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Is Postoperative Prophylactic Antibiotics Necessary for Pediatric Scrotal and Inguinal Outpatient Surgeries?
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Seungsoo Lee, Chang Soo Park, Sung Hye Jo, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2014;9(2):111-114. Published online October 31, 2014
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 Abstract
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Excess usage of antibiotics can cause complications of antibiotics and rise of antibiotic-resistant strains. However, guidelines for antibiotic prophylaxis differ between countries. We evaluated necessity of postoperative prophylactic antibiotics for pediatric patients who underwent scrotal and inguinal outpatient surgeries. Materials and Methods: From April 2011 to April 2014, 725 patients (mean age, 30.5±21.6 months) who underwent outpatient surgery (hydrocelectomy, orchiopexy, orchiectomy, and inguinal herniorrhaphy) were evaluated. In group 1 (556 cases), each patient had intravenous antibiotic prophylaxis only preoperatively. In group 2 (169 cases), each patient had intravenous antibiotic prophylaxis pre- and post-operatively. In group 1 and group 2, we analyzed postoperative complications including wound dehiscence, fever, skin erythema, pain, pus, and diarrhea with medical records. Results: In group 1 and group 2, mean age was 30.4±21.7 months (5.0-108.0 months) and 30.8±21.2 months (7.0-108.0 months), respectively. In group 1 and group 2, the mean operative time was 29.6±2.4 minutes and 29.7±2.5 minutes, respectively. The differences of mean age and mean operative time were not statistically significant (p=0.82 and p=0.77, respectively). Nine patients in group 1 and two patients in group 2 had postoperative complications. The difference between two groups was statistically insignificant (p=0.69). According to age and operation, the differences of postoperative complications were not statistically significant. However, in patients under 2 years old, more complications tended to occur in group 1 than in group 2. Conclusions: Postoperative prophylactic antibiotics may not be necessary for pediatric scrotal and inguinal outpatient surgeries.
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Clinical Characteristics of Children with Febrile Urinary Tract Infection
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Chang Soo Park, Seok Gun Jung, Jae Hyun Ahn, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2010;5(1):57-62. Published online April 30, 2010
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- "Purpose: Knowledge of baseline risk of urinary tract infection (UTI) can help clinicians make informed diagnostic and therapeutic decisions. We evaluated the clinical features of children with febrile UTI. Materials and Methods: We identified 141 patients with febrile UTI, who visited for treatment. We retrospectively reviewed the sex, age, hydronephrosis, vesicoureteral reflux (VUR), concomitant disease, previous urologic surgical history, prophylactic antibiotics, voiding symptom, pathogen, used antibiotics and antibiotics resistance. Results: In 105 infants with febrile UTI who were 12 months or less, the male to female ratio was 3:1 (79 boys, 26 girls), which showed a definite male predominance. But, female children had a relatively high prevalence rate of febrile UTI, especially after the first year of life. Comorbidity of hydronephrosis was 38.1%. The most prenatal hydronephrosis persisted until presenting febrile UTI. Comorbidity of VUR was 26.1%. There was no significant difference between the prevalence of febrile UTI and the use of prophylactic antibiotics according to the VUR grade (p>0.05). The most common pathogen was E. coli (70.2%), the most commonly used antibiotics was cefotaxime (79.4%) and the most commonly resistant antibiotics was ampicillin (77.9%). Conclusions: Our results of male to female ratio according to the age are consistent with the data from large epidemiologic UTI studies. Febrile UTI of infant significantly correlated with hydronephrosis and VUR. Understanding pathogen and resistance is mandatory."
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