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Review article: Medical guidelines

Vol. 152 No. 3738 (2022)

Swiss recommendations on perioperative antimicrobial prophylaxis in children

  • Paolo Paioni
  • Christoph Aebi
  • Julia Bielicki
  • Michael Buettcher
  • Pierre Alex Crisinel
  • Christian R. Kahlert
  • Noémie Wagner
  • Christoph Berger
Cite this as:
Swiss Med Wkly. 2022;152:w30230


Infection following surgical procedures leads to significant morbidity and mortality in all age groups. Sterile techniques, antibiotic prophylaxis and improved postoperative wound care have contributed to the decline of surgical site infections since the early days of surgery. Recommendations on the use of perioperative antimicrobial prophylaxis exist for adults, but are rare for the paediatric population. Here, we provide a standardised approach to the effective use of antimicrobial agents for the prevention of surgical site infections in children contributing to a targeted and rational perioperative use of antibiotics in Switzerland.


  1. Sherrod BA, Arynchyna AA, Johnston JM, Rozzelle CA, Blount JP, Oakes WJ, et al. Risk factors for surgical site infection following nonshunt pediatric neurosurgery: a review of 9296 procedures from a national database and comparison with a single-center experience. J Neurosurg Pediatr. 2017 Apr;19(4):407–20.
  2. Laituri C, Arnold MA. A standardized guideline for antibiotic prophylaxis in surgical neonates. Semin Pediatr Surg. 2019 Feb;28(1):53–6.
  3. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, et al.; American Society of Health-System Pharmacists; Infectious Disease Society of America; Surgical Infection Society; Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013 Feb;70(3):195–283.
  4. Kreter B, Woods M. Antibiotic prophylaxis for cardiothoracic operations. Meta-analysis of thirty years of clinical trials. J Thorac Cardiovasc Surg. 1992 Sep;104(3):590–9.
  5. Andersen BR, Kallehave FL, Andersen HK. Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. Cochrane Database Syst Rev. 2005 Jul;CD001439(3):CD001439.
  6. Aznar R, Mateu M, Miró JM, Gatell JM, Gimferrer JM, Aznar E, et al. Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo. Eur J Cardiothorac Surg. 1991;5(10):515–8.
  7. Allegranzi B, Bischoff P, de Jonge S, Kubilay NZ, Zayed B, Gomes SM, et al.; WHO Guidelines Development Group. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016 Dec;16(12):e276–87.
  8. Allegranzi B, Zayed B, Bischoff P, Kubilay NZ, de Jonge S, de Vries F, et al.; WHO Guidelines Development Group. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016 Dec;16(12):e288–303.
  9. Tilen R, Panis D, Aeschbacher S, Sabine T, Meyer Zu Schwabedissen HE, Berger C. Development of the Swiss Database for dosing medicinal products in pediatrics. Eur J Pediatr. 2022 Mar;181(3):1221–31.
  10. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, et al.; Safe Surgery Saves Lives Study Group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009 Jan;360(5):491–9.
  11. Günthard J, Knirsch W. Neue Empfehlungen zur antibiotischen Endokarditisprophylaxe: pädiatrische Applikation. Kardiovaskuläre Medizin. 2010;13:297–301.
  12. WHO WHO model list of essential medicines for Children. 6th list. World Health Organization 2017:
  13. Senn LV, Widmer A, Zanetti G, Kuster S. Aktualisierte Empfehlungen zur perioperativen Antibiotikaprophylaxe in der Schweiz, 2015. Swissnoso Bulletin. 2015;20:1–8.
  14. Hebert C, Robicsek A. Decolonization therapy in infection control. Curr Opin Infect Dis. 2010 Aug;23(4):340–5.
  15. Kallen AJ, Wilson CT, Larson RJ. Perioperative intranasal mupirocin for the prevention of surgical-site infections: systematic review of the literature and meta-analysis. Infect Control Hosp Epidemiol. 2005 Dec;26(12):916–22.
  16. Brand M, Bizos D, O’Farrell P Jr. Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. Cochrane Database Syst Rev. 2010 Oct;CD007345(10):CD007345.
  17. Ishigaki T, Sasaki T, Serikawa M, Kobayashi K, Kamigaki M, Minami T, et al. Evaluation of antibiotic use to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis and cholangitis. Hepatogastroenterology. 2015 Mar-Apr;62(138):417–24.
  18. Hoff WS, Bonadies JA, Cachecho R, Dorlac WC. East Practice Management Guidelines Work Group: update to practice management guidelines for prophylactic antibiotic use in open fractures. J Trauma. 2011 Mar;70(3):751–4.
  19. Zhang Y, Dong J, Qiao Y, He J, Wang T, Ma S. Efficacy and safety profile of antibiotic prophylaxis usage in clean and clean-contaminated plastic and reconstructive surgery: a meta-analysis of randomized controlled trials. Ann Plast Surg. 2014 Jan;72(1):121–30.

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