1. Association of the Duration of Antibiotic Therapy With Major Surgical Site Infection in Cochlear Implantation
- Author
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Nicolas Guevara, Eric Truy, Bruno Pereira, Yannick Lerosey, T. Mom, Ruben Hermann, Sonanda Bailleux, B. Baladi, Yohan Gallois, Frédéric Chidiac, Cécile Parietti-Winkler, Olivier Deguine, Benoit Godey, Achraf Sayed-Hassan, Alexis Bozorg-Grayeli, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Institut Universitaire de la Face et du Cou [Nice], Hôpitaux Pédiatriques de Nice Lenval (CHU-Lenval), Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Pierre-Paul Riquet [Toulouse], CHU Toulouse [Toulouse], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Charles Nicolle [Rouen], Service d'ORL et de chirurgie maxillo-faciale [Rennes] = ENT Head and Neck Surgery [Rennes], CHU Pontchaillou [Rennes], Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Purpan [Toulouse], Service d'oto-rhino-laryngologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Service d'ORL et de chirurgie maxillo-faciale [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité. (DevAH), Université de Lorraine (UL), Unité de biostatistiques, Service ORL, Hôtel-Dieu, and CHU Gabriel Montpied (CHU)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Antibiotics ,Drug Administration Schedule ,Perioperative Care ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Surgical Wound Infection ,Medicine ,Antibiotic prophylaxis ,Young adult ,Child ,030223 otorhinolaryngology ,Cochlear implantation ,ComputingMilieux_MISCELLANEOUS ,Gram-Positive Bacterial Infections ,Aged ,Retrospective Studies ,Original Investigation ,business.industry ,Infant ,Retrospective cohort study ,Perioperative ,Odds ratio ,Antibiotic Prophylaxis ,Middle Aged ,medicine.disease ,Cochlear Implantation ,Anti-Bacterial Agents ,3. Good health ,Treatment Outcome ,Otorhinolaryngology ,Child, Preschool ,Female ,Surgery ,[INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM] ,Gram-Negative Bacterial Infections ,business ,Meningitis ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
International audience; Importance: Infection after cochlear implantation is a rare but serious event that can lead to meningitis. There is no consensus on prevention of infection in these patients, and each center applies its own strategy.Objective: To describe the rates of major surgical site infection for patients undergoing cochlear implantation who receive prolonged antibiotic treatment compared with those who receive a single perioperative dose of antibiotic prophylaxis.Design, setting, and participants: Retrospective cohort study of patients who underwent cochlear implantation between January 1, 2011, and July 8, 2015, with a postoperative follow-up of 1 to 3 years. In this multicenter study at 8 French university centers, 1180 patients (509 children and 671 adults) who underwent cochlear implantation during this period were included.Interventions: Prolonged antibiotic treatment vs single-dose antibiotic prophylaxis.Main outcomes and measures: Major infection and explantation.Results: Among 1180 patients (509 children [51.7% female] with a mean [SD] age of 4.6 [3.8] years and 671 adults [54.9% female] with a mean [SD] age of 54.8 [17.0] years), 12 patients (1.0%) developed a major infection, with 4 infections occurring in the prolonged antibiotic treatment group and 8 infections occurring in the antibiotic prophylaxis group (odds ratio, 2.45; 95% CI, 0.73-8.17). Children (9 of 509 [1.8%]) were more likely to develop infection than adults (3 of 671 [0.4%]). Among children, 4 infections occurred in the prolonged antibiotic group (n = 344), and 5 infections occurred in the antibiotic prophylaxis group (n = 158) (odds ratio, 2.78; 95% CI, 0.74-10.49). Among adults, 3 infections occurred in the antibiotic prophylaxis group (n = 365), whereas no infections occurred in the prolonged antibiotic treatment group (n = 290).Conclusions and relevance: After cochlear implantation, infection was rare, was less common among those who received prolonged antibiotic treatment, and was less likely to occur in adults than in children.
- Published
- 2019
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