Antibiotic Prophylaxis in Paediatric Surgery

Effect of antibiotic prophylaxis was studied in 400 children undergoing various types of surgery. Patients were divided into different classes according to the type of operation and each was further randomized into a routine or trial group. The routine group received antibiotics for prolonged periods. In the trial group, "clean" cases (class A) did not getany antibiotics. The “clean-contaminated” (class B) and "contaminated" cases (class C) received pen-operative antibiotics only. Frankly infected cases were not included in this trial. There were 131, 213 and 56 cases in classes A, B and C respectively; of these 13 (3.25%) cases were diagnosed as infected, four in the trial group and nine in the routine group. It was found that a short course of pen-operative antibiotics was equally, if not more effective. Prolonged courses of antibiotics were not only useless and expensive but could also be harmful. For clean cases there is no need for antibiotic prophylaxis. Children behave no differently and these results may be extrapolated to adults (JPMA 42: 286, 1992).