Antibiotic prophylaxis in clean and clean-contaminated ear surgery

Abstract

There is no strong evidence that the large scale use of prophylactic of antibiotics in clean and clean-contaminated ear surgery is helpful in reducing postoperative complications such as wound infection, discharge from the outer ear canal, labyrinthitis and graft failure.

Systematic Review of the Effectiveness of Perioperative Prophylactic Antibiotics for Skull Base Surgeries

“…16 Otolaryngologists have examined this issue in other fields, such as endoscopic sinus surgery, tonsillectomy, uncomplicated neck dissection, and otologic surgery, with findings that routine postoperative antibiotic use is not supported despite these surgeries also being in the clean-contaminated category. 1,[38][39][40] In addition, for clean-contaminated neurosurgical procedures, antimicrobial prophylaxis demonstrated no difference in postoperative meningitis and infection rate. 41,42 However, the American Society of Health System Pharmacists recommends 1 g of single-dose cefazolin within 60 minutes before skin incision for patients undergoing clean neurosurgical procedures or CSF-shunting procedures, without recommendations for clean-contaminated procedures.…”

Results of a European Survey on Current Controversies in Otology

“…In our survey, 20% of all surgeons routinely provide antibiotics in ear surgery for noninfected ears. However, according to a literature review, there is no strong evidence that the largescale use of antibiotics in clean and clean-contaminated ear surgery is helpful in reducing postoperative complications such as wound infection, discharge from the outer ear canal, labyrinthitis, and graft failure (2).…”

Clinical microbiology in the intensive care unit: Strategic and operational characteristics

“…The evidence regarding the efficacy of antibiotic prophylaxis in preventing postoperative infections is highly variable. Although there are clearly areas where the benefit of peri-operative antibiotics is fairly well established, [5][6][7] there are areas where there either no evidence that prophylaxis has any effect, [8] or the evidence on either side of the argument does not exist because of lack of adequate studies. [9] It is important that evidence based recommendations for surgical prophylaxis is adhered to not only in the choice and dose of agent but also for the duration.…”