Effects of Prophylactic Antibiotics on Length of Stay and Total Costs for Pediatric Acute Pancreatitis: A Nationwide Database Study in Japan.
2020
Objectives Acute pancreatitis (AP) guidelines for adult patients do not recommend routine prophylactic use of antibiotics because of no clinical merit on mortality, infectious complications, or length of stay. Although the mortality of pediatric AP is low, no studies have explored the rationale for antibiotic use in pediatric patients. The aim of this study was to evaluate the effects of early prophylactic antibiotics on length of stay and total costs in pediatric patients. Methods Using the Japanese Diagnosis Procedure Combination database from 2010 to 2017, we used the stabilized inverse probability of treatment weighting method using propensity scores to balance the background characteristics in the antibiotics group and the control group, and compared length of stay and total costs between the groups. Results We found significant differences between the antibiotics group (n = 652) and the control group (n = 467) in length of stay (11 days vs 9 days; percent difference, 15.4%; 95% confidence interval, 5.0%-26.8%) and total costs (US $4085 vs US $3648; percent difference, 19.8%; 95% confidence interval, 8.0%-32.9%). Conclusions Prophylactic antibiotics were associated with longer length of stay and higher total costs. Our results do not support routine use of prophylactic antibiotics in pediatric AP populations.
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