410 Is a Single Dose, Single Agent Peri-Operative Antibiotic Protocol Adequate for Endoscopic Endonasal Skull Base Surgery? A 14-Year Review of 574 Cases

Abstract Post-operative meningitis is a rare but potentially fatal complication of endoscopic endonasal skull base surgery. As approaches to the are clean-contaminated procedures, peri-operative antibiotics routinely used. We sought analyse safety and efficacy single agent, dose protocol in cases anterior Database all skull-base procedures performed ENT Department at Leeds General Infirmary between 2008 February 2022 was prospectively recorded. The primary outcome measure development within 30-days Our uses IV co-amoxiclav 1.2g (or teicoplanin if allergy precludes co-amoxiclav). data further divided according or revision surgery, presence absence intra-operative CSF leak, not post-operative leak. Over 14-year period, 574 operations that fulfilled inclusion criteria were performed. overall rate across entire cohort 2.6%(n = 15). Among 15 cases:80% (12/15) had leak47% (7/15) cases73% (11/15) extended approach as pathology required an intentional opening arachnoid80% LeakThere no following repair long-standing fistula encephalocele surgery for sinonasal tumours with involvement. In conclusion, intravenous teicoplanin) safe context sellar-centred pathologies, pre-existing spontaneous leaks, on