Faculty Collaboration Database

Antibiotic Prophylaxis Use and Outcomes in Children Undergoing Laparoscopic Orchiopexy. J Urol 2025 Dec;214(6):622-630

Date

08/14/2025

Pubmed ID

40811823

DOI

10.1097/JU.0000000000004728

Scopus ID

2-s2.0-105013625292 (requires institutional sign-in at Scopus site)

Abstract

PURPOSE: We compared clinically relevant outcomes in children undergoing laparoscopic orchiopexy who did and did not receive antimicrobial prophylaxis.

MATERIALS AND METHODS: This was a multicenter cohort study using data from 144 National Surgical Quality Improvement Program-Pediatric hospitals. Patients younger than 18 years who underwent laparoscopic orchiopexy from January 1, 2021, to December 31, 2023, were included. Complementary hospital and patient-level analyses were performed to explore the relationship between prophylaxis and 30-day postoperative surgical site infection (SSI) rates. In the patient-level analysis, propensity score matching was used to balance groups on patient and procedural characteristics. The hospital-level analysis explored the correlation between prophylaxis and observed-to-expected SSI rate ratios after adjusting for patient and procedural characteristics.

RESULTS: A total of 2739 children met inclusion criteria, of whom 57% received prophylaxis. Outcomes were similar for SSIs in the patient-level analysis, including 2066 patients (prophylaxis: 13/1033 [1.3%] vs no prophylaxis: 13/1033 [1.3%]; adjusted odds ratio [aOR], 0.79; 95% CI, 0.30-2.11), and no correlation was found between rates of prophylaxis and SSIs in the hospital-level analysis (Spearman ρ = -0.081; P = .3). Outcomes were similar between groups in the patient-level analysis for reoperation (prophylaxis: 5/1033 [0.48%] vs no prophylaxis: 7/1033 [0.68%]; aOR, 0.86; 95% CI, 0.22-3.45) and readmission (prophylaxis: 6/1033 [0.58%] vs no prophylaxis: 10/1033 [1.0%]; aOR, 0.72; 95% CI, 0.23-2.32).

CONCLUSIONS: This study does not find significant evidence to support the association between the routine use of antimicrobial prophylaxis and improved outcomes in children undergoing laparoscopic orchiopexy.

Author List

McKie KA, Moturu A, Graham DA, Coleman M, Huang R, Grant C, Saito JM, Hall BL, Finkelstein JB, Berrondo C, Newland JG, Ko C, Ellison JS, Rangel SJ

Author

Jonathan Scott Ellison MD Associate Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Antibiotic Prophylaxis
Child
Child, Preschool
Cohort Studies
Cryptorchidism
Humans
Infant
Laparoscopy
Male
Orchiopexy
Propensity Score
Retrospective Studies
Surgical Wound Infection
Treatment Outcome