Prophylactic Antibiotics in Appendicitis—Are We Getting the Timing Right?
Bibliographic record
Abstract
Background. The Infectious Diseases Society of America (IDSA) recommends that prophylactic antibiotics (PAs) be administered within 30–60 minutes of skin incision to achieve adequate therapeutic levels and reduce the risk of postoperative surgical site infection (SSI). Preoperative checklists can ensure appropriate PAs are ordered. We measured the compliance of pediatric surgeons with the IDSA recommendations regarding the timing of administration of PAs. Methods. We conducted a retrospective chart review with Research Ethics Board Approval (REB14-1733) of all children who underwent appendectomy at our institution from November 2014 to March 2015. Patient outcomes and compliance with IDSA recommendations were analyzed. Results. We reviewed 114 charts. Surgeons determined 33 cases to be perforated and 81 non-perforated. Only 78 patients (68.4%) received PAs within 60 minutes of skin incision, and 35 (30.7%) did not. One patient underwent drainage of a deep SSI during their original admission; five patients were re-admitted via the emergency department (perforated appendicitis and received appropriate PAs). Ten patients presented to the emergency department or surgery clinic for management of superficial SSIs (3/10 received appropriately timed PAs). Conclusion. Despite the availability of surgical prophylaxis recommendations and preoperative checklists, many patients fail to receive appropriately timed PAs before undergoing appendectomy. An intensive program with ongoing education, monitoring, and feedback to surgeons may improve compliance with established recommendations, decrease SSIs, decrease the clinical burden on the patient, and reduce the resource burden on the health care system. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".