Antibiotic Resistance as a Growing Concern in Pediatric Surgery: A Narrative Review
DOI:
https://doi.org/10.63682/jns.v14i30S.7029Keywords:
Antibiotics Resistance, Antimicrobial Drug Resistance, Drug Resistances, Microbial, ProphylaxisAbstract
Antibiotic resistance is a growing challenge in pediatric surgery, significantly impacting clinical outcomes and healthcare systems worldwide. Antibiotics play a critical role in preventing surgical site infections (SSIs), which are particularly dangerous in children due to their underdeveloped immune systems and heightened vulnerability to infections. However, the misuse and overuse of antibiotics have led to the emergence of resistant pathogens, complicating the management of postoperative infections and increasing morbidity, healthcare costs, and the length of hospital stays. This narrative review explores the multifaceted issue of antibiotic resistance in pediatric surgery, examining its contributing factors, clinical implications, and potential mitigation strategies. Key factors driving resistance include the misuse of prophylactic antibiotics, inconsistent adherence to surgical guidelines, and environmental risks within pediatric surgical wards. Resistant pathogens such as Staphylococcus aureus, Klebsiella pneumoniae, and Acinetobacter baumannii have been identified as major contributors to postoperative complications, posing significant treatment challenges. The review highlights the importance of targeted interventions such as antibiotic stewardship programs, adherence to evidence-based surgical protocols, and the integration of innovative technologies like antibiotic-coated sutures and rapid diagnostic tools. Education of healthcare workers and parents is emphasized as a critical strategy to minimize unnecessary antibiotic use. Furthermore, the implementation of strict infection control practices and pediatric-specific guidelines is essential to counteract the rising trend of resistance. Despite advancements in research and infection control, gaps remain in addressing pediatric-specific challenges in antibiotic resistance. Future efforts must focus on multidisciplinary collaboration, enhanced surveillance, and the development of novel therapeutic approaches tailored to pediatric populations. By prioritizing these measures, healthcare systems can safeguard the efficacy of antibiotics and ensure better outcomes for pediatric surgical patients.
Downloads
Metrics
References
Fischer, J. E., Ramser, M., & Fanconi, S. (2000). Use of antibiotics in pediatric intensive care and potential savings. Intensive care medicine, 26, 959-966.
https://doi.org/10.1007/s001340051288
Aminov, R. I. (2009). The role of antibiotics and antibiotic resistance in nature. Environmental microbiology, 11(12), 2970-2988.
https://doi.org/10.1111/j.1462-2920.2009.01972.x
Menz, B. D., Charani, E., Gordon, D. L., Leather, A. J., Moonesinghe, S. R., & Phillips, C. J. (2021). Surgical antibiotic prophylaxis in an era of antibiotic resistance: common resistant bacteria and wider considerations for practice. Infection and Drug Resistance, 5235-5252. https://doi.org/10.2147/IDR.S319780
Schollenberg, E., & Albritton, W. L. (1980). Antibiotic misuse in a pediatric teaching hospital. Canadian Medical Association Journal, 122(1), 49. https://doi.org/10.46982/gjmt.2024.104
Armin, S., Karimi, A., Fallah, F., Tabatabaii, S. R., Alfatemi, S. M. H., Khiabanirad, P., . & Nia, R. S. S. (2015). Antimicrobial resistance patterns of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus isolated from patients with nosocomial infections admitted to tehran hospitals. Archives of Pediatric Infectious Diseases, 3(4). https://doi.org/10.5812/pedinfect.32554
Kollmann, T. R., Kampmann, B., Mazmanian, S. K., Marchant, A., & Levy, O. (2017). Protecting the newborn and young infant from infectious diseases: lessons from immune ontogeny. Immunity, 46(3), 350-363. https://10.1016/j.immuni.2017.03.009
De Nies, L., Kobras, C. M., & Stracy, M. (2023). Antibiotic-induced collateral damage to the microbiota and associated infections. Nature Reviews Microbiology, 21(12), 789-804. https://doi.org/10.1038/s41579-023-00936-9
Iwamoto, M., Mu, Y., Lynfield, R., Bulens, S. N., Nadle, J., Aragon, D., & Lessa, F. C. (2013). Trends in invasive methicillin-resistant Staphylococcus aureus infections. Pediatrics, 132(4), e817-e824.
https://doi.org/10.1542/peds.2013-1112
Anderson, K., & Hamm, R. L. (2012). Factors that impair wound healing. Journal of the American College of Clinical Wound Specialists, 4(4), 84-91. https://doi.org/10.1016/j.jccw.2014.03.001
Shrestha, P., Cooper, B. S., Coast, J., Oppong, R., Do Thi Thuy, N., Phodha, T., & Lubell, Y. (2018). Enumerating the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Antimicrobial Resistance & Infection Control, 7, 1-9. https://doi.org/10.1186/s13756-018-0384-3
Nathwani, D., Varghese, D., Stephens, J., Ansari, W., Martin, S., & Charbonneau, C. (2019). Value of hospital antimicrobial stewardship programs [ASPs]: a systematic review. Antimicrobial Resistance & Infection Control, 8, 1-13.
https://doi.org/10.1186/s13756-019-0471-0
Cannon, M., Hersey, D., Harrison, S., Joy, B., Naguib, A., Galantowicz, M., & Simsic, J. (2016). Improving surveillance and prevention of surgical site infection in pediatric cardiac surgery. American Journal of Critical Care, 25(2), e30-e37. https://doi.org/10.4037/ajcc2016531
Trepka, M. J., Belongia, E. A., Chyou, P. H., Davis, J. P., & Schwartz, B. (2001). The effect of a community intervention trial on parental knowledge and awareness of antibiotic resistance and appropriate antibiotic use in children. Pediatrics, 107(1), e6-e6. https://doi.org/10.1542/peds.107.1.e6
Dhole, S., Mahakalkar, C., Kshirsagar, S., & Bhargava, A. (2023). Antibiotic prophylaxis in surgery: current insights and future directions for surgical site infection prevention. Cureus, 15(10). https://doi.org/10.7759/cureus.47858
Petrof, E. O., Claud, E. C., Gloor, G. B., & Allen-Vercoe, E. (2013). Microbial ecosystems therapeutics: a new paradigm in medicine? Beneficial microbes, 4(1), 53-65. https://doi.org/10.3920/BM2012.0039
Romandini, A., Pani, A., Schenardi, P. A., Pattarino, G. A. C., De Giacomo, C., & Scaglione, F. (2021). Antibiotic resistance in pediatric infections: global emerging threats, predicting the near future. Antibiotics, 10(4), 393.
https://doi.org/10.3390/antibiotics10040393
Larson, E. L., Saiman, L., Haas, J., Neumann, A., Lowy, F. D., Fatato, B., & Bakken, S. (2005). Perspectives on antimicrobial resistance: Establishing an interdisciplinary research approach. American journal of infection control, 33(7), 410-418. https://doi.org/10.1016/j.ajic.2005.05.006
Sun, L., Liu, S., Wang, J., & Wang, L. (2019). Analysis of Risk Factors for Multiantibiotic-Resistant Infections among Surgical Patients at a Children's Hospital. Microbial Drug Resistance, 25(2), 297-303.
https://doi.org/10.1089/mdr.2018.0279
Bobade, S., & Asutkar, S. (2025). Losing open approach surgical skills and techniques to minimally invasive surgery in the era of artificial intelligence: A narrative review. Multidisciplinary Reviews, 8(5), 2025135-2025135. https://10.31893/multirev.2025135
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
