29: Descriptive Analysis of Paediatric Antimicrobial Prophylaxis in Surgery in Four University Teaching Hospitals
Bibliographic record
Abstract
Antimicrobial prophylaxis is used in surgical patients to prevent wound infection because this possible complication is associated with increased patient morbidity and increased costs for the health-care system. New guidelines have been recently published. To describe how antimicrobial prophylaxis was used in paediatric patients at our centers, and to review if prescription was in accordance with the new guidelines. A descriptive retrospective analysis for paediatric patients admitted to four university hospitals and who underwent selected surgeries (cardiac, appendectomies, closed fracture, scoliosis) between April 1st 2012 and March 31st 2013. Compliance criteria evaluated were choice of antibiotic, dosage, duration and timing of administration. The utilization of pre-printed orders for the prescription of antibiotics used in surgical antimicrobial prophylaxis was another aspect evaluated. A total of 222 children were included in the compliance analysis. For all surgeries, the choice and the duration of therapy showed the highest compliance scores (>85%), except for cardiac surgery (duration: 63%). Criteria for dosage and timing of dose administration showed varying scores, according to the types of surgery (scores for dosage from 18% to 100% and scores for timing from 65% to 100%). In particular, cefazolin doses were quite variable (from 13 mg/kg/dose to 50 mg/kg/dose), and the maximal dose prescribed (in grams/dose) was often found to be lower than recommended. As seen in the table, global compliance to all criteria (choice, dosage, timing of administration, duration) was also quite variable according to the type of surgery. Finally, utilization of pre-printed orders was infrequent (<20%). For several types of surgery, a relatively low percentage of paediatric patients received optimal prophylactic antibiotic treatment based on the four essential criteria. Many recommendations have been made to improve current practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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 source (direct Gemma or distilled Codex), 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".