Perioperative use of antibiotics in otologic procedures

Abstract

Purpose of review: Surgical site infections (SSIs) have garnered tremendous attention in recent years. Surgeons tend to administer antimicrobial agents liberally, partly over fears of being sued or not paid to care for the SSI. As a result, microbial resistance to conventional agents continues to increase.

Recent findings: Few new studies have been published in the otologic literature. The use of perioperative 'bundles' has been shown to be effective in reducing SSIs in procedures such as craniotomy. A single dose of antistaphylococcal and antipseudomonal prophylaxis appears to be highly efficacious prior to contaminated tympanomastoid surgery. Overuse of antimicrobial therapy can paradoxically increase SSIs.

Summary: Otologic surgeons should adhere to established best practices when prescribing antimicrobial therapy perioperatively. Clinical trials of perioperative bundles are needed for otologic procedures.