Fang CH, Hawn VS, Agarwal V, et al. - Via distributing an online-based survey to the membership of the North American Skull Base Society in 2018, researchers identified antibiotic prescribing patterns and factors that affect antibiotic use in anterior skull-base surgery (ASBS). Practitioner preference for intraoperative or postoperative use of antibiotics, practice location and environment, surgeon experience, and patient factors influencing antibiotic use were included outcomes in this study. Findings revealed that there were 208 participants of which 182 performed ASBS; 60.4% were in academic institutions. Respondents were neurosurgeons or otolaryngologists, and 75.3% were fellowship-trained in ASBS. Regression analysis showed that the presence of actively infected sinuses, transplantation, diabetes, HIV/AIDS, and pulmonary disease influenced decision-making among surgeons who did not routinely prescribe intraoperative antibiotics. Regression modeling indicated that the decision to use postoperative antibiotics was influenced by HIV/AIDS, cystic fibrosis, diabetes, transplantation, and pulmonary disease, as well as the use of absorbable packaging. Among surgeons performing ASBS, the significant variation in intra- and postoperative antibiotic use was noted by investigators. In order to establish evidence-based practice guidelines for perioperative antibiotic use in ASBS, prospective randomized studies are required.