Prophylactic antibiotics has no benefit for outcome in clean myringoplasty-A register-based cohort study from SwedEar

Clin Otolaryngol. 2023 Nov;48(6):895-901. doi: 10.1111/coa.14089. Epub 2023 Aug 9.

Abstract

Objectives: To investigate if prophylactic antibiotics (PA) in conjunction with myringoplasty of clean and uninfected ears entails a reduction of postoperative infections within 6 weeks after surgery, and whether it affects the healing rate of the tympanic membrane (TM) at follow-up, 6-24 months after surgery.

Design: A retrospective cohort study of prospectively collected data.

Setting: Data extracted from The Swedish Quality Register for Ear Surgery (SwedEar), the years 2013-2019.

Participants: All patients in SwedEar with a registered clean conventional myringoplasty (tympanoplasty type I) including a follow-up visit.

Main outcome measures: The effect of PA use on TM healing rate at follow-up and postoperative infection within 6 weeks of surgery.

Results: In the study group (n = 1665) 86.2% had a healed TM at follow-up. There was no significant difference between the groups that had PA administered (87.2%) or not (86.1%). A total of 8.0% had a postoperative infection within 6 weeks. Postoperative infection occurred in 10.2% of the group that received PA (n = 187) compared with 7.7% of the group that did not receive PA. However, this difference was not statistically significant. Postoperative infection within 6 weeks significantly lowered the frequency of healed TMs.

Conclusion: PA administered during clean conventional myringoplasty does not improve the chance of having a healed TM at follow up, nor decrease the risk of having a postoperative infection within 6 weeks after surgery.

Keywords: myringoplasty; postoperative infection; prophylactic antibiotics; tympanic membrane; tympanoplasty.

MeSH terms

  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Antibiotic Prophylaxis / statistics & numerical data
  • Cohort Studies
  • Follow-Up Studies
  • Humans
  • Myringoplasty* / adverse effects
  • Myringoplasty* / statistics & numerical data
  • Registries / statistics & numerical data
  • Retrospective Studies
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / etiology
  • Surgical Wound Infection* / prevention & control
  • Sweden / epidemiology
  • Treatment Outcome
  • Tympanic Membrane Perforation* / drug therapy
  • Tympanic Membrane Perforation* / epidemiology
  • Tympanic Membrane Perforation* / surgery
  • Tympanic Membrane* / drug effects
  • Tympanic Membrane* / injuries
  • Tympanic Membrane* / surgery
  • Wound Healing* / drug effects

Substances

  • Anti-Bacterial Agents