Perioperative antibiotic prophylaxis in pediatric vertebrology: short or long course?

Introduction . Infectious complications in spine surgery occur in 0.6–17.6% of cases and are associated with high treatment costs. Perioperative antibiotic prophylaxis is considered to be an effective preventive measure. However, there are no clear recommendations for its use in children, including the optimal duration of antibiotic administration. This study presents a retrospective analysis of the impact of different perioperative antibiotic prophylaxis regimens on infection rates and the length of hospitalization. The objective was to evaluate the effectiveness of different perioperative antibiotic prophylaxis regimens in pediatric patients undergoing spinal surgery. Materials and methods . A retrospective study was conducted involving 319 children (aged 1–18 years) who underwent elective spine surgeries at the H.Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery. The patients were divided into two groups: the main group (perioperative prophylaxis ≥ 72 hours, n = 205) and the control group (perioperative prophylaxis ≤ 48 hours, n = 114). Antibiotics were administered intravenously 30–60 minutes before skin incision in all cases. The effectiveness of perioperative antibiotic prophylaxis was assessed based on clinical and laboratory data and local signs of infection at the surgical site. Results . The average length of hospitalization was shorter in the short-protocol perioperative antibiotic prophylaxis group (21.29 days vs. 25.22 days, p = 0.00005). Local inflammatory changes were not observed in the short-protocol group, whereas 13 cases were recorded in the prolonged-protocol group ( p = 0.0053). The results suggest the effectiveness of the short protocol of perioperative antibiotic prophylaxis. Conclusion . Surgical site infection is a common and serious complication after spinal surgery in children. Adequate perioperative antibiotic prophylaxis plays a crucial role in reducing the risks of infectious complications. However, clear guidelines accounting for the anatomical and physiological characteristics of pediatric patients are lacking. Therefore, further studies are needed to develop a unified concept, which will significantly reduce the incidence of surgical site infections.