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

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.