Perioperative Antibiotic Prophylaxis May Not Be Required Routinely in Thyroid Surgery

Abstract

Purpose: Although perioperative antibiotic prophylaxis is used to prevent surgical site infection (SSI), thyroid surgery is classified as a clean surgical procedure and routine use of perioperative antibiotic prophylaxis is not recommend. The purpose of this study is to evaluate the therapeutic benefits of using perioperative antibiotic prophylaxis in thyroid surgery. Methods: We evaluated medical records of 1,895 patients who underwent thyroid surgery between January 2013 and December 2013. We divided 2 groups with or without perioperative antibiotic prophylaxis. Clinical factors including sex, age, body mass index (BMI), and comorbidity and surgical factors for SSI were analyzed. Results: The male to female ratio was 1:3.3, the average age was 43 (14-82) years old. The numbers of groups without and with antibiotic prophylaxis were 593 and 1,303. Thirty-seven cases (2.0%) of postoperative complications were observed including chyle leakage, SSI, and nerve injury. The SSI was occurred in 10 patients (0.5%). Clinical factors with SSI were analyzed and there was no statistical significance between 2 groups. Conclusion: In thyroid surgery, perioperative antibiotic prophylaxis may not be required routinely once the surgical procedure underwent with aseptic condition and the patients care was performed appropriately.

Effect of Antibiotic Prophylaxis on Surgical Site Infection in Thyroid and Parathyroid Surgery: A Systematic Review and Meta-Analysis

“…After exclusion of duplicates, we screened 760 references and identified 18 eligible references; from these, nine were excluded as not meeting inclusion criteria or not providing data on the outcome of interest [12,[16][17][18][19][20][21][22][23]. The remaining nine studies presenting quantitative data were included in the meta-analysis [11,[13][14][15][24][25][26][27][28].…”

“…Characteristics of the included studies are presented in Table 1. Four studies were RCTs [14,24,27,28] and five nRCTs [13,15,25,26], published between 2013 and 2021. Two studies were multicentric [11,13], involving 27 and 38 departments of surgery, respectively, while the remaining studies provided data from a single center [13,14,[24][25][26][27][28].…”

“…Four studies were RCTs [14,24,27,28] and five nRCTs [13,15,25,26], published between 2013 and 2021. Two studies were multicentric [11,13], involving 27 and 38 departments of surgery, respectively, while the remaining studies provided data from a single center [13,14,[24][25][26][27][28]. The included studies involved 8710 participants (a range of 53 to 2926 per study) from eight countries (Greece, Korea, India, Israel, Italy, Japan, the US and Sweden) in three continents (Europe, Asia and America).…”

“…The mean age ranged from 43.11 to 60.6 years, while the highest prevalence of male sex was 26.6%. Similar inclusion criteria across studies were clean neck surgery for thyroid [11,14,15,25,28] or thyroid and parathyroid diseases [24,26,27,29]. Five studies included only thyroidectomies, while four also included parathyroidectomies; in one study [27] two parotidectomies were also included (3.7%, one per each group).…”

“…Five of six studies including malignant pathology [14,15,24,26,27] reported on neck dissections (from a tenth to about a quarter of cases), while the presence of cases of neck dissection was unclear in two studies [11,13]. The mean duration of the procedures was provided by four studies [13,[24][25][26], and ranged from 75 to 168 min, while the hospital stay was between three and four days, according to three studies [24,27,28]. Five studies reported the use of a drain [11,13,14,25,28], which varied from 2% [13] to all of the participants [14,25,28], respectively.…”