Appropriateness of antibiotic use in ENT surgery

Introduction: Although extensive studies on the use of antibiotics during a nd after surgery exist, antibiotics are still used too liberally. Purpose: To analyse the appropriateness of antibiotic use in ENT surgery. Patients and methods: Retrospective study of all surgical procedures perfor med at the Department of Otolaryngology, Head and Neck Surgery of the Unive rsity of Basel between April and June 1999. Of the 174 procedures 30 were c lassified clean, 50 clean-contaminated (group A), 69 clean-contaminated (gr oup B), 14 contaminated, and 11 dirty. Results: 9% of all patients received inappropriate antibiotic prophylaxis a nd 4% inappropriate primary antibiotic treatment. 22% of antibiotic prophyl axis, 39% of primary antibiotic treatments and 29% of secondary antibiotic treatments were considered inappropriate. Discussion: The too liberal use of antibiotics during and after surgery is largely due to the surgeon's fear of infectious complications. Only a peer- review process of all antibiotic prescriptions can reduce the inappropriate use of antibiotics.