Is antibiotic prophylaxis really needed in thyroid surgery?
Keywords:Thyroidectomy, Antibiotic prophylaxis, Surgical site infection, Wound infection
Background: Thyroid surgery is considered under clean surgical procedures and antibiotics are not routinely recommended for such clean surgical procedures. However, many hospitals in India still give post-operative antibiotics to thyroidectomy patients. Our aim was to find out if administering antibiotics in thyroid surgeries really helpful?
Methods: A retrospective study was conducted for a period of one year with total number of 30 participants, 15 of which were given antibiotic prophylaxis and remaining 15 weren’t given. The patients were observed for signs of infection and hence need for antibiotics till one month postoperatively.
Results: None of the patients in both the groups with and without antibiotics developed post-operative surgical site infection necessitating the need for antibiotics.
Conclusions: Thyroid surgery being classified as clean surgical procedure with small incision and short duration and given that strict aseptic precautions are followed in surgery, then antibiotic prophylaxis may not be needed. However, our study should be considered as only a preliminary case control study and a larger prolonged study is needed to provide statistically significant data.
Cruse PJ, Food R. The epidemiology of wound infection. A 10 year prospective study of 62.939 wounds. Surg Clin North Am. 1980;60:27-40.
Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992;13:606-8.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20:250-78.
Fennessy BG, Harney M, O’Sullivan MJ, Timon C. Antimicrobial prophylaxis in otorhino-laryngology/head and neck surgery. Clin Otolaryngol. 2007;32(5):197-208.
Lu Q, Xie SQ, Chen SY, Chen LJ, Qin Q. Experience of 1166 Thyroidectomy without Use of Prophylactic Antibiotic. Hindawi Publishing Corporation BioMed Res Int. 2014;758432:5.
Avenia N, Sanguinetti A, Cirocchi R, Docimo G, Ragusa M, Ruggiero R, et al. Antibiotic prophylaxis in thyroid surgery: a preliminary multicentric italian experience. Ann Surgical Innovation Res. 2009;3:10.
Fachinetti A, Chiappa C, Arlant V, Kim HY, Liu X, Sun H, et al. Antibiotic prophylaxis in thyroid surgery. Gland Surg. 2017;6(5):525-9.
Lee KB, Kim SY, Kim SM, Kim BW, Lee YS, Chang HS, et al. Perioperative Antibiotic Prophylaxis May Not Be Required Routinely in Thyroid Surgery. J Endocr Surg. 2017;17(4):160-7.