A pilot study to assess the efficacy of antibiotic prophylaxis in clean otologic surgeries.

Latha Mary, T S (2007) A pilot study to assess the efficacy of antibiotic prophylaxis in clean otologic surgeries. Masters thesis, Christian Medical College, Vellore.


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Aim of the study: A study to evaluate the efficacy of antibiotic prophylaxis in the outcome of surgeries for CSOM tubotympanic type, namely post operative wound infection and graft status. 6. Introduction :Post operative surgical site infection and hospital acquired infections are a lingering problem as widespread antibiotic therapy has resulted in the emergence of bacteria resistant to antibiotics. The use of prophylactic antibiotics for surgeries has evolved over the last 20 years. Improvements in the timing of initial administration, the appropriate choice of antibiotic agents and shorter durations of administration have made its use valuable in reducing post operative wound infections. All the studies on antibiotic prophylaxis in otologic surgeries have been done in Western setups and there is no published data from the Indian subcontinent , where a course of antibiotics are given even in clean surgeries. As the climatic conditions and the general standard of living in a developing country like India differs from those in the West, this pilot study was undertaken to assess the outcome of antibiotic prophylaxis in an Indian set up. Cefuroxime was the drug used in this study because of its activity against both Gram positive and Gram negative bacteria and increased resistance to beta lactamases Methods: 50 patients with CSOM -tubotympanic disease, were included in the study. Intraoperatively, one dose of iv Cefuroxime 750 mg was given half an hour before the incision and no oral or systemic antibiotics given post operatively. The patients underwent either tympanoplasty alone or combined with cortical mastoidectomy. If the surgery lasted for more than three hours, the patient would receive a second dose of Cefuroxime 750 mg after six hours. The duration of surgery was calculated from the time of the incision to the placement of the last suture. The wound was examined on the second and the seventh post operative days for infection. Antibiotic ear drops were prescribed and the patient was asked to report in a month to assess the condition of the ear. Results : Out of the 50 patients, only one developed a wound infection and one patient developed acute otitis media following an upper respiratory infection. Out of the 24 patients who came for follow up, the grafts of 19 patients had taken up well and 5 patients had residual perforations. Conclusions : The infection rate obtained in this study, following the use of antibiotic prophylaxis in clean otologic surgeries, which is 4% ,is well within the range accepted by the US Centers for Disease Control and Prevention for clean surgeries, which is upto 5%. This study has proved that antibiotic prophylaxis using Cefuroxime axetil as a perioperative dose, is adequate in limiting post operative wound infection in surgeries for non discharging tubotympanic type of chronic suppurative otitis media.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clean otologic surgeries; wound infection; antibiotic prophylaxis
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 11 Jul 2017 05:02
Last Modified: 11 Jul 2017 05:02
URI: http://repository-tnmgrmu.ac.in/id/eprint/1412

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