Almosnino Galit, Zeitler Daniel M, Schwartz Seth R
1 Depatment of Otolaryngology/Head and Neck Surgery, Section of Otology/Neurotology, Virginia Mason Medical Center, Seattle, Washington, USA.
Ann Otol Rhinol Laryngol. 2018 Apr;127(4):266-269. doi: 10.1177/0003489418758101. Epub 2018 Feb 11.
Evaluate whether prophylactic antibiotics administered following cochlear implant (CI) surgery impact short-term infection rates.
Retrospective, concurrent, case-control.
Tertiary referral center.
All patients (range, 9 months-91 years) undergoing cochlear implantation between 2013 and 2017 (n = 188).
INTERVENTION(S): Starting in 2015, one surgeon stopped prescribing postoperative antibiotics after CI surgery. We compared infection rates in a control group that received antibiotics in the 18 months prior to this change (n = 95) to the cohort of patients that did not receive postoperative antibiotics (n = 49). In a second analysis, 44 patients that underwent CI surgery concurrently from a second surgeon and were prescribed postoperative antibiotics were compared to the 49 patients who did not receive postoperative antibiotics.
MAIN OUTCOME MEASURE(S): Postoperative infection rates in the perioperative period (0-30 days) following cochlear implantation.
None of the 49 cases and none of the 95 historic controls or 44 concurrent controls experienced postoperative infection.
In this sample, postoperative antibiotics following cochlear implantation did not impact perioperative infection rates. Unnecessary antibiotics can lead to increased resistance, allergic sequelae, and unnecessary costs while having little effect on reducing infection rates. This pilot study should encourage surgeons to reevaluate standard practice around antibiotic use after CI surgery.
评估人工耳蜗植入（CI）手术后预防性使用抗生素是否会影响短期感染率。
回顾性、同期病例对照研究。
三级转诊中心。
2013年至2017年间接受人工耳蜗植入的所有患者（年龄范围9个月至91岁，n = 188）。
从2015年开始，一名外科医生在人工耳蜗植入手术后停止开具术后抗生素处方。我们将在此变化前18个月接受抗生素治疗的对照组患者（n = 95）与未接受术后抗生素治疗的患者队列（n = 49）的感染率进行了比较。在第二项分析中，将另一名外科医生同期进行人工耳蜗植入手术并开具术后抗生素处方的44例患者与49例未接受术后抗生素治疗的患者进行了比较。
人工耳蜗植入后围手术期（0 - 30天）的术后感染率。
49例患者以及95例历史对照患者和44例同期对照患者中均无术后感染发生。
在本样本中，人工耳蜗植入术后使用抗生素对围手术期感染率没有影响。不必要的抗生素会导致耐药性增加、过敏后遗症以及不必要的费用，同时对降低感染率几乎没有作用。这项初步研究应促使外科医生重新评估人工耳蜗植入手术后抗生素使用的标准做法。
