Postoperative antibiotic continuation does not reduce infectious complications after elective pediatric ostomy reversal: A NSQIP Pediatric analysis
In brief
Post-op antibiotics after pediatric ostomy reversal do not cut wound infections
In a review of 2,064 children undergoing elective ostomy reversal, continuing antibiotics beyond the operation did not lower rates of superficial, deep, or organ/space wound infections, nor did it affect pneumonia, urinary-tract infection, or hospital stay. Higher pre-operative albumin, not extended antibiotics, was linked to fewer infections, suggesting nutritional optimization may be more important.
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 30 August 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Chidiebere Onongaya, Anmol Nigam, Eileen K Peterson, Pravin Meshram, Daniel A Saltzman, James V Harmon, et al.
- PMID
- 42749591
- DOI
- 10.1016/j.jpedsurg.2026.163377
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 17 September 2026): Postoperative antibiotic continuation, no SSI benefit after ostomy reversal
Abstract
INTRODUCTION: The optimal duration of perioperative antibiotic prophylaxis for elective ostomy reversal in children remains unclear, and antibiotic regimens vary widely despite limited evidence supporting extended use. This study evaluated whether continuation of perioperative antibiotics beyond surgery completion reduces postoperative infectious complications in pediatric ostomy reversal. METHODS: A retrospective cohort study used the NSQIP Pediatric database and Surgical Antibiotic Prophylaxis files from 2021 to 2023. Children <18 years undergoing elective ostomy reversal were identified by CPT codes 44620, 44625, and 44626. Exclusion criteria included immunodeficiency, transplantation, malignancy, age <28 days, outpatient surgery, and missing antibiotic data. Patients were categorized as receiving antibiotics intraoperatively only versus postoperative continuation. The primary outcome was wound infection (superficial, deep, organ/space); secondary outcomes included pneumonia, UTI, length of stay, and days to discharge. RESULTS: Of 2064 patients (median age 331 days), 60.4% continued antibiotics postoperatively. On multivariate analysis, postoperative antibiotic continuation was not associated with reduced wound infection. Higher preoperative albumin was protective against wound infection. No differences were observed in infection subtypes, UTI, pneumonia, or length of stay. Among children <1-year, antibiotic continuation was not protective, while term birth was associated with increased wound infection risk (OR 2.63, 95% CI 1.24-5.65). CONCLUSION: Postoperative antibiotic continuation was not associated with reduced infectious complications following pediatric ostomy reversal. Preoperative nutritional optimization may play a greater role in reducing SSI than postoperative antibiotic continuation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.