Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Erika Rigotti¹, Sonia Bianchini², Laura Nicoletti², Sara Monaco², Elena Carrara³, Francesca Opri¹, Roberta Opri¹, Caterina Caminiti⁴, Daniele Donà⁵, Mario Giuffré⁶, Alessandro Inserra⁷, Laura Lancella⁸, Alessandro Mugelli⁹, Giorgio Piacentini¹, Nicola Principi¹⁰, Simonetta Tesoro¹¹, Elisabetta Venturini¹², Annamaria Staiano¹³, Alberto Villani⁸, Enrico Sesenna¹⁴, Claudio Vicini¹⁵, Susanna Esposito², On Behalf Of The Peri-Operative Prophylaxis In Neonatal And Paediatric Age Pop-NeoPed Study Group

Affiliations

¹ Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy.
² Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
³ Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy.
⁴ Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy.
⁵ Division of Paediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35100 Padua, Italy.
⁶ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, 90134 Palermo, Italy.
⁷ General Surgery Department, Bambino Gesu Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy.
⁸ Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, IRCCS Bambino Gesù Children's Hospital, 00165 Rome, Italy.
⁹ Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139 Florence, Italy.
¹⁰ Università degli Studi di Milano, 20122 Milan, Italy.
¹¹ Division of Anesthesia, Analgesia, and Intensive Care, Department of Surgical and Biomedical Sciences, University of Perugia, 06129 Perugia, Italy.
¹² Pediatric Infectious Disease Unit, Meyer Children's Hospital, 50139 Florence, Italy.
¹³ Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", 80138 Naples, Italy.
¹⁴ Maxillo-Facial Surgery Unit, Head and Neck Department, University Hospital of Parma, 43126 Parma, Italy.
¹⁵ Head-Neck and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Piertoni Hospital, 47121 Forli, Italy.

PMID: 35326845
PMCID: PMC8944694
DOI: 10.3390/antibiotics11030382

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Erika Rigotti et al. Antibiotics (Basel). 2022.

. 2022 Mar 13;11(3):382.

doi: 10.3390/antibiotics11030382.

Authors

Affiliations

¹ Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy.
² Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
³ Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy.
⁴ Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy.
⁵ Division of Paediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35100 Padua, Italy.
⁶ Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, 90134 Palermo, Italy.
⁷ General Surgery Department, Bambino Gesu Children's Hospital, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy.
⁸ Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, IRCCS Bambino Gesù Children's Hospital, 00165 Rome, Italy.
⁹ Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale G. Pieraccini, 6, 50139 Florence, Italy.
¹⁰ Università degli Studi di Milano, 20122 Milan, Italy.
¹¹ Division of Anesthesia, Analgesia, and Intensive Care, Department of Surgical and Biomedical Sciences, University of Perugia, 06129 Perugia, Italy.
¹² Pediatric Infectious Disease Unit, Meyer Children's Hospital, 50139 Florence, Italy.
¹³ Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", 80138 Naples, Italy.
¹⁴ Maxillo-Facial Surgery Unit, Head and Neck Department, University Hospital of Parma, 43126 Parma, Italy.
¹⁵ Head-Neck and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Piertoni Hospital, 47121 Forli, Italy.

PMID: 35326845
PMCID: PMC8944694
DOI: 10.3390/antibiotics11030382

Abstract

Surgical site infections (SSIs) represent a potential complication in surgical procedures, mainly because clean/contaminated surgery involves organs that are normally colonized by bacteria. Dental, maxillo-facial and ear-nose-throat (ENT) surgeries are among those that carry a risk of SSIs because the mouth and the first respiratory tracts are normally colonized by a bacterial flora. The aim of this consensus document was to provide clinicians with recommendations on surgical antimicrobial prophylaxis in neonates (<28 days of chronological age) and pediatric patients (within the age range of 29 days−18 years) undergoing dental, maxillo-facial or ENT surgical procedures. These included: (1) dental surgery; (2) maxilla-facial surgery following trauma with fracture; (3) temporo-mandibular surgery; (4) cleft palate and cleft lip repair; (5) ear surgery; (6) endoscopic paranasal cavity surgery and septoplasty; (7) clean head and neck surgery; (8) clean/contaminated head and neck surgery and (9) tonsillectomy and adenoidectomy. Due to the lack of pediatric data for the majority of dental, maxillo-facial and ENT surgeries and the fact that the recommendations for adults are currently used, there is a need for ad hoc studies to be rapidly planned for the most deficient areas. This seems even more urgent for interventions such as those involving the first airways since the different composition of the respiratory microbiota in children compared to adults implies the possibility that surgical antibiotic prophylaxis schemes that are ideal for adults may not be equally effective in children.

Keywords: ENT surgery; dental surgery; head and neck surgery; maxilla-facial surgery; surgical antimicrobial prophylaxis.

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Conflict of interest statement

The authors declare no conflict of interest.

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Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Affiliations

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Authors

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Abstract

Conflict of interest statement

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