Single perioperative Ceftriaxone prophylaxis is sufficient for cochlear implantation in adults

Introduction In the pertinent literature there is no consensus for the optimal antibiotic prophylaxis for cochlear implantation in adults. This study evaluates our experience with a single perioperative prophylaxis in combination with a film dressing.

Method Routine additional post-operative antibiotic prophylaxis following cochlear implantation in adults has no longer been performed in our clinic since September 2019. This amendment to our protocol was only adopted for patients who clinically showed no signs of otitis media. In addition, the necessity of application of local antibiotic was avoided through the application of a transparent adhesive polyurethane film to protect the incision site.

Results A total of 82 patients who received a cochlear implant fulfilled the above-mentioned inclusion criteria (mean age 55.3 yrs.: range 17.4 to 93.8 yrs.). None of these patients had postoperative infection (mean follow-up time 1 year: range 0.1 to 2.1 year). In two patients, one with a partial dehiscence of the surgical wound following self-manipulation and a second with prolonged haematoma, additional antibiotic prophylaxis was applied one week postoperatively. The transparent foil enabled continual assessment of the surgical wound in addition to providing sufficient protection of the site until removal of the stitches. The foil dressing was particularly advantageous in cases where the processor was fitted soon after surgery. 

Conclusion A single perioperative Ceftriaxon prophylaxis for cochlear implantation in adults without otitis media is sufficient when sterility of the surgical site is secured. The need for local antibiotic application can be avoided with application of a film dressing.

Publication History

Article published online:
24 May 2022