Association of the Duration of Antibiotic Therapy With Major Surgical Site Infection in Cochlear Implantation

Sayed-Hassan, Achraf; Hermann, R.; Chidiac, Frédéric; Truy, Éric; Guevara, N.; Bailleux, Sonanda; Deguine, Olivier; Baladi, Blandine; Gallois, Yohan; Bozorg-Grayeli, Alexis; Lerosey, Y.; Godey, Benoît; Parietti‐Winkler, Cécile; Pereira, Bruno; Mom, T.

doi:10.1001/jamaoto.2018.1998

Cited by 15 publications

(26 citation statements)

References 32 publications

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“…As such, the role of postoperative oral antibiotics in preventing infectious complications is unclear. 7,8…”

mentioning

confidence: 99%

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Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Moon¹,

Qian²,

Ahmad³

et al. 2022

Otolaryngol.--head neck surg.

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Objective To describe the natural history, detail the treatment patterns, and identify the risk factors for cochlear implant (CI) infections in a large US cohort. Study Design Retrospective study based on insurance claims. Setting Optum Data Mart database: 6101 patients who received CIs from 2003 to 2019. Methods Infections, treatments patterns, and timelines were described. A multivariable logistic regression model was used to assess the association between postoperative oral antibiotics and CI infection. Results The cohort includes 4736 (77.6%) adults and 1365 (22.4%) children. Between adult and pediatric patients, rates of CI infection (5.1% vs 4.5%, P = .18) and explantation (1.2% vs 0.8%, P = .11) were not significantly different. Infections typically occurred within 5 months of surgery. Children were diagnosed with CI infection earlier than adults (median difference, –1.5 months; P = .001). Postoperative oral antibiotic supply was not associated with lower risk of CI infection in either children or adults. However, among adults, otitis media was associated with higher odds of CI infection (odds ratio, 1.41; P < .001), while higher income was associated with lower odds of CI infection (odds ratio, 0.71; P = .03). Conclusions Postoperative oral antibiotics were not associated with lower risk of infection or interventions. Otitis media episodes and lower income were associated with increased risk of infection among adults as well as intervention overall. Infection typically presented within the first 6 months after surgery, with children presenting earlier than adults. Overall, our findings serve as a resource for providers to consider in their care of patients with CIs.

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“…As such, the role of postoperative oral antibiotics in preventing infectious complications is unclear. 7,8…”

mentioning

confidence: 99%

“…Currently, risk factors that may predispose patients to CI infections are not well understood. As such, the role of postoperative oral antibiotics in preventing infectious complications is unclear 7,8 …”

mentioning

confidence: 99%

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Moon¹,

Qian²,

Ahmad³

et al. 2022

Otolaryngol.--head neck surg.

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show abstract

“…After title and abstract review, 1945 articles were excluded according to exclusion criteria. A full‐text review was completed on the remaining 179 articles and a total of 38 articles were included for data analysis 4,14–50 . A total of 10 articles met the criteria for meta‐analysis and 28 articles were included for the qualitative systematic review, as they had data regarding wound complications following CI reporting patient‐level factors.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Adult and Pediatric Cochlear Implant Wound Complications: AMeta‐Analysis

et al. 2022

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Objective To compare age‐related differences in wound complications following cochlear implantation (CI). Methods We performed a systematic review of PubMed, Cochrane Database, and Web of Science databases to identify original research evaluating the patient‐level factors (demographics and medical history) associated with wound complications following CI. Outcomes were expressed as relative risk (RR) with 95% confidence intervals using the inverse variance method. Studies without comparison groups were described qualitatively. Results Thirty‐eight studies representing 21,838 cochlear implantations were included. The rate of wound complications ranges from 0% to 22%. Patient age (adult versus pediatric) was the only factor with comparison groups appropriate for meta‐analysis. The 10 studies (n = 9547 CI's) included in the meta‐analysis demonstrated that adults had a higher incidence of overall wound complications (2.94%) than in children (2.44%) (RR 1.31, 95% CI 1.01–1.69). Adults had a higher incidence of general/unclassified wound complications (2.07%) than in children (1.34%) (RR 1.68, 95% CI 1.12–2.52). There was no difference between adults and children for specific complications such as hematoma, infection, or seroma. Elderly patients (over age 75) have wound complication rates that range from 1% to 4%. No studies contained comparison groups regarding other patient‐level factors and CI wound complications. Conclusion CI wound complication rates reported in the literature are low; however, adults have a higher risk of these complications than pediatric patients. The reported complication rate in elderly adults is low. There is a gap in CI research in consistently reporting wound complications and rigorous research investigating the impact of patient‐level factors and wound complications. Level of Evidence NA Laryngoscope, 133:218–226, 2023

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“…Also discussed is how to perform SAP, whether with a single pre-intervention dose or with a more or less protracted antibiotic administration after surgical wound closure. A recent French study showed that a short treatment is ideal for adults, while a protracted one is more effective in children [57]. However, our panel of experts considered pre-operative antibiotic prophylaxis with a single dose of cefazolin EV as more appropriate, as recommended for clean/contaminated or contaminated ear surgery [49].…”

Section: Scenario #5 Ear Surgerymentioning

confidence: 99%

“…These studies seem to indicate that no form of SAP is useful in modifying the low tendency to develop SSIs in subjects undergoing cochlear implantation, suggesting no use of SAP in these cases [56]. In reality, these data are not convincing, as demonstrated by the fact that some authors believe they should suggest a different choice depending on the characteristics of the individual patient and some prestigious scientific institutions recommend, for caution, a systematic peri-operative prophylaxis with cefazolin EV [57]. Also discussed is how to perform SAP, whether with a single pre-intervention dose or with a more or less protracted antibiotic administration after surgical wound closure.…”

Section: Scenario #5 Ear Surgerymentioning

confidence: 99%

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

et al. 2022

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Surgical site infections (SSIs) represent a potential complication in surgical procedures, mainly because clean/contaminated surgery involves organs that are normally colonized by bacteria. Dental, maxillo-facial and ear-nose-throat (ENT) surgeries are among those that carry a risk of SSIs because the mouth and the first respiratory tracts are normally colonized by a bacterial flora. The aim of this consensus document was to provide clinicians with recommendations on surgical antimicrobial prophylaxis in neonates (<28 days of chronological age) and pediatric patients (within the age range of 29 days–18 years) undergoing dental, maxillo-facial or ENT surgical procedures. These included: (1) dental surgery; (2) maxilla-facial surgery following trauma with fracture; (3) temporo-mandibular surgery; (4) cleft palate and cleft lip repair; (5) ear surgery; (6) endoscopic paranasal cavity surgery and septoplasty; (7) clean head and neck surgery; (8) clean/contaminated head and neck surgery and (9) tonsillectomy and adenoidectomy. Due to the lack of pediatric data for the majority of dental, maxillo-facial and ENT surgeries and the fact that the recommendations for adults are currently used, there is a need for ad hoc studies to be rapidly planned for the most deficient areas. This seems even more urgent for interventions such as those involving the first airways since the different composition of the respiratory microbiota in children compared to adults implies the possibility that surgical antibiotic prophylaxis schemes that are ideal for adults may not be equally effective in children.

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Association of the Duration of Antibiotic Therapy With Major Surgical Site Infection in Cochlear Implantation

Cited by 15 publications

References 32 publications

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Infectious Complications Following Cochlear Implant: Risk Factors, Natural History, and Management Patterns

Comparison of Adult and Pediatric Cochlear Implant Wound Complications: AMeta‐Analysis

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study

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