Questioning routine antibiotic prophylaxis in sialendoscopy: a single-surgeon 164-case analysis

Area of Science:

• Otolaryngology
• Surgical Infection Prevention
• Salivary Gland Disorders

Background:

• Sialendoscopy is a minimally invasive technique for diagnosing and treating salivary gland disorders.
• The role of peri-operative antibiotics in reducing infection rates following sialendoscopy is not well-established.
• Understanding infection risk factors is crucial for optimizing patient care and antibiotic stewardship.

Purpose of the Study:

• To evaluate the association between different antibiotic regimens (pre-operative, post-operative, both, or none) and post-operative infection rates in patients undergoing sialendoscopy.
• To determine if conversion to a hybrid or open procedure influences infection rates.

Main Methods:

• Retrospective chart review of 164 patients who underwent sialendoscopy between 2020 and 2023.
• Data collected included patient demographics, operative details (gland explored, findings, conversion to hybrid/open), and antibiotic administration.
• Statistical analysis utilized chi-squared tests and descriptive statistics to compare infection rates across antibiotic groups.

Main Results:

• A total of 164 sialendoscopies were analyzed; 28.7% required conversion to hybrid procedures.
• Antibiotic usage varied: 39% received no antibiotics, 26.8% received both pre- and post-operative, 24.2% received pre-operative only, and 10.6% received post-operative only.
• The overall post-operative infection rate was 2.6% (3 patients), with no statistically significant difference observed between the antibiotic groups (p=0.23) or based on procedure conversion.

Conclusions:

• Peri-operative antibiotic administration did not demonstrate a significant reduction in post-operative infection rates compared to no antibiotics in sialendoscopy.
• Infection rates were comparable regardless of whether the procedure was converted to a hybrid/open approach.
• Further investigation via prospective clinical trials is warranted to definitively assess the necessity of antibiotic use in diagnostic sialendoscopy.