A team of investigators further clarified questions regarding the use of prophylactic antibiotics prior to endoscopic dacryocystorhinostomy (endo-DCR) at the American Society of Ophthalmic Plastic and Reconstructive Surgery 2021 Fall Scientific Symposium.

While preoperative administration of antibiotics to minimize surgical site infection risk is common practice, data are limited regarding the appropriateness of this practice as it pertains to lacrimal procedures such as endo-DCR. The Boston-based presenters assessed how antibiotics intervention at various stages affected postoperative infection in patients undergoing endo-DCR. 

The investigators evaluated 331 patients who underwent endo-DCR via a 5-year retrospective chart review from 2015 to 2020 at 2 separate academic institutions. Each eye counted for 1 case. The majority of patients (71.9%) were women, and about 80% were aged 70 years or younger. Relevant past medical history included prior DCR surgery (external or endoscopic) in 18.4% of patients and dacryocystitis (acute or chronic) in 13.6% of patients.


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Odds ratios were calculated to assess the relationship between receipt of antibiotic prophylaxis and postoperative infection rates. Among the 331 patients, 22 cases (6.6%) had postoperative surgical site infections, which the team defined as wound infection or early recurrent dacryocystitis. 

Comparison of the odds ratios (ORs) based on time of administering the antibiotics showed an OR of 1.02 for perioperative antibiotics (P =1.00; 95% CI, 0.39-12.79), an OR of 0.85 for postoperative antibiotics (P =.83; 95% CI, 0.31-2.22), and an OR of 0.62 for either perioperative or postoperative antibiotics (P =.30, 95% CI, 0.23-1.86). 

The study findings echo results of previously published research indicating that use of prophylactic antibiotics is not linked to a decreased risk of developing postoperative surgical site infections. The investigators emphasized that additional studies are needed to generate formal guidelines for antibiotic utilization prior to surgical intervention in the setting of endo-DCR.

Reference

Boal NS, Lefebvre DR, Chiou CA, Sadlak N, Sarmiento VA, Distefano AG. Prophylactic antibiotic prescribing patterns and postoperative infection rates during endoscopic dacryocystorhinostomy at two institutions. Poster presented at: American Society of Ophthalmic Plastic and Reconstructive Surgery 52nd Annual Fall Scientific Symposium; November 11-12, 2021; New Orleans.

This article originally appeared on Ophthalmology Advisor