Surgery · Infectious Disease ·
Survey Finds International Variation in Head and Neck Surgery Antibiotic Use
An international cross-sectional survey of 468 head and neck surgeons found substantial variation in perioperative antibiotic prescribing across regions and procedure types. Routine use for conventional thyroidectomy and the duration of prophylaxis for clean-contaminated cancer surgery differed notably between respondents in Europe, North America, and other regions.
- Routine thyroidectomy prophylaxis varied by region.
- Most respondents reported prophylaxis for clean-contaminated cancer surgery.
- Reported prophylaxis duration differed between Europe and North America.
- Guideline availability did not correspond to shorter courses.
Researchers surveyed head and neck surgeons through professional societies from October 2024 to December 2025 about antibiotic use across six endocrine and oncologic procedure categories. The 468 respondents reported routine prophylaxis, antibiotic selection and duration, as well as departmental guideline availability. The analysis compared responses from Europe, North America and the rest of the world.
Routine antibiotic use for conventional thyroidectomy was reported by 12% of European respondents, 35% of North American respondents and 56% of respondents elsewhere. For clean-contaminated head and neck squamous cell carcinoma procedures, prophylaxis use was 93% to 99%. For low-complexity clean-contaminated procedures, 24-hour regimens were reported by 43% of North American versus 11% of European respondents; seven-day courses were reported by 23% of European versus 8% of North American respondents. Departmental HNSCC guidelines were reported by 83% in Europe and 38% in North America.
The findings document heterogeneous self-reported practice and possible opportunities for antimicrobial stewardship, including routine use in clean procedures and prolonged courses. As a survey, the study describes reported practice rather than patient outcomes or prescribing appropriateness in individual cases. Guideline availability did not correspond to shorter reported prophylaxis duration, pointing to implementation as a potential challenge.
In practice
The survey documents substantial regional variation in reported perioperative antibiotic use among head and neck surgeons, including routine prophylaxis for conventional thyroidectomy and differing course durations for clean-contaminated procedures. It may help clinicians and departments identify prescribing practices to review in local antimicrobial-stewardship efforts. However, the study is cross-sectional and based on self-reported practice; it does not compare patient outcomes or establish which regimens are appropriate for an individual patient. It does not by itself justify changing prophylaxis practice.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
JAMA Network Open: Perioperative Antibiotic Use in Head and Neck Surgery ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.