Determining the Necessity for Postoperative Antibiotics After Salivary Stent Placement
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/23/2019 |
| Start Date: | June 15, 2018 |
| End Date: | November 2019 |
| Contact: | Rohan Walvekar, M.D. |
| Email: | rwalve@lsuhsc.edu |
| Phone: | 225-765-1765 |
Salivary duct stent placement is a common practice to maintain duct patency after salivary
duct repair or interventional sialendoscopy; procedures performed to manage salivary duct
pathology such as stenosis, traumatic injury or most commonly salivary duct stones. It is
common practice for patients to receive perioperative antibiotics while undergoing
interventional sialendoscopy and postoperative oral antibiotic therapy with Clindamycin or
Augmentin for 10-14 days, if a short term (2 week) salivary duct stenting was considered
necessary due to the nature of the intervention. However, In reviewing the literature, there
are controversial trials that indicate post-operative antibiotics may not be best practice in
all surgical scenarios, as the adverse events ie. gastrointestinal disturbances, nausea,
Clostridium difficile (C.diff) infection and antibiotic resistance over time surrounding
overuse of antibiotics may outweigh the clinical need for the antibiotic regiment and the
chances of post-operative infection.
duct repair or interventional sialendoscopy; procedures performed to manage salivary duct
pathology such as stenosis, traumatic injury or most commonly salivary duct stones. It is
common practice for patients to receive perioperative antibiotics while undergoing
interventional sialendoscopy and postoperative oral antibiotic therapy with Clindamycin or
Augmentin for 10-14 days, if a short term (2 week) salivary duct stenting was considered
necessary due to the nature of the intervention. However, In reviewing the literature, there
are controversial trials that indicate post-operative antibiotics may not be best practice in
all surgical scenarios, as the adverse events ie. gastrointestinal disturbances, nausea,
Clostridium difficile (C.diff) infection and antibiotic resistance over time surrounding
overuse of antibiotics may outweigh the clinical need for the antibiotic regiment and the
chances of post-operative infection.
Inclusion Criteria:
- All adult patients (18 years of age or older) who are undergoing salivary duct surgery
and stent placement at Our Lady of the Lake Regional Medical Center
Exclusion Criteria:
- Patients who are unwilling to consent to the study and/or to being placed in a
randomized arm of either receiving post-operative antibiotics or not receiving
post-operative antibiotics
- Patients with acute infections at the time of surgery
- Patients who are immunocompromised
- Patients who are recruited but then have early dislodgement of the stent
- Patients who do not complete their postoperative antibiotic therapy due to intolerance
or antibiotic side effects. However, data on these patients will be recorded to
provide an observational results that will support the need for this investigation on
antibiotic use.
- Patients who are in the non-post operative antibiotic arm but choose to put themselves
on antibiotics without consultation from the physician
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