Efficacy of antibiotic prophylaxis prior to tympanoplasty for contaminated cholesteatoma.

Abstract

OBJECTIVES:

To evaluate the efficacy of combined antistaphylococcal and antipseudomonal preoperative antibiotics for preventing surgical site infections following tympanoplasty and mastoidectomy with contaminated cholesteatoma.

STUDY DESIGN:

Retrospective chart review.

METHODS:

Medical records of patients who underwent tympanoplasty ± mastoidectomy for cholesteatoma were reviewed. Only cases considered to have contaminated or dirty surgical fields were included. The primary outcome measure was occurrence of postoperative surgical site infections, perichondritis, pinna abscess, periotic cellulitis, or periotic abscess requiring systemic antibiotic therapy or surgical intervention.

RESULTS:

The charts of 326 patients who underwent tympanoplasty ± mastoidectomy were reviewed. Of those, 195 met inclusion criteria. Preoperative antibiotics included clindamycin and ceftazidime or gentamicin. Patients treated with no perioperative antibiotics had a surgical site infection rate of 11%, and those treated with perioperative antibiotics had a rate of 1% (P = 0.02).

CONCLUSION:

Administration of preoperative antibiotics to cover staphylococcal and pseudomonal species may prevent surgical site infections with tympanoplasty ± mastoidectomy for contaminated cholesteatoma.

LEVEL OF EVIDENCE:

4. Laryngoscope, 126:2363-2366, 2016.

• Authors: Nathan E Pierce, Patrick J Antonelli
• Journal: The Laryngoscope (Laryngoscope) Vol. 126 Issue 10 Pg. 2363-6 (10 2016) ISSN: 1531-4995 [Electronic] United States
• PMID: 27497428 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Chemical References

• Anti-Bacterial Agents
• Gentamicins
• Clindamycin
• Vancomycin
• Ceftazidime

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (administration & dosage)
• Antibiotic Prophylaxis (methods)
• Ceftazidime (administration & dosage)
• Child
• Child, Preschool
• Cholesteatoma, Middle Ear (drug therapy, microbiology)
• Clindamycin (administration & dosage)
• Female
• Gentamicins (administration & dosage)
• Humans
• Male
• Middle Aged
• Pseudomonas Infections (etiology, prevention & control)
• Retrospective Studies
• Staphylococcal Infections (etiology, prevention & control)
• Surgical Wound Infection (etiology, microbiology, prevention & control)
• Treatment Outcome
• Tympanoplasty (adverse effects, methods)
• Vancomycin (administration & dosage)
• Young Adult