Introduction:Rational surgical antibiotic
prophylaxis is suggested for some selected surgical processes. However, inappropriate utilization of antimicrobial
prophylaxis reduces benefits and increases costs and risks, such as antibiotic resistance. This study aimed to evaluate the current practice of antibiotics prescribed by surgeons in common otologic surgeries. Materials and Methods:This cross-sectional study was conducted among otolaryngologists with at least ۵ years of experience in common otologic surgeries (tympanoplasty, tympanomastoidectomy, stapes, or middle ear exploration (MEE) surgeries). A total of ۲۵۷ otolaryngologists filled a checklist about their selected regimen and timing of antibiotic(s) administration. Results:The rates of antibiotic
prophylaxis prescription in dry and wet ears in tympanoplasty were ۷.۴% and ۸۷.۱% (preoperative), ۴۰.۹% and ۴۷% (intraoperative), ۸۸.۳% and ۹۸% (postoperative); in tympanomastoidectomy with no cholesteatoma were ۷.۱% and ۹۷.۸% (preoperative), ۳۹.۶% and ۵۰.۹% (intraoperative), ۹۳.۷% and ۹۹.۶% (postoperative); in tympanomastoidectomy with cholesteatoma were ۱۴% and ۹۸.۳% (preoperative), ۴۵.۴% and ۵۱.۹% (intraoperative), ۹۸.۳% and ۹۹.۶% (postoperative), respectively, and in stapes or MEE surgeries were ۶.۴% (preoperative), ۴۱.۷% (intraoperative) and ۷۳.۱% (postoperative), respectively. There were no significant differences in the rates of prescribing intraoperative
prophylaxis between wet and dry ears, except in tympanomastoidectomy without cholesteatoma. Overall, the most prescribed antibiotics were cephazolin, cephlexin, and ciprofloxacin drop.Conclusion:The results of this study revealed the inappropriate administration and timing of antibiotic
prophylaxis regarding current literature evidence. Despite the lack of evidence on the potential role of antibiotic
prophylaxis in clean-contaminated and contaminated ears, a significant number of surgeons prescribed prophylactic antibiotics in tympanoplasty and tympanomastoidectomy without cholesteatoma.