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Appropriate use of antibiotics to prevent surgical site infections varies substantially across children’s hospitals, according to a  reported today in JAMA Pediatrics. Based on a review of administrative data from 31 freestanding children’s hospitals between 2010 and 2013, appropriate use of surgical antibiotic prophylaxis varied by hospital from 47.3% to 84.4%. When antibiotic prophylaxis was indicated for a procedure based on guidelines or consensus statements, the median rate of appropriate use was 93.8%; when antibiotic prophylaxis was not recommended, the median rate of appropriate use was 52%. The authors said the lack of pediatric-specific guidelines for antibiotic prophylaxis use may be the most likely reason for the variation. They cited an urgent need for additional research to document the procedure-specific risk of surgical site infection among pediatric patients and establish strategies to improve antibiotic prophylaxis use for children.