Prophylactic antibiotics in otolaryngologic surgeries: from knowledge to practice

Iran J Otorhinolaryngol. 2012 Spring;24(67):79-84.


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.

Keywords: Antibiotic; Head; Neck; Otolaryngology; Prophylaxis.