Table 2.
Prophylaxis recommendations for surgical site infections in neonates [adapted from Laituri et al. (228)].
| Wound classification | Examples of procedures | First choice of antibiotics |
Penicillin Allergy |
Initial dose timing |
Post-op duration |
Citation |
|---|---|---|---|---|---|---|
| Clean (class 1) | PDA ligation, CVL insertion, inguinal hernia, circumcision. Exceptions: CDH repair, gastroschisis reduction, omphalocele. | None | NA | NA | NA | (228, 230–232) |
| Clean-contaminated (class 2) | Duodenal atresia repair, gastrostomy (G)-tube insertion, choledochal cyst excision. Exceptions: laparoscopy pyloromyotomy, colorectal surgery | cefazolin IV | Within 1 h of incision | None | (228) | |
| Contaminated (class IV) | Perforated NEC | See NEC guidelines | ||||
| Specific cases | Gastroschisis | Ampicillin or cloxacillin + gentamicin | Cloxacillin + gentamicin | At birth | Discontinue after wound closure | (228, 235) |
| Specific cases | Colorectal surgery | Cefazolin + metronidazole | within 1 h of incision | Discontinue within 24 h of surgery | (241, 242) |