Prophylactic antimicrobial drugs are routinely administered for most surgical procedures worldwide. However, the benefit may be modest and supported by low-certainty evidence, while little is known about safety in contemporary practice.
✦ The floor
Discussion
Signed responses from readers of the wire.
✦ Clinical Takeaway ✦
No actionable change for audiologists — this surgical prophylaxis study has no direct relevance to audiology clinical practice.
✦ Why It Matters ✦
This study has minimal relevance to the audiology field; it may have indirect relevance only if future analyses isolate ototoxic (hearing-damaging) antibiotic use within the prophylaxis data.
✦ Key Points ✦
- 01SAPPHIRE is a prospective multi-centre cohort study examining routine antimicrobial prophylaxis safety across surgical procedures.
- 02Published in EClinicalMedicine (2026); DOI 10.1016/j.eclinm.2026.104151.
- 03No audiology-specific outcomes (e.g., hearing loss, ototoxicity) are reported or described.
- 04Study design is a prospective cohort — methodologically sound for its surgical safety question.
- 05Peripheral relevance to audiology only if ototoxic prophylactic agents are examined in sub-analyses.
✦ Research metadata ✦
- PMID
- 42662844
- DOI
- 10.1016/j.eclinm.2026.104151.
- Journal
- EClinicalMedicine
- Publication type
- research_article
- Evidence level
- 2b
- Population
- Surgical patients across multiple centres receiving routine antimicrobial prophylaxis
- Intervention
- Routine antimicrobial prophylaxis prior to surgery
- Comparator
- No prophylaxis or alternative prophylaxis regimens
Primary outcomes
Safety of routine antimicrobial prophylaxis; Clinical benefit of prophylaxis across surgical procedure types