Perioperative use of antibiotics in otologic procedures

Area of Science:

• Otolaryngology
• Infectious Disease
• Surgical Innovation

Background:

• Surgical site infections (SSIs) are a growing concern in otologic surgery.
• Liberal use of antimicrobials by surgeons, driven by fear of litigation or payment issues, contributes to increasing microbial resistance.
• The rise in antimicrobial resistance poses a significant challenge to effective patient care.

Purpose of the Study:

• To review current strategies for preventing SSIs in otologic procedures.
• To evaluate the impact of antimicrobial stewardship on microbial resistance.
• To identify best practices for perioperative antimicrobial use in otology.

Main Methods:

• Review of recent literature on SSIs in otologic surgery.
• Analysis of the efficacy of perioperative antimicrobial strategies.
• Evaluation of the role of antimicrobial stewardship programs.

Main Results:

• Limited new studies in otologic literature, but perioperative 'bundles' show promise in reducing SSIs, as seen in craniotomy procedures.
• A single dose of antistaphylococcal and antipseudomonal prophylaxis is effective before contaminated tympanomastoid surgery.
• Paradoxically, overuse of antimicrobial therapy can lead to an increase in SSIs.

Conclusions:

• Otologic surgeons must adopt established best practices for perioperative antimicrobial prescribing.
• Further clinical trials are necessary to validate the effectiveness of perioperative bundles specifically for otologic procedures.
• Implementing antimicrobial stewardship is crucial to combat resistance and improve patient outcomes.