Effect of antibiotic prophylaxis on surgical site infection after elective laparoscopic cholecystectomy in low-risk pediatric patients
In brief
Antibiotics did not reduce infections after low-risk pediatric gallbladder surgery
In 5,004 adolescents undergoing elective laparoscopic gallbladder removal, surgical infections were similarly rare with and without preventive antibiotics: 0.3% versus 0.4%. Antibiotic use was associated with about $2,109 in additional charges per patient, with no difference in readmissions or interventions; the database study supports current guidance against routine use in this low-risk group.
- Journal
- Journal of pediatric surgery (Q1)
- Published
- 29 October 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Maria G Sacco Casamassima, Nadeen Alturki, Janelle R Noel-MacDonnell, Shawn D St Peter
- PMID
- 42956887
- DOI
- 10.1016/j.jpedsurg.2026.163570
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 1 November 2026): Large pediatric comparative study of antibiotic prophylaxis in laparoscopic surgery
Abstract
BACKGROUND: Laparoscopic cholecystectomy (LC) is a common elective procedure performed in children for which adherence to the guideline recommendations against the routine use of surgical antibiotic prophylaxis (SAP) remains low. Given limited pediatric-specific evidence, this study evaluated the effectiveness of SAP in reducing surgical site infection (SSI) among low-risk children undergoing elective LC. METHODS: Low-risk pediatric patients aged 12-18 years undergoing elective LC for uncomplicated gallbladder disease were identified in the Pediatric Health Information System (PHIS) database from January 2020 to December 2025. Outcomes were compared between patients who received SAP and those who did not (NSAP). Multivariable logistic regression and a generalized linear model were used to evaluate risk factors for SSI and estimate differences in expected SSI-related readmission charges. RESULTS: 5,004 patients were included. 4,042 (80.8%) received SAP and 962 (19.2%) did not. SAP use varied significantly among centers, ranging from 100% to 23% (p<0.001). SSI occurred in 15 cases, with no difference between groups: SAP, 0.3%; NSAP, 0.4% (p=0.508), corresponding to an absolute risk difference of 0.14% and a number-needed-to-treat of 696. No risk predictors were identified. There were no differences in readmission rates or interventions at readmission between the SAP and NSAP groups. SAP was associated with an estimated net increase in charges of approximately $2,109 per patient. CONCLUSION: Routine prophylactic antibiotic use offers no meaningful reduction in SSI risk among low-risk pediatric patients undergoing LC, while it is associated with increased healthcare costs.
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.