1447. Prophylactic Antibiotics in Appendicitis – Are We Getting the Timing Right?
Session: Poster Abstract Session: HAI: Surgical Site Infections
Friday, October 28, 2016
Room: Poster Hall
  • FINAL ID Week Appy Prophy Poster.pdf (434.9 kB)
  • Background: The Infectious Diseases Society of America (IDSA) recommends that prophylactic antibiotics (PAs) be administered within 30-60 minutes of skin incision to achieve adequate therapeutic levels and reduce the risk of postoperative surgical site infection (SSI). Preoperative checklists can ensure appropriate PAs are ordered. We measured the compliance of pediatric surgeons with the IDSA recommendations regarding the timing of administration of PAs.

    Methods: We conducted a retrospective chart review with Research Ethics Board Approval (REB14-1733) of all children who underwent appendectomy at our institution from November 2014 to March 2015. Patient outcomes and compliance with IDSA recommendations were analyzed.

    Results: We reviewed 114 charts. Surgeons determined 33 cases to be perforated and 81 non-perforated. Only 78 patients (68.4%) received PAs within 60 minutes of skin incision, and 35 (30.7%) did not. One patient underwent drainage of a deep SSI during their original admission; five patients were re-admitted via the emergency department (perforated appendicitis and received appropriate PAs). Ten patients presented to the emergency department or surgery clinic for management of superficial SSIs (3/10 received appropriately timed PAs).

    Conclusion: Despite the availability of surgical prophylaxis recommendations and preoperative checklists, many patients fail to receive appropriately timed PAs before undergoing appendectomy. An intensive program with ongoing education, monitoring, and feedback to surgeons may improve compliance with established recommendations, decrease SSIs, decrease the clinical burden on the patient, and reduce the resource burden on the health care system.

    Anna Shawyer, MD1, Nipunie Rajapakse, MD2, Mary Brindle, MD1 and Joseph V. Vayalumkal, MD2, (1)Pediatric Surgery, Alberta Children's Hospital, Calgary, AB, Canada, (2)Pediatric Infectious Diseases, Alberta Children's Hospital, Calgary, AB, Canada


    A. Shawyer, None

    N. Rajapakse, None

    M. Brindle, None

    J. V. Vayalumkal, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.