[Antibiotic treatment in surgery for cholesteatoma].
Cholesteatoma surgery is considered as a dirty one and consequently tributary of preoperative and postoperative antibiotic treatment. Thirty-seven patients diagnosed of cholesteatoma and surgically treated in 1994 are retrospectively analyzed in this article. All of them, whether or not presented with active preoperative otorrhea, received a protocolized antibiotic treatment with topical gentamicin and dexamethasone and oral clindamycin during seven postoperative days. The presence or absence of preoperative or postoperative infection, usually as suppuration is analyzed. Otopyorrhea occurred in 22 patients (62%) before surgery and only in 9 cases (25%) after surgery. Preoperative discharging ears showed greater disposition to continuing the suppuration. The surgical technique followed and the reconstructive middle ear procedure--with autologous bone or other synthetic materials (PORP, TORP)--have not proved, statistically, any predictably value regarding the appearance of any active postoperative infection. As a result of the study done, oral ciprofloxacin has been protocolized only in those adults showing a refractory suppuration to the antibiotic treatment employed. In patients with preoperative otorrhea, topical ciprofloxacin has been protocolized before surgery with the main aim to decrease the postoperative infections incidence of these cases.
Matiñó
E
E
Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona.
Venegas
M P
MP
Díez
S
S
Pinart
J
J
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000188:drug therapy* / Q000601:surgery; D002981:Clindamycin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014433:Tympanoplasty
D002981:Clindamycin