The following article features coverage from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Annual Meeting. Click here to read more of MPR‘s conference coverage.

Prophylactic topical antimicrobial therapy appears to benefit patients undergoing mucosal head and neck surgery, according to findings presented at the AAO-HNSF 2021 Annual Meeting.

To determine whether topical antimicrobial prophylaxis should become the standard of care in patients undergoing mucosal head and neck surgery, study authors searched various databases for clinical trials, cohort studies, and case-control studies that reported on surgical site infection (SSI) rates in adults who received perioperative topical antimicrobial therapy to the oral cavity and/or pharynx.

A total of 9 studies were included in the analysis. “Topical treatments included clindamycin, tetracycline, piperacillin-tazobactam, ampicillin-carbenicillin, neomycin-erythromycin, mupirocin, and povidone-iodine,” the authors reported.

Results showed a pooled SSI rate of 8% (95% CI, 3-14%; I2, 61.2%) in patients who received topical antimicrobial prophylaxis (n=252) compared with 29% (95% CI, 16-43%; I2, 79.5%) for control patients who did not receive therapy (n=218). Moreover, findings from an additional meta-analysis that included 7 comparative studies (192 topical antimicrobial therapy patients and 218 control patients) revealed a pooled relative risk equal to 0.44 (95% CI, 0.28-0.68; I2, 0%) favoring the treatment group.

“Our meta-analysis reveals a greater than 50% risk reduction in SSIs in patients who underwent perioperative topical antimicrobial therapy to the oral cavity and/or pharynx compared with patients who did not receive topical prophylaxis, which is both statistically significant and clinically meaningful,” the study authors concluded.


Lee JJ, Pipkorn P, Chibueze S, Zenga J, Puram SV, Jackson RS. Efficacy of topical antimicrobial prophylaxis for mucosal head and neck surgery: A meta-analysis. Presented at: AAO-HNSF 2021 Annual Meeting; October 3-6, 2021; Los Angeles, CA.