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Korean J Urogenit Tract Infect Inflamm. 2014 Oct;9(2):111-114. Korean.
Published online October 31, 2014.
Copyright © 2014, Korean Association of Urogenital Tract Infection and Inflammation. All rights reserved.
Is Postoperative Prophylactic Antibiotics Necessary for Pediatric Scrotal and Inguinal Outpatient Surgeries?
Seungsoo Lee,1,2,* Chang Soo Park,2,* Sung Hye Jo,1 and Sang Don Lee1,2
1Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
2Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.

Correspondence to: Sang Don Lee. Department of Urology, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan 626-770, Korea. Tel: +82-55-360-2134, Fax: +82-55-360-2164, Email:

*These authors contributed equally to this study as co-first authors.

Received September 30, 2014; Revised October 12, 2014; Accepted October 22, 2014.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



Excess usage of antibiotics can cause complications of antibiotics and rise of antibiotic-resistant strains. However, guidelines for antibiotic prophylaxis differ between countries. We evaluated necessity of postoperative prophylactic antibiotics for pediatric patients who underwent scrotal and inguinal outpatient surgeries.

Materials and Methods

From April 2011 to April 2014, 725 patients (mean age, 30.5±21.6 months) who underwent outpatient surgery (hydrocelectomy, orchiopexy, orchiectomy, and inguinal herniorrhaphy) were evaluated. In group 1 (556 cases), each patient had intravenous antibiotic prophylaxis only preoperatively. In group 2 (169 cases), each patient had intravenous antibiotic prophylaxis pre- and post-operatively. In group 1 and group 2, we analyzed postoperative complications including wound dehiscence, fever, skin erythema, pain, pus, and diarrhea with medical records.


In group 1 and group 2, mean age was 30.4±21.7 months (5.0-108.0 months) and 30.8±21.2 months (7.0-108.0 months), respectively. In group 1 and group 2, the mean operative time was 29.6±2.4 minutes and 29.7±2.5 minutes, respectively. The differences of mean age and mean operative time were not statistically significant (p=0.82 and p=0.77, respectively). Nine patients in group 1 and two patients in group 2 had postoperative complications. The difference between two groups was statistically insignificant (p=0.69). According to age and operation, the differences of postoperative complications were not statistically significant. However, in patients under 2 years old, more complications tended to occur in group 1 than in group 2.


Postoperative prophylactic antibiotics may not be necessary for pediatric scrotal and inguinal outpatient surgeries.

Keywords: Antibiotic prophylaxis; Herniorrhaphy; Orchiopexy; Scrotal hydrocele


Table 1
Comparison of postoperative complications between group 1 and 2
Click for larger image

Table 2
Comparison of postoperative complications between group 1 and 2 according to age and operation
Click for larger image


No potential conflict of interest relevant to this article was reported.

1. McGowan JE Jr. Cost and benefit of perioperative antimicrobial prophylaxis: methods for economic analysis. Rev Infect Dis 1991;13 Suppl 10:S879–S889.
2. Cek M, Tandogdu Z, Naber K, Tenke P, Wagenlehner F, van Oostrum E, et al. Global Prevalence Study of Infections in Urology Investigators. Antibiotic prophylaxis in urology departments, 2005-2010. Eur Urol 2013;63:386–394.
3. Nam HJ, Jeong SC, Kong MY, Lee KS, Lee SD. Trial for clinical guideline of the use of prophylactic antibiotics in pediatric urologic outpatient surgery. Korean J Urogenit Tract Infect Inflamm 2012;7:50–55.
4. Chung JM, Lee SD. Korean Society of Pediatric Urology. The use of prophylactic antibiotics in pediatric urologic surgery: a questionnaire survey of pediatric urologist in Korea. J Korean Ped Urol 2010;2:29–37.
5. Dellinger EP, Gross PA, Barrett TL, Krause PJ, Martone WJ, McGowan JE Jr, et al. Infectious Diseases Society of America. Quality standard for antimicrobial prophylaxis in surgical procedures. Clin Infect Dis 1994;18:422–427.
6. Vaze D, Samujh R, Narasimha Rao KL. Risk of surgical site infection in paediatric herniotomies without any prophylactic antibiotics: A preliminary experience. Afr J Paediatr Surg 2014;11:158–161.
7. Knight R, Charbonneau P, Ratzer E, Zeren F, Haun W, Clark J. Prophylactic antibiotics are not indicated in clean general surgery cases. Am J Surg 2001;182:682–686.
8. Sanchez-Manuel FJ, Lozano-Garcia J, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev 2012;2:CD003769.
9. Hasan GZ, Saleh FM, Hossain MZ, Amin MR, Siddiqui TH, Islam MD, et al. Antibiotic prophylaxis is unnecessary in clean surgery. Mymensingh Med J 2013;22:342–344.
10. Berard F, Gandon J. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 1964;160 Suppl 2:1–192.
11. Barreca M, Stipa F, Cardi E, Bianchini L, Lucandri G, Randone B. Antibiotic prophylaxis in the surgical treatment of inguinal hernia: need or habit? Minerva Chir 2000;55:599–605.
12. Matsumoto T, Kiyota H, Matsukawa M, Yasuda M, Arakawa S, Monden K. Japanese Society of UTI Cooperative Study Group (Chairman; Tetsuro Matsumoto). Japanese guidelines for prevention of perioperative infections in urological field. Int J Urol 2007;14:890–909.
13. Wolf JS Jr, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Urologic Surgery Antimicrobial Prophylaxis Best Practice Policy Panel. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol 2008;179:1379–1390.
14. Agodi A, Barchitta M, Anzaldi A, Marchese F, Bonaccorsi A, Motta M. Active surveillance of nosocomial infections in urologic patients. Eur Urol 2007;51:247–253.
15. Ichikawa S, Ishihara M, Okazaki T, Warabi K, Kato Y, Hori S, et al. Prospective study of antibiotic protocols for managing surgical site infections in children. J Pediatr Surg 2007;42:1002–1007.