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Rethinking Perioperative Antibiotic Prophylaxis for Low-Risk Head and Neck Procedures
Avery Nelson1, Jordan W Baur2, Alison Lew2
1Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
The Annals of Otology, Rhinology, and Laryngology
|January 6, 2024
Summary
Many head and neck procedures do not require antibiotic prophylaxis. This study found unnecessary antibiotic use in 29% of low-risk procedures, with no impact on surgical site infections.
Area of Science:
- Otolaryngology
- Infectious Disease
- Surgical Prophylaxis
Background:
- Evidence supports ≤24 hours of perioperative antibiotics for clean-contaminated head and neck procedures.
- Low-risk otolaryngology procedures may not benefit from antibiotic prophylaxis.
- Antibiotic stewardship is crucial in surgical settings.
Purpose of the Study:
- To describe antibiotic use in low-risk head and neck procedures.
- To evaluate adherence to institutional guidelines for antibiotic prophylaxis.
- To assess the impact of unnecessary antibiotic use on outcomes.
Main Methods:
- Single-center, retrospective cohort study.
- Included patients undergoing low-risk, clean-contaminated head and neck procedures.
- Antibiotic use and surgical site infection (SSI) rates were analyzed.
Main Results:
- Perioperative antibiotics were unnecessarily given to 29% of patients.
- Of those receiving antibiotics, 76% had preoperative and 41% had postoperative courses (median 7 days).
- No significant differences in SSIs, mortality, or length of stay were observed between groups.
Conclusions:
- Highlighting the need for antibiotic stewardship interventions.
- Emphasizing the importance of collaboration between stewardship teams and surgical services.
- Suggesting a review of antibiotic prescribing practices for low-risk procedures.
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