Artikel
Effects of a modification in the standard operating procedure regarding antibiotic prophylaxis for standard interventions in the field of otorhinolaryngology
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Autoren
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Boris A. Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Ute Walliczek
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Karl Hörmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
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Carsten Thorn
- Department of Otorhinolaryngology, Head and Neck Surgery, Mannheim, Germany
| Veröffentlicht: | 24. Juli 2014 |
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Gliederung
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The majority of standard interventions in the field of otorhinolaryngology are classified as “clean-contaminated” according to international classifications. For these interventions, there is no consensus regarding the necessity of a perioperative antibiotic prophylaxis (pAP). According to the current literature, there are only limited positive effects of such a pAP.
In August 2012, a modification to the standard operating procedure (SOP) regarding pAP was implemented in our department: The routine application of a single shot pAP for standard interventions was terminated. A retrospective chart review was performed for two 6-month periods (one before and one after implementation of the new SOP) to assess the effects of the new SOP on specific outcome measures for selected procedures (e.g., tonsillectomy, septoplasty and sinus surgery and their combinations). The charts were analyzed regarding age, gender, the necessity of postoperative antibiotic treatment, postoperative complication and the length of hospital stay.
The group before implementation of the new SOP (with_pAP) consisted of 316 patients (132f, 184m) with a mean age of 30±20 years. The group after implementation (without_pAP) consisted of 308 patients (128f, 180m) with a mean age of 31±19 years. In the with_pAP group, a postoperative antibiotic treatment was applied in 45 cases (14%), while in the without_pAPgroup, a postoperative antibiotic treatment was applied in 76 cases (25%).The majority of the cases in both groups were tonsillectomies. The necessity of postoperative antibiotic treatment increased by 1.25–4 times depending on the type of surgery performed. The length of hospital stay was unaffected by the change in pAP (7.1±3.0 days with pAP; 7.0±2.9 days without pAP) as was the rate of postoperative complications.
Termination of a routine pAP for standard interventions in the field of otorhinolaryngology led to an increase in the need for postoperative antibiotic treatment. However, there was no increase in the length of hospital stay or the rate of complications.
