Does antibiotic prophylaxis reduce SSI rates in children undergoing laparoscopic orchiopexy?

Routine use of antibiotic prophylaxis does not appear to improve outcomes in children undergoing laparoscopic orchiopexy, reveals a recent study.

This multicentre cohort study used data from 144 National Surgical Quality Improvement Program–Pediatric hospitals, including 2,739 children aged <18 years who underwent laparoscopic orchiopexy from 1 January 2021 to 31 December 2023.

The authors performed complementary hospital and patient-level analyses to examine the association between prophylaxis and 30-day postoperative surgical site infection (SSI) rates.

In the patient-level analysis, groups were balanced on patient and procedural characteristics using propensity score matching. In the hospital-level analysis, the authors explored the relationship between prophylaxis and observed-to-expected SSI rate ratios after adjusting for patients and procedural characteristics.

Of the children, 57 percent received antimicrobial prophylaxis. Outcomes for SSIs in the patient-level analysis were similar between groups (1.3 percent vs 1.3 percent in the prophylaxis vs no prophylaxis groups, respectively; adjusted odds ratio [aOR], 0.79, 95 percent confidence interval [CI], 0.30–2.11). 

In the hospital-level analysis, no association existed between rates of prophylaxis and SSI (Spearman ρ, −0.081; p=0.3).

Moreover, outcomes did not significantly differ between groups in the patient-level analysis for reoperation (0.48 percent vs 0.68 percent; aOR, 0.86, 95 percent CI, 0.22–3.45) and readmission (0.58 percent vs 1.0 percent; aOR, 0.72, 95 percent CI, 0.23–2.32).