Duration of perioperative antibiotic prophylaxis in neonatal surgery: Less is more

Background: The ideal duration of neonatal antibiotic prophylaxis is not determined with wide variance in practice. This study aims to evaluate the association between duration of antibiotics and surgical site infection (SSI) in neonatal surgery. Methods: A retrospective review regarding antibiotic prophylaxis was performed on <30-day-old surgical patients at a children's hospital from 2014 to 2019. The patients were analyzed based on demographics, presence of SSI, and antibiotic duration. The primary outcome was the development of SSI with ANOVA, chi-square, and recursive partitioning used for statistical analysis. Results: 19/155 patients developed an SSI (12.26 %). Those with an SSI had a lower weight at surgery (p = 0.03). Additionally, wound classification (p = 0.17) and antibiotic duration >48hrs (p = 0.94) made no statistical difference in SSI rate. The two variables most closely linked to SSI development were gestational age (100 %) and weight at time of procedure (80.76 %). Conclusions: Antibiotic prophylaxis >48 h did not decrease the incidence of SSI. Risk factors for SSI development in neonatal surgery were lower gestational age, decreased weight at time of procedure and total length of procedure.