Antibiotic prophylaxis in thyroid surgery: a preliminary multicentric Italian experience.
Post-operatory wound infections are a very uncommon finding after thyroidectomy. For these reasons international guidelines do not routinely recommend systemic antibiotic prophylaxis. The benefits of this antibiotic prophylaxis is not supported by clinical evidence in the literature. We have conducted a multicentric randomized double-blind trial on 500 patients who had undergone thyroidectomy for goitre or thyroid carcinoma. The 500 patients enrolled in the study (mean age 47 years) were randomized in two subgroups of 250 patients. 250 patients were treated with standard antibiotic prophylaxis with sulbactam/ampicillin 1 fl (3 gr.) 30 min before surgery. No antibiotic prophylaxis was instituted in the remainder 250 patients. Our RCT showed that prophylactic antibiotic treatment is not beneficial in patients younger than eighty years old, with no concomitant metabolic, infective and hematologic disease, with no cardiac valvulopathies, not under steroidal or immunosuppressive treatment, and not severely obese. Our study should be regarded only as a preliminary RCT, and should be followed by a study in which a larger number of patients should be enrolled so that statistically significant data can be obtained.
Avenia
Nicola
N
Endocrine Surgical Unit, University of Perugia, Italy.
Sanguinetti
Alessandro
A
Endocrine Surgical Unit, University of Perugia, Italy.
Cirocchi
Roberto
R
General Surgical Unit, University of Perugia, Italy.
Docimo
Giovanni
G
General Surgical Unit, Second University of Naples, Italy.
Ragusa
Mark
M
Thoracic Surgical Unit, University of Perugia, Italy.
Ruggiero
Roberto
R
General Surgical Unit, Second University of Naples, Italy.
Procaccini
Eugenio
E
General Surgical Unit, Second University of Naples, Italy.
Boselli
Carlo
C
General Surgical Unit, University of Perugia, Italy.
D'Ajello
Fabio
F
Endocrine Surgical Unit, University of Perugia, Italy.
Barberini
Francesco
F
General Surgical Unit, University of Perugia, Italy.
Parmeggiani
Domenico
D
General Surgical Unit, Second University of Naples, Italy.
Rosato
Lodovico
L
Endocrine Surgical Unit, ASL9-H of Ivrea (Torino), Italy.
Sciannameo
Francesco
F
General Surgical Unit, University of Perugia, Italy.
De Toma
Giorgio
G
Department of Surgery "P. Valdoni", University of Rome, Italy.
Noya
Giuseppe
G
General Surgical Unit, University of Perugia, Italy.