Usage of Surgical Antibiotic Prophylaxis in Routine Otolaryngologic Surgeries in Turkey

Int Arch Otorhinolaryngol. 2022 Jul 11;27(1):e123-e129. doi: 10.1055/s-0042-1745727. eCollection 2023 Jan.

Abstract

Introduction: Inappropriate antibiotic use in the world leads to an increase in both health care costs and antibiotic resistance. Surgical antibiotic prophylaxis (SAP) is used by most surgeons, especially in the postoperative period. Objective The aim of the study is to determine the approach of ear, nose, and throat (ENT) specialists to surgical antibiotic prophylaxis in routine surgeries, and to raise awareness regarding inappropriate antibiotic use. Methods ENT specialists from all over Turkey participated in the study by filling out a data collecting form. The form consisted of 6 questions and was sent to specialists via email. Routine ENT operations such as adenoidectomy, tonsillectomy, adenotonsillectomy, ventilation tube application, septoplasty, rhinoplasty, septorhinoplasty (noncomplicated), tympanoplasty, and simple mastoidectomy were chosen for the study. Data were analyzed statistically. Results The form results of 110 ENT specialists were evaluated. The rate of participants who used and did not use SAP was 77.3% and 22.7%, respectively. The SAP usage rates of septoplasty, rhinoplasty, and septorhinoplasty operations were 84.7%, 81.2%, and 75.3%, respectively. For tympanoplasty and ventilation tube application operations, the rates were 82.4% and 24.7%, respectively. Finallly, the SAP usage rates of adenoidectomy, tonsillectomy, and adenotonsillectomy were 57.6%, 75.3%, and 72.9%, respectively. Conclusion Otolaryngological surgeries are often classified as clean or clean-contaminated surgeries. In most studies in the literature, it is reported that SAP use is unnecessary in routine otolaryngological surgery. Providing inservice training, regularly updating the prophylaxis guidelines and sharing these guidelines with surgeons may prevent inappropriate SAP use.

Keywords: antibiotic prophylaxis; ear nose and throat; infection.