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[Perioperative antibiotic prophylaxis during standard interventions in ear, nose and throat medicine]

U Walliczek1, C Thorn, M Königstein

  • 1Universitäts-HNO-Klinik Mannheim, Mannheim, Deutschland, wallicze@staff.uni-marburg.de.

HNO
|December 18, 2014
PubMed
Abstract

Insights

Stopping routine perioperative antibiotic prophylaxis (pAP) for standard ear, nose, and throat surgeries increased postoperative antibiotic use. However, this change did not affect other complications or hospital stay duration.

Area of Science:

  • Otorhinolaryngology
  • Surgical Infection Prevention
  • Clinical Practice Guidelines

Context:

  • Standard otorhinolaryngologic procedures are often classified as 'clean contaminated'.
  • Existing guidelines for perioperative antibiotic prophylaxis (pAP) in these procedures are lacking.
  • The clinical value of pAP for such interventions remains uncertain.

Purpose:

  • To evaluate the impact of discontinuing routine perioperative antibiotic prophylaxis (pAP) in standard otorhinolaryngologic surgeries.
  • To assess changes in postoperative complications and hospital stay after implementing a new standard operating procedure (SOP) that terminated routine pAP.
  • To analyze the effects of altering pAP protocols on patient outcomes in ear, nose, and throat procedures.

Summary:

  • A retrospective study compared outcomes before and after implementing an SOP that ceased routine pAP for tonsil, septum, and paranasal sinus surgeries.
  • The study included 316 patients pre-SOP and 308 patients post-SOP.
  • Termination of pAP resulted in a statistically significant increase in postoperative antibiotic treatment across all tested interventions.

Impact:

  • Discontinuation of pAP in standard otorhinolaryngologic procedures leads to increased postoperative antibiotic treatment.
  • There was no statistically significant change in non-inflammatory complications or length of hospital stay following the termination of pAP.
  • Findings suggest a need to re-evaluate antibiotic prophylaxis protocols in clean contaminated surgical procedures.

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