Impact of preoperative antibiotic use in preventing complications of cochlear implantation surgery

Abstract

Objective

To examine the impact of preoperative antibiotic prophylaxis on the occurrence of postoperative complications.

Materials and Methods

Data of 491 patients undergoing cochlear implantation were included in a non–randomized retrospective comparative cohort study. Demographic data, cochlear implant and surgical details, use of preoperative antibiotics and occurrence of postoperative complications were analyzed using a binary logistic regression model.

Results

There were 317 patients (64.56%) who did not receive preoperative antibiotic prophylaxis and 174 (35.44%) patients who received preoperative antibiotic prophylaxis with ceftriaxone. The overall rate of complications requiring surgical treatment was 2.85%. Younger patient age was identified as a positive predictive factor for administering preoperative antibiotic prophylaxis (p<0.001, OR 1.05 CI 95% 1.0124–1.0826). No difference in complication rate was observed between the two groups. No correlation between sex, age, manufacturer, surgeon and postoperative complications were noted (p=0.45).

Conclusion

There is insufficient evidence to inform decision making regarding preoperative intravenous ceftriaxone use for prevention of infection after cochlear implantation surgery, with data failing to show that administration of preoperative antibiotics leads to a decrease in complication rate. Considering a very low overall complication rate, with few complications related to infection, routine use of preoperative antibiotic prophylaxis should be analyzed further.

Keywords:

• Preoperative antibiotics
• Ceftriaxone
• Cochlear implant
• Complication
• Infection
• Revision
• Explantation

Disclaimer statements

Contributors No.

Funding No.

Conflicts of interest No.

Ethics approval No.

Supplemental material

Supplemental data for this article can be accessed at https://doi.org/10.1080/14670100.2021.2013586

Additional information

Notes on contributors

A. Košec

A. Košec, MD, PhD, FEBORL-HNS is a Consultant and Assistant Professor in Otorhinolaryngology and Head and Neck Surgery at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Zagreb, Croatia and School of Medicine, University of Zagreb. He is a Fellow of the European Board of Otorhinolaryngology and Head and Neck Surgery, the European Academy of Otology and Neurotology and the Politzer Society. He is an otologist and Associate Fellow of the American College of Surgeons and a member of Collegium ORL Amicitiae Sacrum.

J. Živko

J. Živko, MD and Stela Marković, MD are medical students devoting their time to research at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Zagreb, Croatia. They are members of the Student ENT Section at the School of Medicine, University of Zagreb.

V. Bedeković

V. Bedeković, MD, PhD is a Consultant and tenured Professor and Chair of the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Zagreb, Croatia and School of Medicine, University of Zagreb.

M. Ries

M. Ries, MD, PhD is a Consultant and Associate Professor at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Zagreb, Croatia and School of Medicine, University of Zagreb. He is a senior otologist with extensive experience in performing cochlear implant surgery.

J. Ajduk

J. Ajduk, MD, PhD is a Consultant and Associate Professor at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre milosrdnice, Zagreb, Croatia and School of Medicine, University of Zagreb. He is a senior otologist with extensive experience in performing cochlear implant surgery.