Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-26T05:23:04.519Z Has data issue: false hasContentIssue false
  • English
  • Français

Current trends in antibiotic prophylaxis for laryngectomy in the UK – a national survey

Published online by Cambridge University Press:  16 January 2015

R Harris ,
E Ofo ,
D Cope ,
I Nixon ,
R Oakley ,
J-P Jeannon  and
R Simo
R Harris
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
E Ofo
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
D Cope
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
I Nixon
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
R Oakley
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
J-P Jeannon
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
R Simo*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
*
Address for correspondence: Mr. Ricard Simo, Department of Otorhinolaryngology Head and Neck Surgery, 3rd Floor, Southwark Wing, Guy's and St Thomas' Hospital NHS Foundation Trust, St Thomas' Street, London SE1 9RT, UK Fax: 0207 188 2206 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

With the increasing use of chemoradiotherapy protocols, total laryngectomy carries increasing risks such as pharyngocutaneous fistula. There is little reference to the use of antibiotic prophylaxis in salvage surgery. This study aimed to determine the current practice in antibiotic prophylaxis for total laryngectomy in the UK.

Method:

A questionnaire was designed using SurveyMonkey software, and distributed to all ENT-UK registered head and neck surgeons.

Results:

The survey revealed that 19 surgeons (51 per cent) follow a protocol for antibiotic prophylaxis in primary total laryngectomy and 17 (46 per cent) follow a protocol in salvage total laryngectomy. Only 11 (30 per cent) use anti-methicillin-resistant Staphylococcus aureus agents in their antibiotic prophylaxis. The duration of prophylaxis varies considerably. Nineteen surgeons (51 per cent) revealed that their choice of antibiotic prophylaxis reflected non-evidence-based practices.

Conclusion:

There appears to be little evidence-based guidance on antibiotic prophylaxis in primary and salvage total laryngectomy. The survey highlights the need for more research in order to inform national guidance on antibiotic prophylaxis in primary and salvage total laryngectomy.

Keywords

LaryngectomyAnti-Bacterial AgentsChemoradiotherapyMethicillin-Resistant Staphylococcus AureusPrevention & ControlSalvage TherapyFistula
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 1 , January 2015 , pp. 63 - 67
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the British Association of Head and Neck Oncologists' annual meeting, 26 April 2013, London, UK.

References

1Simo, R, French, G. The use of prophylactic antibiotics in head and neck oncological surgery. Curr Opin Otolaryngol Head Neck Surg 2006;14:55–61Google Scholar
2Tabet, JC, Johnson, JT. Wound infection in head and neck surgery: prophylaxis, etiology and management. J Otolaryngol 1990;19:197–200Google Scholar
3Rubin, J, Johnson, JT, Wagner, RL, Yu, VL. Bacteriologic analysis of wound infection following major head and neck surgery. Arch Otolaryngol Head Neck Surg 1988;114:969–72CrossRefGoogle ScholarPubMed
4Johnson, JT, Myers, EN, Thearle, PB, Sigler, BA, Schramm, VL Jr.Antimicrobial prophylaxis for contaminated head and neck surgery. Laryngoscope 1984;94:46–51Google Scholar
5Weber, RS, Callender, DL. Antibiotic prophylaxis in clean-contaminated head and neck oncologic surgery. Ann Otol Rhinol Laryngol Suppl 1992;155:16–20Google Scholar
6Jeannon, JP, Orabi, A, Manganaris, A, Simo, R. Methicillin resistant Staphylococcus aureus infection as a causative agent of fistula formation following total laryngectomy for advanced head & neck cancer. Head Neck Oncol 2010;2:14Google Scholar
7Pang, L, Jeannon, JP, Simo, R. Minimizing complications in salvage head and neck oncological surgery following radiotherapy and chemo-radiotherapy. Curr Opin Otolaryngol Head Neck Surg 2001;19:125–31CrossRefGoogle Scholar
8Gil, Z, Gupta, A, Kummer, B, Cordeiro, PG, Kraus, DH, Shah, JP et al. The role of pectoralis major muscle flap in salvage total laryngectomy. Arch Otolaryngol Head Neck Surg 2009;135:1019–23Google Scholar
9Violaris, N, Bridger, M. Prophylactic antibiotics and post-laryngectomy pharyngocutaneous fistulae. J Laryngol Otol 1990;104:225–8Google Scholar
10Paydarfar, JA, Birkmeyer, NJ. Complications in head and neck surgery: a meta-analysis of postlaryngectomy pharyngocutaneous fistula. Arch Otolaryngol Head Neck Surg 2006;132:67–72Google Scholar
11Emerick, KS, Tomycz, L, Bradford, CR, Lyden, TH, Chepeha, DB, Wolf, GT et al. Primary versus secondary tracheoesophageal puncture in salvage total laryngectomy following chemoradiation. Otolaryngol Head Neck Surg 2009;140:386–90Google Scholar
12Scottish Intercollegiate Guidelines Network. Antibiotic Prophylaxis in Surgery (SIGN publication no.104). Edinburgh: SIGN, 2008Google Scholar
13Rodrigo, JP, Alvarez, JC, Gomez, JR, Suarez, C, Fernandez, JA, Martinez, JA. Comparison of three prophylactic antibiotic regimens in clean-contaminated head and neck surgery. Head Neck 1997;19:188–933.0.CO;2-Z>CrossRefGoogle ScholarPubMed
14Seven, H, Sayin, I, Turgut, S. Antibiotic prophylaxis in clean neck dissections. J Laryngol Otol 2004;118:213–16Google Scholar
15Nixon, IJ, Bingham, BJG. The impact of methicillin-resistant staphylococcus aureus on ENT practice. J Laryngol Otol 2006;120:713–17Google Scholar
16Shiomori, T, Miyamoto, H, Udaka, T, Okochi, J, Hiraki, N, Hohchi, N et al. Clinical features of head and neck cancer patients with methicillin-resistant Staphylococcus aureus. Acta Otolaryngol 2007;127:180–5CrossRefGoogle ScholarPubMed