Efficacy of Antibiotic Prophylaxis Prior to Tympanoplasty with Mastoidectomy for Contaminated Cholesteatoma

Abstract

Objectives:

Evaluate the efficacy of combined anti-staphylococcal and anti-pseudomonal preoperative antibiotics for preventing surgical site infections following tympanoplasty with mastoidectomy for contaminated cholesteatoma.

Methods:

Retrospective chart review of medical records of patients who underwent tympanoplasty with mastoidectomy for cholesteatoma were reviewed. Only cases considered to have contaminated or dirty/infected surgical fields were included. The primary outcome measure was postoperative perichondritis, pinna abscess, periotic cellulitis, and periotic abscess requiring systemic antibiotics or surgical intervention.

Results:

Charts of 362 patients who underwent tympanoplasty with mastoidectomy were reviewed, and 195 met inclusion criteria. Preoperative antibiotics included single doses of clindamycin and ceftazidime or gentamicin prior to incision. Patients that received no preoperative antibiotics had an infection rate of 11% and those given perioperative antibiotics had a rate of 1% (P = .02).

Conclusions:

Use of preoperative antibiotics covering both staphylococcus and pseudomonas species appears to be efficacious for the prevention of surgical site infections following tympanoplasty with mastoidectomy for contaminated cholesteatoma.