Research article

Antibiotic prophylaxis in thyroid surgery: a preliminary multicentric italian experience

Nicola Avenia^1* , Alessandro Sanguinetti^1* , Roberto Cirocchi^2* , Giovanni Docimo^3* , Mark Ragusa^4* , Roberto Ruggiero^3* , Eugenio Procaccini^3* , Carlo Boselli^2* , Fabio D'Ajello^1* , Francesco Barberini^2* , Domenico Parmeggiani^3* , Lodovico Rosato^5* , Francesco Sciannameo^2* , Giorgio De Toma^6* and Giuseppe Noya^2*

¹  Endocrine Surgical Unit, University of Perugia, Italy

²  General Surgical Unit, University of Perugia, Italy

³  General Surgical Unit, Second University of Naples, Italy

⁴  Thoracic Surgical Unit, University of Perugia, Italy

⁵  Endocrine Surgical Unit, ASL9-H of Ivrea (Torino), Italy

⁶  Department of Surgery "P. Valdoni", University of Rome, Italy

author email corresponding author email* Contributed equally

Annals of Surgical Innovation and Research 2009, 3:10doi:10.1186/1750-1164-3-10

Published:	5 August 2009

Abstract

Post-operatory wound infections are a very uncommon finding after thyroidectomy. For these reasons international guidelines do not routinely recommend systemic antibiotic prophylaxis.

The benefits of this antibiotic prophylaxis is not supported by clinical evidence in the literature. We have conducted a multicentric randomized double-blind trial on 500 patients who had undergone thyroidectomy for goitre or thyroid carcinoma. The 500 patients enrolled in the study (mean age 47 years) were randomized in two subgroups of 250 patients. 250 patients were treated with standard antibiotic prophylaxis with sulbactam/ampicillin 1 fl (3 gr.) 30 min before surgery. No antibiotic prophylaxis was instituted in the remainder 250 patients. Our RCT showed that prophylactic antibiotic treatment is not beneficial in patients younger than eighty years old, with no concomitant metabolic, infective and hematologic disease, with no cardiac valvulopathies, not under steroidal or immunosuppressive treatment, and not severely obese. Our study should be regarded only as a preliminary RCT, and should be followed by a study in which a larger number of patients should be enrolled so that statistically significant data can be obtained.