Antibiotics Use Practices in Otology Procedures: A Nationwide Survey Study

Objective: To assess practice patterns regarding antibiotics prophylaxis in otologic surgery in the United States. Study Design: Cross-sectional study. Setting: Tertiary care center. Subjects: Members of American Neurotology Society (ANS). Intervention: Nationwide survey. Main Outcome Measures: Prevalence of antibiotic prescribing among surgeons performing the following six ear surgical procedures: cochlear implantation, tympanoplasty with a clean ear, tympanoplasty with active drainage, cholesteatoma surgery without evidence of infection, cholesteatoma surgery with evidence of infection, and stapedectomy. Results: Seventy-three surgeons completed the survey (15.21% response rate). Twenty-seven percent had more than 25 years in experience, and 18% had 0 to 5 years of experience.

practices varied by procedure: cochlear implantation (64.4%, median 5 d), tympanoplasty (clean ear: 23.3%, median 5 d; active drainage: 53.4%, median 7 d), cholesteatoma surgery (no infection: 30.1%, median 7 d; with infection: 58.9%, median 7 d), and stapedectomy (34.2%, mean 5 d). Cephalosporins were preferred for noninfected procedures, whereas amoxicillin dominated for active infections. Conclusions: Prophylactic oral antibiotics varies for ear surgery, with higher usage for procedures with active infection and a preference for cephalosporins in noninfected cases. These findings underscore the need for the development and dissemination of standardized, evidence-based recommendations.