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Antibiotic Use and Infection Rate for Distal Finger Laceration in the Pediatric Population
Yesmeen M. Elgabori, BA, Alejandro J. Friedman, MA, Janet Hsu, BS; Steven M. Koehler, M.D.
Montefiore Medical Center, Bronx, NY
Introduction: Understanding the relationship between antibiotic administration and infection in the context of pediatric finger lacerations can help inform clinical decision-making. This study investigates infection rates and their association with antibiotic use in a large pediatric cohort.
Materials and Methods:
We retrospectively queried the Pediatric Health Information System (PHIS) database and identified 19,340 pediatric patients (mean age 7.3 years; 12,222 male, 7,117 female) seen in emergency departments for finger lacerations. Descriptive statistics were generated and univariate analyses by chi square were performed.
Results:
A total of 8,050 patients (41.6%) received antibiotics. Infections were identified in 235 patients (1.2%), with 104 (44.3%) due to finger lacerations and 131 (55.7%) due to other causes, including respiratory (n = 74) and miscellaneous (n = 55) infections. Among those with infections, 145 (61.7%) had received antibiotics and 90 (38.3%) had not. Infection rates were significantly higher among patients who received antibiotics versus those who did not (1.8% vs. 0.8% p < 0.001, NNT = 100). Finger laceration infections were associated with antibiotic use (77/8,050, 1.0%). A chi-square test revealed a significant difference in infection type by antibiotic exposure (?² = 12.2, p < 0.001).
Conclusion:
In this large pediatric cohort, infection rates were significantly higher among patients who received antibiotics. Finger laceration infections comprised nearly half of all infections and were more frequently associated with antibiotic use compared to other infection types. This highlights the need for clearer guidelines on antibiotic use in pediatric distal finger lacerations to improve outcomes. Our results suggest that prophylactic antibiotic use in pediatric finger lacerations are not recommended and are of dubious benefit.
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