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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: ricard.simo@gstt.nhs.uk
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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

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 1 , January 2015 , pp. 63 - 67
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

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

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