Prophylactic Antibiotics in Otolaryngologic Surgeries: From Knowledge to Practice

Document Type: Original

Authors

1 Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Amir-Alam University Hospital

2 Cancer Institute, Cancer Research Center, Tehran University of Medical Sciences

3 3Department of Infectious Diseases Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction:
The management and use of antimicrobial drugs has clinical, economic, and environmental implications. In many countries, antimicrobial drugs are the most frequently prescribed therapeutic agents. Therefore, health-care policy should focus on how to establish a rational attitude toward antibiotics. This study was performed to investigate antibiotic usage as a prophylactic regimen in head and neck surgeries.
 Materials and Methods:
This study was a retrospective case series. Patients undergoing otolaryngology surgeries in a tertiary referral otolaryngology center were included. Members of operating room staff that were unaware of the study objectives collected patients’ data using a questionnaire that contained information regarding general medical condition, disease, surgical procedure, and prophylaxis regimen and duration.
 
Results:
Excluding infected patients, we studied 1349 patients during a four-month period who needed prophylactic antibiotics. A total of 34 different types of surgical procedures were performed. Out of the total number of patients, 503 (37.0%) received a parenteral antibiotic directly before surgery. The main antibiotics used before surgery were cephalosporins (94.9%). All of the 1349 patients were administered antibiotics after the procedure. These antibiotics where given with a mean number of doses of 4.81 (range: 1–68), and also consisted of mostly cephalosporins.
Conclusion:
Our results indicate that prophylactic antibiotics were being significantly misused in a tertiary referral center of a university hospital. Although teaching the principles of prophylaxis to physicians is important, we think that finding a way to bring this knowledge to practice is more important.