Current trends in antibiotic prophylaxis for laryngectomy in the UK - a national survey

Background: With the increasing use of chemoradiotherapy protocols, total laryngectomy carries increasing risks such as pharyngocutaneous fistula. There is little reference to the use of antibiotic prophylaxis in salvage surgery. This study aimed to determine the current practice in antibiotic prophylaxis for total laryngectomy in the UK. Method: A questionnaire was designed using SurveyMonkey software, and distributed to all ENT-UK registered head and neck surgeons. Results: The survey revealed that 19 surgeons (51 per cent) follow a protocol for antibiotic prophylaxis in primary total laryngectomy and 17 (46 per cent) follow a protocol in salvage total laryngectomy. Only 11 (30 per cent) use anti-methicillin-resistant Staphylococcus aureus agents in their antibiotic prophylaxis. The duration of prophylaxis varies considerably. Nineteen surgeons (51 per cent) revealed that their choice of antibiotic prophylaxis reflected non-evidence-based practices. Conclusion: There appears to be little evidence-based guidance on antibiotic prophylaxis in primary and salvage total laryngectomy. The survey highlights the need for more research in order to inform national guidance on antibiotic prophylaxis in primary and salvage total laryngectomy.