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Antibiotic prophylaxis in otolaryngologic surgery

Sergio Obeso1, Juan P Rodrigo, Rafael Sánchez

  • 1Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Asturias, España. sergioobeso@yahoo.es

Acta Otorrinolaringologica Espanola
|January 12, 2010
PubMed

Insights

Perioperative antibiotics reduce infections in upper respiratory tract surgery, but optimal protocols and guidelines for reconstructive procedures remain unclear. Evidence-based antibiotic use is needed across various ENT surgeries.

Area of Science:

  • Otorhinolaryngology
  • Surgical Infections
  • Antibiotic Prophylaxis

Background:

  • Numerous trials since the 1980s demonstrate reduced infections with perioperative antibiotics in clean-contaminated upper respiratory tract surgery.
  • However, consensus on optimal antibiotic protocols and guidelines for reconstructive flap procedures is lacking.
  • Antibiotic use in specific ENT procedures like tonsillectomy and cochlear implants often relies on preference over evidence.

Purpose of the Study:

  • To review clinical trials on antibiotic use in various otorhinolaryngological (ENT) procedures.
  • To assess antibiotic choice, treatment duration, and administration routes based on available evidence.
  • To identify gaps in clinical trial data for specific ENT surgeries.

Main Methods:

  • Systematic review of clinical trials concerning antibiotic use in otorhinolaryngological surgery.
  • Analysis focused on different surgical procedures, antibiotic selection, treatment length, and administration methods.
  • Identification of procedures lacking dedicated clinical trials.

Main Results:

  • Evidence supports antibiotic use in reducing infections for clean-contaminated upper respiratory tract surgery.
  • No established consensus exists for the best antibiotic protocols or guidelines for reconstructive surgery.
  • Clinical trials are absent for laryngo-pharyngeal laser surgery and cochlear implant surgery, though prophylaxis is recommended.
  • Antibiotic selection in many ENT procedures is based on institutional or personal preference.

Conclusions:

  • While perioperative antibiotics are effective in reducing surgical site infections in the upper airway, evidence-based guidelines are needed.
  • Further research and clinical trials are essential to establish optimal antibiotic strategies for diverse ENT procedures, including laser and cochlear implant surgeries.
  • Standardized, evidence-based antibiotic protocols are crucial to replace current preference-based practices in otorhinolaryngology.

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