1104. Antibiotic Prophylaxis for the Endoscopic Endonasal Approach

Background Evidence available to guide perioperative antibiotic prophylaxis for endoscopic endonasal (EEN) procedures remains limited. The primary objective of this study was to characterize the impact of antibiotic prophylaxis on the incidence of post-operative central nervous system (CNS) or sinonasal infections in patients undergoing EEN procedures. Methods This was an IRB-approved descriptive analysis including patients >18 years of age who underwent EEN surgery at AdventHealth Orlando over a 3-year period. Patients were excluded if they had an infection present prior to surgery, ongoing antibiotic treatment (other than surgical prophylaxis) at the time of surgery, or a basic sinonasal surgery which lacked CNS penetration. The primary endpoint assessed was the rate of CNS or sinonasal infection within 30 days of EEN procedure. Results After screening 160 patient encounters, a total of 118 patients were included. The most common antibiotic prophylaxis utilized was ceftriaxone, followed by cefazolin, or alternative/combination therapy (72.8% vs. 13.6% vs. 13.6% of cases, respectively). There were 4 total patients who met the primary endpoint, and all 4 cases were due to a diagnosis of meningitis (overall rate 3.4%). Infection rate by antibiotic prophylaxis was 2.4% for ceftriaxone, 0% for cefazolin, and 14.3% for alternative/combination therapy. Based upon the retrospective nature of this study, we were unable to account for provider preference in selection of surgical prophylaxis or other surgeon-specific factors. Conclusion In this retrospective descriptive analysis, rates of CNS or sinonasal infections occurred at a rate similar to previously published literature. Larger, prospective studies are warranted to evaluate the impact of antibiotic selection on the rate of CNS or sinonasal infections post-EEN procedures. Disclosures All authors: No reported disclosures.