjusted odds ratio: 3.0, 95% CI, 0.96-9.47, P=0.0587). When expressed as the number needed to treat, strict adherence to antibiotic bundle compliance prevented 1 SSI within 90 days of surgery for every 26 patients treated with the antibiotic bundle. Reasons for noncompliance included failure to infuse preoperative antibiotics 1 hour before incision (10.3%), failure to redose antibiotics intraoperatively based on time or blood loss (5.5%), and failure to discontinue antibiotics within 24 hours postoperatively (1.9%).
conclusionsCompliance with a comprehensive antibiotic protocol can lead to meaningful reductions in SSI incidences in pediatric spine surgery. Institutions should focus on improving compliance with prophylactic antibiotic protocols to decrease SSI in pediatric spine surgery. LEVEL OF EVIDENCE: Level III-retrospective cohort study.
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