Perioperative antibiotic prophylaxis in cochlear implantation (CI) – is a single shot enough?

Background Postoperative wound infections after CI are rare, but can lead to the loss of the implant. In the current German AWMF guideline, there is a strong consensus that antibiotics should be given perioperatively. The aim of the study is to clarify the role of perioperative antibiotic prophylaxis with regard to the type and duration of the antibiotics used to avoid postoperative complications.

Methods 700 patients from the ENT University Clinic who received a CI between 2007 and 2019 were retrospectively evaluated for wound infections and complications in the first 28 postoperative days. The wound infections were divided into major and minor infections. In addition to the duration of antibiotic prophylaxis, pre-existing diseases and medications that impair the immune system and / or blood clotting were also recorded. The data were then analyzed with the IBM statistics program SPSS.

Results A total of 66 of 700 patients (9.4%) showed abnormalities in the wound assessment within the first 28 postoperative days after CI. Major infections were only found in 12 patients. Explantation was only carried out in two patients (0.2%) with a major infection. In 670 patients, the duration of antibiotic intake could be related to the infections. There was no significant difference in the wound infection rate between single shot antibiosis (N  = 67 / 11.9%), 48h prophylaxis (N  = 158 / 10.8%) and > 72h antibiosis (N  = 445 / 8.7%).

Conclusion Patients with perioperative single shot antibiosis do not seem to have a significantly increased risk of infection compared to patients with antibiotic prophylaxis for several days. A cross-center continuation of data collection appears sensible.

Publication History

Article published online:
24 May 2022