내시경을 이용한 경접형동 접근 수술 중에 시행한 비강내 세균 배양 검사 및 그에 대한 항생제 감수성 결과 분석과 3세대 세팔로스포린의 예방적 항생제로서의 임상적 효과에 대한 분석

Analysis of intraoperative nasal cavity culture with the antibiotics susceptibility test and clinical outcomes of antibiotic prophylaxis with third-generation cephalosporins for endoscopic transsphenoidal surgery

Background : We analyzed the distribution of identified micro-organisms from the nasal cavity during EETS and their antibiotic susceptibility testing (AST) results. In addition, we evaluated the clinical outcomes of antibiotic prophylaxis with third-generation cephalosporins for endoscopic transsphenoidal surgery. Methods : From November 2014 to October 2017, a total of 225 EETS cases with available nasal cavity culture results were reviewed to identify the clinical data relevant to CNS infection. Ceftriaxone was used for antibiotic prophylaxis, and the patients were divided into subgroups according to the AST results. Results : Gram-positive cocci were the most commonly identified micro-organisms. The patient population was divided into the following three groups: prophylaxis-appropriate, prophylaxis-inappropriate, and Undetermined group, each amounting to 132 (59.5%), 34 (15.3%), and 56 (25.2%) cases, respectively. CNS infection was observed in 2 (0.9%) cases. But, statistical analyses did not show significant differences in the occurrence of CNS infection among the studied groups. Conclusions : Antibiotic prophylaxis with third-generation cephalosporins showed that most (85%) patients received appropriate prophylaxis, and the clinical outcomes regarding the CNS infection were also comparable to other previous reports. Future larger-scale studies are mandatory to establish the relationship between prophylaxis-appropriateness and the occurrence of CNS infection.