ArticleFrontiers in pediatrics2026
Assessing the knowledge, attitudes and practices of physicians on perioperative antibiotic prophylaxis in pediatric surgery in China: a descriptive study.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Surgical site infection (SSI) prevention is a critical component of pediatric surgical safety, yet the irrational prolongation of perioperative antimicrobial prophylaxis (PAP) remains a global driver of antimicrobial resistance (AMR). While guidelines explicitly recommend discontinuing prophylaxis within 24 h for clean incisions, compliance varies significantly. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of pediatric surgeons regarding PAP and to identify the determinants of non-compliant behaviors using a novel clustering approach. Methods: A multicenter, cross-sectional study was conducted from July to August 2025 across Children's hospitals in Jiangsu Province, China. A total of 143 surgeons from different surgical departments (e.g., General Surgery, Orthopedics, Neurosurgery, Cardiothoracic Surgery) were surveyed using a validated questionnaire based on WHO guidelines. Data were analyzed using Spearman's rank correlation to assess knowledge-practice associations and K-Means clustering to identify distinct behavioral patterns among clinical departments. Results: The study achieved a valid response rate of 95.3%. While surgeons demonstrated high cognitive accuracy regarding drug selection (>84.0%) and administration timing (95.1%), only 74.8% acknowledged the standard of discontinuing prophylaxis within 24 h for Class I incisions. A significant positive correlation was found between knowledge and practice scores ( Conclusion: A high level of cognitive reserve cannot ensure consistent implementation of standard practices. In high-risk departments, clinicians' focus on SSI rather than AMR may trigger defensive medicine, which is likely to impair guideline adherence. This association requires further verification in targeted investigations.
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