Association of Recent Antibiotic Therapy on Post-Thyroidectomy Wound Complications

To assess the association between antibiotic use, for any indication, within 30 days prior to thyroidectomy and the incidence of surgical site infections (SSIs) using a large global electronic medical records database.

A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults who underwent thyroidectomy were stratified into two groups: those who received antibiotics within 30 days prior to the surgical procedure and those who did not. Propensity score matching (PSM) was employed to adjust for demographic and clinical variables. The primary outcome was the development of SSIs up to 90 days following the surgical procedure. Secondary outcomes included wound dehiscence, emergency department (ED) visits, and the use of post-operative antibiotics.

After 1:1 PSM, each cohort consisted of 3,518 patients. At 30 days following thyroidectomy, patients who received antibiotics prior to the surgical procedure exhibited significantly higher risks of SSI (risk ratio [RR] 1.75, 95% confidence interval [CI]: 1.136-2.695), wound dehiscence (RR 2.571, 95% CI: 1.389-4.759), ED visits (RR 1.367, 95% CI: 1.126-1.661), and post-operative antibiotic use (RR 4.205, 95% CI: 3.702-4.775) compared to patients without pre-operative antibiotic exposure. These elevated risks were also observed at 60 and 90 days post-surgical procedure.

Exposure to pre-surgical antibiotics, for any reason, is associated with post-thyroidectomy complications for at least 90 days. This finding should be considered in the decision-making process regarding the timing of the surgical procedure, particularly for elective, non-urgent procedures such as thyroidectomy.