Prevention of Surgical Site Infection in Clean-Contaminated Middle Ear Surgery with Levofloxacin Administration

概要

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Levofloxacin (LVFX) 500 mg in tablet form, one of the fluoroquinolone antibiotics, has recently become available in Japan, and is rapidly absorbed and extensively distributed into various tissues. In the present study, we try to clarify whether LVFX could prevent surgical site infection (SSI) in clean-contaminated middle ear surgery. LVFX was administered to each patient without otorrhea 2 to 4 hours before middle ear surgery. Although one of 40 cases (2.5%) developed SSI, the infectious lesion immediately disappeared with the administration of additional LVFX. There were 2 cases with mild adverse reaction, i.e. slight liver dysfunction and diarrhea. The drug concentrations in the middle ear and in the serum were simultaneously investigated 3 to 4 hours after LVFX administration in 5 patients. The LVFX concentration in the middle ear was 1.23 times higher than the serum concentration. From the above observations, we concluded that LVFX has adequate ability enough to prevent SSI in clean-contaminated middle ear surgery.