Objectives With the rise of antibiotic resistance, the use of prophylactic preoperative antibiotics (PPA) has been questioned in cases with low rates of surgical site infection (SSI). We report PPA usage and SSI rates after elective laparoscopic cholecystectomy at our institution.

Materials and Methods A retrospective review of children younger than 18 years who underwent elective outpatient laparoscopic cholecystectomy between July 2010 and August 2020 was performed. Demographic, preoperative work-up, antibiotic use, intraoperative characteristics, and SSI data were collected via chart review. SSI was defined as clinical signs of infection that required antibiotics within 30 days of surgery.

Results A total of 502 patients met the inclusion criteria; 50% were preoperatively diagnosed with symptomatic cholelithiasis, 47% with biliary dyskinesia, 2% with hyperkinetic gallbladder, and 1% with gallbladder polyp(s). The majority were female (78%) and Caucasian (80%). In total, 60% (n = 301) of patients received PPA, while 40% (n = 201) did not; 1.3% (n = 4) of those who received PPA developed SSI, compared with 5.5% (n = 11) of those who did not receive PPA (p = 0.01). Though PPA use was associated with a 77% reduction in the risk of SSI in multivariate analysis (p = 0.01), all SSIs were superficial. One child required readmission for intravenous antibiotics, while the remainder were treated with outpatient antibiotics. Gender, age, body mass index, ethnicity, and preoperative diagnosis did not influence the likelihood of receiving PPA.

Conclusion Given the relatively low morbidity of the superficial SSI, conservative use of PPA is advised to avoid contributing to antibiotic resistance.

目的 随着抗生素耐药性的增加，在手术部位感染 (SSI) 发生率较低的情况下，预防性术前抗生素 (PPA) 的使用受到质疑。我们报告了我们机构择期腹腔镜胆囊切除术后 PPA 的使用情况和 SSI 率。

材料和方法 对 2010 年 7 月至 2020 年 8 月期间接受选择性门诊腹腔镜胆囊切除术的 18 岁以下儿童进行了回顾性研究。通过图表审查收集人口统计学、术前检查、抗生素使用、术中特征和 SSI 数据。SSI 被定义为需要在手术后 30 天内使用抗生素的感染的临床症状。

结果 共502例患者符合纳入标准；50% 的术前诊断为有症状的胆石症，47% 的胆道运动障碍，2% 的胆囊运动亢进，1% 的胆囊息肉。大多数是女性 (78%) 和白种人 (80%)。总共有 60% ( n  = 301) 的患者接受了 PPA，而 40% ( n  = 201) 没有； 接受 PPA 的人中有1.3% ( n = 4) 发生了 SSI， 而未接受 PPA 的人中有 5.5% ( n = 11) ( p  = 0.01)。尽管在多变量分析中，PPA 的使用与 SSI 风险降低 77% 相关（p = 0.01)，所有 SSI 都是表面的。一名儿童因静脉注射抗生素而需要重新入院，而其余儿童则接受门诊抗生素治疗。性别、年龄、体重指数、种族和术前诊断不影响接受 PPA 的可能性。

结论 鉴于浅表 SSI 的发病率相对较低，建议保守使用 PPA 以避免导致抗生素耐药性。