title: Study on the effectiveness of antibiotic prophylaxis in external dacryocystorhinostomy: a review of 697 cases.
abstract: OBJECTIVE
  To evaluate the prophylactic use of antibiotics in external dacryocystorhinostomy for the prevention of postoperative complications.
  
  
  METHODS
  This study included 697 patients diagnosed with distal nasolacrimal duct obstruction and who were operated on by the same surgeon. Direct culture of the lacrimal sac content was carried out. Data were collected regarding clinical signs and symptoms, use of intraoperative antibiotics, results of culture samples obtained during surgery, and antibiogram analysis. Also, the postoperative period was analyzed with regard to the presence of postoperative complications.
  
  
  RESULTS
  Out of 697 patients, 536 were women. The mean age at surgery was 67.0 ± 13.3 years. Prior to surgery, 19.5%, 18.5%, 11%, and 17.8% of patients showed recurrent conjunctivitis, mucocele, mucopyocele, and episodes of acute dacryocystitis, respectively. Seventy-three patients did not receive prophylactic treatment during surgery. A total of 8.3% of lacrimal sacs were culture positive, the most commonly isolated organism being Staphylococcus aureus. The use of antibiotics during surgery was not associated with a lower rate of postoperative complications. A statistically significant association was found between some clinical pictures, such as mucocele, mucopyocele, and dacryocystitis, and a higher rate of positive cultures.
  
  
  CONCLUSIONS
  This study questions the generalized use of prophylactic antibiotics for external dacryocystorhinostomy, while providing evidence to indicate their use for patients who have had prior episodes of mucocele, mucopyocele, or acute dacryocystitis.
authors.affiliation: Oculoplastics and Orbit, Ophthalmology Service of the Cruces Hospital, Barakaldo, Biscay, Spain. luengonosvemos@yahoo.es
authors.forename: Sergio
authors.initials: S
authors.lastname: Pinar-Sueiro
authors.forename: Roberto-Víctor
authors.initials: RV
authors.lastname: Fernández-Hermida
authors.forename: Ane
authors.initials: A
authors.lastname: Gibelalde
authors.forename: Lorea
authors.initials: L
authors.lastname: Martínez-Indart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000382:microbiology / Q000601:surgery*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents