OBJECTIVES: Infection rates associated with intrathecal baclofen pump (ITBP) procedures are 4.5-9%. Practice guidelines recommend appropriate administration of perioperative antimicrobial prophylaxis (cefazolin or vancomycin monotherapy) to reduce surgical infection, which is expected to decrease morbidity and mortality, and control duration/cost of care. This study explored the prevalence and specific antibiotic prophylaxis (AP) used in pediatric patients undergoing ITBP placement and factors associated with compliance of AP use. METHODS:  Using Pediatrics Health Information System (PHIS), the study cohort comprised patients who had ITBP surgery (ICD-9 CM procedure code 86.06) within 3 days of admission, between 7/1/2004-12/31/2013, with minimum follow up 90 days. Exclusion criteria were prior infection, antibiotic use within 30 days of admission, and/or missing financial data. Chi-squared test and multivariate logistic regression were used to determine factors associated with compliance to AP administration in ITBP surgeries. Analyses used SAS^®