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A Systematic Review of Prophylactic Antibiotic Use in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions.

Abstract：

BACKGROUND:The benefit of prophylactic antibiotic use in endoscopic endonasal transsphenoidal surgery (EETS) for pituitary lesions is controversial. Many surgeons administer antibiotics perioperatively not based on clear guidelines but to be safe. The purpose of this study was to determine if antibiotic prophylaxis use reduces the risk of infection (e.g., meningitis, sinusitis) within 30 days after the surgery in adult patients with pituitary lesions undergoing EETS. METHODS:A systematic review was performed to assess the effectiveness of perioperative antibiotic use in preventing infectious complications in patients undergoing EETS. Data sources included Ovid Databases, Scopus, PubMed, Cochrane Library, and Grey Literature. The inclusion criteria were randomized controlled trials, systematic reviews, observational studies, and case series of prophylactic antibiotic perioperative use for EETS. The study end points were the rates of meningitis and sinusitis as infectious complications after EETS. RESULTS:A total of 282 articles were identified by the initial literature search. Four studies met the inclusion criteria: 3 retrospective cohort and 1 prospective case series studies. All patients included in each study received different antibiotic regimens perioperatively. The quality of studies did not permit performance of a meta-analysis. CONCLUSIONS:Even though there are no clear practice guidelines regarding the antibiotic prophylaxis need in EETS, various antibiotic regimens have been used by surgeons. Our systematic review identified a limited number of published studies assessing this question, all observational. Randomized controlled trials are needed to evaluate the effectiveness of prophylactic antibiotic use in patients with pituitary lesions undergoing EETS.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Moldovan ID,Agbi C,Kilty S,Alkherayf F

doi

10.1016/j.wneu.2019.05.082

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

408-414

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)31356-7

journal_volume

128

pub_type

杂志文章

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