Efficacy of antibiotic prophylaxis prior to tympanoplasty for contaminated cholesteatoma
Presented at the American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting, Orlando, Florida, U.S.A., September 21–24, 2014.
Financial support for this study was provided by the University of Florida. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
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
