Vol.98No.9contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 98 No. 9 September 2005
Examination of Efficacy of Azithromycin for
Prevention of Postoperative Infection
Akihiro Homma and Satoshi Fukuda
(Hokkaido University Graduate School of Medicine)
〈Background〉In the field of otolaryngology-head & neck surgery, antimicrobial agents are administered in order to prevent perioperative period infections caused by mainly Gram-positive coccus such as Staphylococcus aureus or Staphylococcus epidermidis. Short-period administration of penicillin or 1st generation cephems antibiotics are recommended for clean/clean-contaminated operations. For a short operation, a single administration within 30 minutes from the start of operation is considered sufficient. However, in Japan it is administered as a customary practice for several days after the operation in many cases.
〈Purpose〉Oral antimicrobial agent azithromycin (AZM, Zithromac?) was administered in order to prevent postoperative infection in patients who underwent clean/clean-contaminated operations in the field of otolaryngology-head & neck surgery, and its efficacy was examined.
〈Patients and method〉Of patients who underwent clean/clean-contaminated operations in the operation room of the Department of Otolaryngology, Hokkaido University Hospital from April 2003 to November 2004, patients who underwent minor or intermediate operations for mouth, pharyngolarynx, trachea, or neck were selected. Patients who had experience of irradiation, or past history of surgical site infection, or those who were considered to have a high risk of infection due to systemic complications and to whom a doctor in charge judged it appropriate to intravenously infuse antimicrobial agents, were excluded.
〈Results〉Three hundred patients were administered, and of these, violation of the treatment occurred in 2 patients (0.6％). Postoperative infection occurred in 8 (2.4％) Some of them had medical problems, or past histories of MRSA infection, or operations of the head and neck area.
〈Conclusion〉In clean/clean-contaminated operation in the field of department of otolaryngology-head & neck surgery, intravenous antimicrobial injection is commonly used to prevent postoperative infection, but these results suggest that a sufficient effect can be achieved by 3-day-administration of the oral antimicrobial agent AZM.
Key words : azithromycin, prevention, postoperative infection