Prophylactic antibiotic trends in transsphenoidal surgery for pituitary lesions

• Published in: Pituitary Vol. 14; no. 2; pp. 99 - 104
• Main Authors: Little, Andrew S., White, William L.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2011; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis - methods; Antibiotic Prophylaxis - statistics & numerical data; Antibiotic Prophylaxis - trends; Antibiotic Prophylaxis - utilization; Data Collection; Endocrine Surgical Procedures - adverse effects; Endocrine Surgical Procedures - methods; Endocrine Surgical Procedures - statistics & numerical data; Endocrine Surgical Procedures - trends; Endocrinology; Human Physiology; Humans; Medicine; Medicine & Public Health; Pituitary Diseases - epidemiology; Pituitary Diseases - surgery; Pituitary Gland - surgery; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Practice Patterns, Physicians' - statistics & numerical data; Practice Patterns, Physicians' - trends; Sphenoid Bone - surgery; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Surveys and Questionnaires; Transsphenoidal approach; Meningitis; Antibiotics; Sinusitis; Pituitary adenoma
• ISSN: 1386-341X; 1573-7403
• DOI: 10.1007/s11102-010-0256-1

Pituitary surgery involves operating in the nasal cavity, which is considered a clean-contaminated wound. In the absence of evidence-based guidelines for preventing surgical site infections in trans-sphenoidal surgery, a survey of current opinion on prophylactic antibiotics might help elucidate the current acceptable practices and identify opportunities for prospective clinical trials that could lead to the development of practice guidelines. An on-line, 10-question, multiple-choice survey was distributed by e-mail link to the membership of the International Society of Pituitary Surgeons. Sixty-nine members responded to the survey. Ninety-one percent indicated that there was no strong evidence supporting antibiotic use, but 81% used them to be safe. Ninety percent of respondents used intravenous prophylactic antibiotics, while only 16% used intranasal antibiotics. The most commonly used antibiotics were cephalosporins (72%) and penicillins (21%). Seventy-six percent used antibiotics for 24 h or less after surgery. The most commonly reported indications for prophylactic antibiotics were prevention of meningitis and sinusitis. The results of the survey describe current acceptable practices for chemoprophylaxis in patients undergoing transsphenoidal pituitary surgery.