Prophylactic effect of clarithromycin in skin flap complications in cochlear implants surgery.
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.
Garcia-Valdecasas
Juan
J
Otorhinolaryngology Department, Hospital Universitario San Cecilio, C/Nueva de la Virgen 9, University of Granada, Granada, Spain. orlvaldecasas@gmail.com
Jiménez-Moleon
Jose Juan
JJ
Sainz
Manuel
M
Fornieles
Constanza
C
Ballesteros
Jose Manuel
JM
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
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D017291:Clarithromycin