Prophylactic Antibiotic Practices in Common Otologic Surgeries in Iran

Area of Science:

• Otolaryngology
• Surgical Infections
• Antimicrobial Stewardship

Background:

• Rational surgical antibiotic prophylaxis is recommended for specific procedures.
• Inappropriate antibiotic use increases risks like antibiotic resistance and costs.
• Current practices in otologic surgery require evaluation.

Purpose of the Study:

• To assess the current practices of antibiotic prescription by otolaryngologists for common otologic surgeries.
• To identify deviations from evidence-based guidelines in antibiotic prophylaxis.

Main Methods:

• A cross-sectional study involving 257 otolaryngologists with over 5 years of experience.
• Participants completed a checklist on antibiotic regimen and timing for surgeries (tympanoplasty, tympanomastoidectomy, stapes, MEE).

Main Results:

• High rates of postoperative antibiotic prophylaxis were observed across all procedures, regardless of ear condition (dry/wet).
• Preoperative and intraoperative prophylaxis rates varied, with some inconsistencies noted, especially in wet ears.
• Cephazolin, cephlexin, and ciprofloxacin drops were the most frequently prescribed antibiotics.

Conclusions:

• Significant inappropriate administration and timing of antibiotic prophylaxis were identified in otologic surgeries.
• Many surgeons prescribed prophylactic antibiotics even without clear evidence, particularly in tympanoplasty and tympanomastoidectomy without cholesteatoma.
• Findings highlight a need for improved adherence to antibiotic prophylaxis guidelines in otologic surgery.