Reducing Excessive Antibiotic Prophylaxis in Ear, Nose, and Throat (ENT) Surgeries
Care Process & Redesign
National Healthcare Group Quality Improvement
National Healthcare Group
24 December 2025
Reducing excessive perioperative antibiotic prophylaxis in TTSH ENT from 76% to 10% in 6 months. The intervention shows promise in reducing unnecessary antibiotic use and associated costs while maintaining low infection rates.
Year Submitted: 2025
Published Date: 24 December 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Cost Saving, Productivity, Value Based Care, Adherence Rate, Adverse Outcome Reduction, Risk Management
About this Content
Aims
Reducing excessive perioperative antibiotic prophylaxis in TTSH ENT from 76% to 10% in 6 months.
Background
Excessive use of antibiotics in ENT surgeries, particularly in thyroid/parathyroidectomy, parotidectomy, and tonsillectomy, where there is level 1A evidence against antibiotics.
Methods
Implementation of strategies such as regular reporting of infection rates without antibiotics, reducing duration and spectrum of antibiotic prophylaxis, gathering feedback from surgeons, and individualized reporting of infection rates and side-effects of antibiotics.
Results
Cost savings of $20,557.80 annually, reduction in antibiotic use from 76% to 29%, and infection rates with a median of 0% definite and 5% possible.
Conclusion
The intervention shows promise in reducing unnecessary antibiotic use and associated costs while maintaining low infection rates.
Lessons Learnt
Challenges include motivating team members, the importance of leadership, the impact of HOD support, and the potential for overnight behavioral change.
Keywords
Antibiotic, Prophylaxis, ENT, Surgery, Cost Saving
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | National Healthcare Group Quality Improvement |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Otolaryngology |
Project Lead(s) | Li Hao |
Project Member(s) | Chong Yaw Khian |
Connect with this contributor!
Group Quality - nhggroup.QRM@nhghealth.com.sg