Achraf Sayed-Hassan1, Ruben Hermann2, Frédéric Chidiac2, Eric Truy2, Nicolas Guevara3, Sonanda Bailleux4, Olivier Deguine5, Blandine Baladi5, Yohan Gallois5, Alexis Bozorg-Grayeli6, Yannick Lerosey7, Benoit Godey8, Cécile Parietti-Winkler9, Bruno Pereira10, Thierry Mom1,11. 1. Otorhinolaryngology and Head and Neck Surgery, Gabriel Montpied University Hospital, Clermont-Ferrand, France. 2. Otorhinolaryngology, Head and Neck Surgery and Speech and Hearing, Edouard Herriot Hospital, Lyon, France. 3. University Institute of the Head and Neck, Nice University Hospital, Nice, France. 4. Lenval-University Pediatric Hospitals of Nice, Nice, France. 5. Otorhinolaryngology, Otoneurology and Pediatric Otorhinolaryngology, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France. 6. Otorhinolaryngology and Head and Neck Surgery, Dijon Bourgogne University Hospital, Dijon, France. 7. Otorhinolaryngology and Head and Neck Surgery, Rouen University Hospital, Rouen, France. 8. Otorhinolaryngology and Oral and Maxillofacial Surgery, Pontchaillou Hospital, Rennes University Hospital, Rennes, France. 9. Otorhinolaryngology and Head and Neck Surgery, Nancy University Hospital, Nancy, France. 10. Department of Statistics, Gabriel Montpied University Hospital, Clermont-Ferrand, France. 11. Laboratory of Biophysics of Sensory Handicaps, Unité Mixte de Recherche Institut National de la Santé et de la Recherche Médicale 1107, University of Clermont Auvergne, Clermont-Ferrand, France.
Abstract
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.
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.
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