title: Prophylactic effect of clarithromycin in skin flap complications in cochlear implants surgery.
abstract: OBJECTIVE
  To assess the usefulness of postoperative clarithromycin versus classical postoperative prophylaxis with occlusive dressing to prevent cochlear implant skin flap complications.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Surgical site infections were compared in four groups: 1) ceramic/classical postoperative cares (21 patients), 2) titanium-silicon/classical postoperative cares (75), 3) ceramic/clarithromycin (24), and 4) titanium-silicon/clarithromycin (76). Preoperative ceftriaxone was systematically used in all patients in all four groups. Patients were followed up for at least 4 months. Attributable risk and number needed to treat were calculated.
  
  
  RESULTS
  All infections appeared in titanium-silicon covered implants, and the risk of surgical site infection was 8.1 times higher in patients treated only with ceftriaxone and classical postoperative prophylaxis compared to those also given clarithromycin. Eleven patients needed to receive clarithromycin to avoid surgical infection.
  
  
  CONCLUSIONS
  Long-term treatment with low-dose clarithromycin may reduce the incidence of surgical site infections.
authors.affiliation: Otorhinolaryngology Department, Hospital Universitario San Cecilio, C/Nueva de la Virgen 9, University of Granada, Granada, Spain. orlvaldecasas@gmail.com
authors.forename: Juan
authors.initials: J
authors.lastname: Garcia-Valdecasas
authors.forename: Jose Juan
authors.initials: JJ
authors.lastname: Jiménez-Moleon
authors.forename: Manuel
authors.initials: M
authors.lastname: Sainz
authors.forename: Constanza
authors.initials: C
authors.lastname: Fornieles
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Ballesteros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D019929:Cochlear Implantation; D003054:Cochlear Implants; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009779:Occlusive Dressings; D011474:Prosthesis Design; D013524:Surgical Flaps / Q000473:pathology; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D017291:Clarithromycin