Routine Prophylactic Antibiotics Do not Reduce Early Port-Related Infections in Children: A Time-Based Cohort Study
DOI:
https://doi.org/10.58600/eurjther3075Keywords:
antibacterial prophylaxis, catheter-related infections, central venous catheterization, hematologic malignancies, pediatric oncologyAbstract
Objective: This study aimed to investigate the effect of systemic prophylactic antibiotic use during port catheter placement on port-related infections in pediatric patients.
Methods: We retrospectively analyzed 234 patients aged 0–18 years who underwent first-time port catheter placement between September 2020 and March 2025 and had at least three months of follow-up. According to institutional protocol, cefazolin (50 mg/kg) was routinely administered 30 minutes before the procedure until December 2022, after which the practice was discontinued. This created two time-based groups: Group A (antibiotic, n = 108) and Group B (no-antibiotic, n = 126). Port-related infection was defined as fever (≥38°C) and/or positive blood culture within 30 days without another source. Groups were compared for infection rates, and multivariable analysis was performed to control for confounders (age, diagnosis, and catheter size). A subgroup analysis was performed for neutropenic patients (absolute neutrophil count <1,500/mm³).
Results: The overall incidence of port-related infection was 19.2% (n = 45). Infection rates were 19.4% in Group A and 19.0% in Group B, with no statistically significant difference (p = 1,000). In multivariable analysis, prophylactic antibiotic use was not significantly associated with infection risk (OR: 0.98; 95% CI: 0.51–1.89; p = 0.957). Similarly, in the neutropenic subgroup, no significant difference in infection rates was observed between patients who did and did not receive prophylactic antibiotics (p = 0.76).
Conclusion: Systemic prophylactic antibiotic use during port placement did not significantly reduce infection rates in pediatric patients. These findings support individualized risk-based decision-making and the avoidance of unnecessary antibiotic exposure, contributing to antimicrobial stewardship.
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