Perioperative Antibiotics for Otologic Surgery

Abstract

A computerized PubMed search of MEDLINE 1966-November 2004 was performed. Articles mapping to any of the following medical subject headings were exploded and combined: “antibiotic prophylaxis,” “antibacterial agents,” “lactams,” “fluoroquinolones,” “macrolides,” “clindamycin.” These articles were then cross-referenced with those mapping to either the exploded medical subject heading “myringoplasty” or textword “myringoplasty.” This process yielded 21 trials. These articles were then reviewed to identify those that met the following inclusion criteria: 1) a distinct patient population under-going myringoplasty alone, 2) intervention with perioperative systemic antibiotics versus placebo or other no-antibiotic control, 3) outcome measured in terms of postoperative surgical site infections¹ and/or graft success, 4) randomized controlled trials (RCTs). The outcome of graft success was considered relevant because SSIs have been correlated with graft failure. Articles in which the use of randomization was not clearly specified were excluded.

Surgical site infection (SSI) is the term used by the Centers for Disease Control to specify an infection at the operative site, usually within 30 postoperative days [4]. This term excludes infections at other sites, such as pneumonias.