Objective:

To evaluate the knowledge, attitudes, and practices (KAP) of pediatric surgeons regarding perioperative antibiotic prophylaxis (PAP) and identify determinants of non-compliant behaviors.

Approach:

• Study Design: A multicenter, cross-sectional study was conducted across Children's hospitals in Jiangsu Province, China, surveying 143 surgeons using a validated questionnaire.
• Data Analysis: Data were analyzed using Spearman's rank correlation to assess knowledge-practice associations and K-Means clustering to identify behavioral patterns.

Key Findings:

• Valid response rate of 95.3% from surveyed surgeons.
• Surgeons showed high cognitive accuracy in drug selection (>84.0%) and administration timing (95.1%).
• Only 74.8% acknowledged the guideline of discontinuing prophylaxis within 24 hours for Class I incisions.
• A significant positive correlation was found between knowledge and practice scores (r = 0.579, P < 0.001).
• Cluster analysis revealed a 'Knowledge-Practice Disassociation' in Oncology, Burns, and SICU departments.

Interpretation:

High cognitive reserve among surgeons does not guarantee consistent adherence to standard practices, particularly in high-risk departments.

Limitations:

• The study's findings may not be generalizable beyond Jiangsu Province.
• Self-reported data may introduce bias in assessing knowledge and practices.

Conclusion:

Further verification in targeted investigations is required to explore the association between focus on SSI and guideline adherence.