Assessing Antibiotic Prophylaxis Prescribing in Paediatrics Following Cardiac Surgery: Current Practices, Adherence to Guidelines and Clinical Implications

Abstract Background: Antibiotic prophylaxis in paediatric cardiac surgery is essential for preventing post-operative infections, which are particularly dangerous due to the patients’ compromised immune systems. These measures aim to reduce the risk of infections such as surgical site infections (SSIs) and mediastinitis, contributing to better patient outcomes. Studies in this area focus on evaluating current practices, adherence to guidelines and the impact of antibiotic prophylaxis on these patients. Aim: The aim of this study was to assess antibiotic prophylaxis prescribing practices in paediatric cardiac surgery, focussing on current practices, adherence to guidelines and clinical implications, for example, increased risk of infection, prolonged hospital stays or potentially affecting cardiac function. Methodology: A systematic review was conducted using PubMed, Web of Science, ScienceDirect, Google Scholar and Cochrane Library databases up to December 2023. Out of 650 articles, 42 studies met the inclusion criteria. The studies included cohort, cross-sectional, prospective, systematic reviews, retrospective and meta-analysis studies, with quality assessed using the Risk of Bias in Non-randomized Studies-of Interventions tool. Results: The review included 42 studies, highlighting the importance of administering prophylactic antibiotics, particularly vancomycin and cefazolin, in paediatric cardiac surgery. Limiting antibiotic duration to 24–48 h postoperatively did not increase infection risk when guidelines were followed. The appropriate use of prophylactic antibiotics significantly reduced the risk of SSIs and bloodstream infections. Conclusion: Prophylactic antibiotics play a key role in reducing post-operative infections in paediatric cardiac surgery. Adherence to guidelines, particularly short-term protocols, is essential for minimising resistance and optimising patient care. Future research should focus on refining these protocols and evaluating their clinical impact.