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Article Abstract
Background: The effectiveness of prophylactic antibiotics in pediatric inguinal hernia repair remains unclear. As the procedure is considered clean, the necessity of prophylactic antibiotics is debated.
Methods: We conducted a retrospective cohort study using the TriNetX Research Network. Pediatric patients aged ≤16 years who underwent open or laparoscopic inguinal hernia repair between 2005 and 2025 were included. Patients were divided based on their receipt of prophylactic antibiotics, and separate analyses were performed based on surgical approach or risk classification. Propensity score matching was applied to balance covariates. The primary outcome was surgical site infection (SSI), and risk factors associated with SSI were evaluated.
Results: A total of 42,779 patients were analyzed. In matched cohorts undergoing open repair (n = 2533 per group), the SSI rate was 0.43 % without antibiotics and 0.63 % with antibiotics (risk difference [RD], -0.002; 95 % CI, -0.006 to 0.002). For laparoscopic repair (n = 2516 per group), SSI rates were ≤0.40 % without and 0.56 % with antibiotics (RD, -0.002; 95 % CI, -0.005 to 0.002). Among patients who did not receive antibiotics, SSI incidence remained low for both open (0.28 %) and laparoscopic (0.27 %) repairs (n = 18,865 per group) and was comparable between high-risk (0.65 %) and average-risk (0.45 %) patients (n = 5572 per group). Cox regression identified male sex, age under 6 months, and immunosuppressant use as significant predictors.
Conclusion: Prophylactic antibiotics did not reduce SSI in pediatric inguinal hernia repair. Their use should be limited to selected high-risk patients, such as those receiving immunosuppressants.
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| http://dx.doi.org/10.1016/j.jpedsurg.2025.162607 | DOI Listing |
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