Changing trends in antibiotic prophylaxis in head and neck surgery: Is short-term prophylaxis feasible?

Abstract

Background: The duration and dosage of prophylactic antibiotics vary substantially among surgeons. This study explored the outcome and efficiency of short-term antibiotic prophylaxis in head and neck procedures. Methods: One hundred and forty-three patients undergoing various head and neck surgical procedures were included. They were categorized into two groups, clean (Group C) and clean-contaminated (Group CC). They received short-term prophylaxis with intravenous (IV) antibiotics. Group C patients received single dose IV antibiotic at induction and Group CC received antibiotic for 3 days. The scoring methods such as American Society of Anesthesiologist (ASA) score, National Nosocomial Infections Surveillance (NNIS) score, and additional treatment, discharge, erythema, purulent discharge, separation of deep tissue, isolation of bacteria and stay (ASEPSIS) were used. Scoring methods were used to analyze the risk factors and complications up to a period of 4 weeks postoperatively. Results: There were 83 patients in Group C and 60 patients in Group CC. Parameters such as body weight, body mass index (BMI), biochemical and hematological parameters along with surgical details, and postoperative wound assessment were analyzed. A significant association of surgical site infection (SSI) with BMI, anemia, hypoalbuminemia, and tobacco usage was noted along with a high incidence of SSI in surgical procedures involving the larynx. There was no significant relationship with ASA score and NNIS score. Conclusion: Short-term antibiotic prophylaxis in clean and clean-contaminated cases is feasible and effective as long-term prophylaxis. Correction of anemia, hypoalbuminemia, weight reduction, and avoidance of tobacco can prevent SSIs.

Keywords

• Antibiotic prophylaxis
• clean and contaminated surgery
• surgical site infection