Antibiotics prophylaxis (thyroid surgery) (AAES guidelines 2020)

Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Surgical site infection is a rare complication after routine transcervical thyroidectomy, with a reported incidence of 0.09% to 2%.

👉In a small European study, preoperative antibiotic administration did not affect the incidence of surgical site infection.

👉Antimicrobial prophylaxis (AMP) for clean surgery of the head and neck was not recommended in a 1999 pharmacy guideline, with moderate strength of evidence.

👉A recent single-institution randomized trial confirmed the safety of clean thyroid and parathyroid surgery without AMP.

👉However, routine AMP is still commonly used for clean thyroid and parathyroid surgeries in Japan and many other countries; according to an international survey of 275 endocrine surgeons, 26% administered AMP “almost always”, particularly in Asia (59%).

👉Because both preoperative (obesity, alcohol use) and intraoperative factors (ie, operative time, airway injury) are associated with infection, high-risk patients may benefit from selective use of AMP, in which case gram-positive coverage should be administered before or on induction.

👉With rare exceptions, postoperative AMP is not indicated.

👉Recommendation 19 AAES: Antimicrobial prophylaxis is not necessary in most cases of standard transcervical thyroid surgery. (Strong recommendation, high-quality evidence)

#Arrangoiz #ThyroidSurgeon #ParathyroidSurgeon #HeadandaneckSurgeon #EndocrineSurgery #CASO #CenterforAdvancedSurgicalOncology #PalmettoGemeralHospital

Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment