Perioperative antibiotic prophylaxis during standard interventions in ear, nose and throat medicine

The majority of standard interventions in otorhinolaryngology are classified as "clean contaminated" according to international classifications; correspondingly, no generally accepted recommendations regarding perioperative antibiotic prophylaxis (pAP) exist. The value of such pAP for these interventions remains unclear. Aim of the study was to assess the effects of pAP in selected standard otorhinolaryngologic procedures. In August 2012 a standard operating procedure (SOP) was implemented, which lead to termination of routine pAP for the majority of standard operations. All patients included in this retrospective study had undergone a standard procedure (tonsil, septum or paranasal sinus surgery) during a period either 6 months before or 6 months after the inauguration of the SOP. The charts were reviewed for demographic factors, postoperative complications and length of hospital stay. The group before the inauguration of the SOP consisted of 316 patients (132 female, 184 male), aged 30 +/- 20 years. The group after the inauguration comprised 308 patients (128 female, 180 male), aged 31 +/- 19 years. For the entire patient collective, the termination of pAP led to a statistically significant increase in postoperative antibiotic treatment for all types of interventions tested. A statistically significant change in noninflammatory complications or the length of hospital stay was not detected. The termination of pAP during standard procedures in otorhinolaryngology is associated with an increase in postoperative antibiotic treatment but has no effect on other postoperative complications tested or the length of hospital stay.