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ARTICLE |

Prophylactic Antibiotics in Nasal Surgery FREE

ARLEN D. MEYERS, MD, MBA
Arch Otolaryngol Head Neck Surg. 1990;116(10):1125-1126. doi:10.1001/archotol.1990.01870100019003
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The use of prophylactic antibiotics in nasal surgery has increased despite the fact that there is little scientific justification for their use. Of 400 American otolaryngologists responding to a questionnaire in 1971, 43% reported that they used preventive antibiotics in their nasal and sinus surgery.1 In 1974, 25% of cosmetic surgeons polled used prophylactic antibiotics in nasal surgery.2 In 1980, Jacobson and Kasworm3 reported the increasing use of antibiotics following the description of toxic shock syndrome following nasal surgery.

RATIONALE  The nasal bacterial flora consists mainly of diphtheroids, coagulase-negative cocci, and enterobacteria. Almost half of the patients who undergo septoplasty or rhinoplasty will also have coagulase-positive Staphylococcus residing in their nasal cavity.4There are many reasons why surgeons recommend antibiotics:5

  1. A postoperative infection is so devastating that if just one infection is prevented, it is worth it from a cost, medicolegal, and outcome viewpoint.

REFERENCES

Eschelman L, Shleuning AJ, Brummett RE.  Prophylactic antibiotics in otolaryngologic surgery: a double-blind study . Trans Am Acad Ophthalmol Otolaryngol . 1971;;75:387-394.
Krisek TJ, Koss N, Robson MC.  The current use of prophylactic antibiotics in plastic and reconstructive surgery . Plast Reconstr Surg. 1975;;55:21-32.
Jacobson JA, Kasworm EM.  Toxic shock syndrome after nasal surgery: case reports and analysis of risk factors . Arch Otolaryngol Head Neck Surg. 1986;;112:329-332.
Jacobson JA, Stevens MN, Kasworm EM.  Evaluation of single-dose cefazolin prophylaxis for toxic shock syndrome . Arch Otolaryngol Head Neck Surg. 1988;;114:327-328.
Weimert TA, Yoder MG.  Antibiotics and nasal surgery . Laryngoscope . 1980;;90:667-672.
Johnson JT, Myers EN, Thearle PB, et al.  Antimicrobial prophylaxis for contaminated head and neck surgery . Laryngoscope . 1984;;94:46-51.
Marples RR.  Effect of antibiotics on the nasal flora in acne patients . Arch Dermatol. 1969;;99:647-651.
Holt GR, Garner ET, McClarey D.  Postoperative sequelae and complications of rhinoplasty . Otolaryngol Clin North Am. 1987;;20:853-876.
Furstenberg AC.  Antibiotics in the treatment of disease of the ear, nose, and throat . Ann Otol. 1949;;58:5-17.

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Eschelman L, Shleuning AJ, Brummett RE.  Prophylactic antibiotics in otolaryngologic surgery: a double-blind study . Trans Am Acad Ophthalmol Otolaryngol . 1971;;75:387-394.
Krisek TJ, Koss N, Robson MC.  The current use of prophylactic antibiotics in plastic and reconstructive surgery . Plast Reconstr Surg. 1975;;55:21-32.
Jacobson JA, Kasworm EM.  Toxic shock syndrome after nasal surgery: case reports and analysis of risk factors . Arch Otolaryngol Head Neck Surg. 1986;;112:329-332.
Jacobson JA, Stevens MN, Kasworm EM.  Evaluation of single-dose cefazolin prophylaxis for toxic shock syndrome . Arch Otolaryngol Head Neck Surg. 1988;;114:327-328.
Weimert TA, Yoder MG.  Antibiotics and nasal surgery . Laryngoscope . 1980;;90:667-672.
Johnson JT, Myers EN, Thearle PB, et al.  Antimicrobial prophylaxis for contaminated head and neck surgery . Laryngoscope . 1984;;94:46-51.
Marples RR.  Effect of antibiotics on the nasal flora in acne patients . Arch Dermatol. 1969;;99:647-651.
Holt GR, Garner ET, McClarey D.  Postoperative sequelae and complications of rhinoplasty . Otolaryngol Clin North Am. 1987;;20:853-876.
Furstenberg AC.  Antibiotics in the treatment of disease of the ear, nose, and throat . Ann Otol. 1949;;58:5-17.

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