الفهرس 
Risk factors for infections in pediatric surgeryOnly 14 pages are availabe for public view
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Abstract
Prophylactic antibiotic usage in pediatric patients undergoing surgical procedures is common. There are very few guidelines that address appropriate antibiotic usage in this population. Both the American Academy of Pediatrics and the American Society of Health System Pharmacists address surgical antibiotic prophylaxis in children, but much of the information is derived from adult studies (American Academy of Pediatrics, 2003).
Despite improvements in prophylaxis and infection control measures, surgical site infections (SSIs) remain an important cause of nosocomial morbidity and mortality. Infections result in longer hospitalization and higher costs. The incidence of infection varies from surgeon to surgeon, from hospital to hospital, from one surgical procedure to another, and—most importantly—from one patient to another(Bratzeler and Houck, 2004).
The correct use of antibiotics in patients undergoing surgery is vitally important because misuse of potent antimicrobial agents leads to drug toxicity, super infection, increase in healthcare cost and colonization of wards by highly resistant strains of bacteria (Zahid et al., 2001).
The following guidelines should be observed when prescribing antibiotics.
1. Select an antibiotic to which the known or presumed pathogen is likely to be fully sensitive. The spectrum of an antibiotic should be known accurately. A broad-spectrum antibiotic is avoided if a suitable narrow spectrum antibiotic is available.
2. Restrict the use of antibiotics to which resistance is developing (or has developed).
3. Antibiotics should be given in full dose by an appropriate route and at the correct intervals.
4. With only a few rare exceptions (e.g. lung abscess) antibiotics are not used to treat abscesses without also ensuring that effective surgical drainage is achieved.
5. The side effects of antibiotics should be known and monitored.
6. Expensive antibiotics are not used if equally effective and cheaper alternatives are suitable (Macleod et al, 2004).
Single dose antibiotic is enough for most cases .while multiple doses for 24hours is indicated in some procedures such as cardiac procedures, colorectal procedures, vascular procedures, orthopedic prosthesis procedures, genitourinary procedures and obstetric procedures(ASHSP,2004).
Infusion of the first antimicrobial dose should begin within 60 min before surgical incision or with induction of anesthesia. And those prophylactic antimicrobials should be discontinued within 24 h after the end of surgery (ASHSP,2004).
Selection of antibiotics and duration of prophylaxis should have the smallest impact possible on the normal bacterial flora of patient and microbiologic ecology of the hospital. Prolonged antibiotic prophylaxis results in emergence of resistant strains (Burke J.P., 2005).