Systematic review of international guidelines for perioperative antibiotic prophylaxis in Head & Neck Surgery. A YO-IFOS Head & Neck Study Group Position Paper

Head Neck. 2019 Sep;41(9):3434-3456. doi: 10.1002/hed.25856. Epub 2019 Jul 8.

Abstract

Background: Surgical site infection (SSI) is defined as an infection that occurs after a surgical incision or organ manipulation during surgery. The frequency reported for clean head and neck surgical procedures without antimicrobial prophylaxis is <1%. In contrast, infection rates in patients undergoing complicated cancer surgery are high, ranging from 24% to 87% of patients without antimicrobial prophylaxis.

Methods: Guidelines and recommendations about the use of antibiotics in head and neck surgery from 2004 to 2019 were reviewed.

Results: Four guidelines from Oceania, 5 from South America, 5 from North America, 2 from the United Kingdom, 11 from Europe, 1 from Africa, 1 from the Middle East, and 3 from Asia were included. A total of 118 papers were included for analysis and recommendation.

Conclusion: Antibiotic prophylaxis can decrease the incidence of SSI. However, the risks associated with antibiotic exposure and the risk of antibiotic resistance need to be taken into consideration.

Keywords: antibiotic; head; neck; prophylaxis; surgery.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antibiotic Prophylaxis*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Practice Guidelines as Topic
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / prevention & control*