The SIGN 104 guideline (2014) for topical antibiotic prophylaxis during grommet insertion: misguided?

Abstract

We write to express both concern and surprise at the updated SIGN (Scottish Intercollegiate guidelines network) guideline 104 (2014) for antibiotic prophylaxis [1]. The original SIGN guideline 104 (2008)[2] recommended the use of a single dose of prophylactic topical antibiotic during grommet insertion based on 3 RCT's one of which showed no difference in outcome in the use of antibiotic and saline drops. Two of the 3 studies used Ciprofloxacin and Ofloxacin, neither of which is licensed for use in the United Kingdom.

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