title: Current trends in antibiotic prophylaxis for laryngectomy in the UK - a national survey.
abstract: BACKGROUND
  With the increasing use of chemoradiotherapy protocols, total laryngectomy carries increasing risks such as pharyngocutaneous fistula. There is little reference to the use of antibiotic prophylaxis in salvage surgery. This study aimed to determine the current practice in antibiotic prophylaxis for total laryngectomy in the UK.
  
  
  METHODS
  A questionnaire was designed using SurveyMonkey software, and distributed to all ENT-UK registered head and neck surgeons.
  
  
  RESULTS
  The survey revealed that 19 surgeons (51 per cent) follow a protocol for antibiotic prophylaxis in primary total laryngectomy and 17 (46 per cent) follow a protocol in salvage total laryngectomy. Only 11 (30 per cent) use anti-methicillin-resistant Staphylococcus aureus agents in their antibiotic prophylaxis. The duration of prophylaxis varies considerably. Nineteen surgeons (51 per cent) revealed that their choice of antibiotic prophylaxis reflected non-evidence-based practices.
  
  
  CONCLUSIONS
  There appears to be little evidence-based guidance on antibiotic prophylaxis in primary and salvage total laryngectomy. The survey highlights the need for more research in order to inform national guidance on antibiotic prophylaxis in primary and salvage total laryngectomy.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Harris
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: E
authors.initials: E
authors.lastname: Ofo
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: D
authors.initials: D
authors.lastname: Cope
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: I
authors.initials: I
authors.lastname: Nixon
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Oakley
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: J-P
authors.initials: JP
authors.lastname: Jeannon
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery,Guy's and St Thomas' NHS Foundation Trust,London,UK.
authors.forename: R
authors.initials: R
authors.lastname: Simo
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000592:standards / Q000639:trends*; D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D005402:Fistula / Q000209:etiology / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects* / Q000379:methods; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D010036:Otolaryngology / Q000639:trends*; D010608:Pharyngeal Diseases / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D016879:Salvage Therapy / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents
keywords: Fistula