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J Laryngol Otol. 2012 Mar;126(3):257-9. doi: 10.1017/S0022215111003215. Epub 2012 Jan 4.

Prospective study of the risk of not using prophylactic antibiotics in nasal packing for epistaxis.

Author information

  • 1ENT Department, St George's Hospital, London, UK. drpepper@doctors.org.uk

Abstract

BACKGROUND:

There is wide variation in UK prescribing practice regarding prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published cases of infective complications in such patients.

METHOD:

This prospective study examined 149 consecutive patients admitted to a tertiary otorhinolaryngology centre with spontaneous epistaxis, who underwent nasal packing, over a six-month period. In the first three-month period, 78 patients were routinely prescribed prophylactic antibiotics; in the second three months, 71 patients were not routinely prescribed antibiotics. Exclusion criteria included antibiotics prescribed for unrelated pathology and post-operative epistaxis. Signs and symptoms of acute otitis media, sinusitis and toxic shock syndrome were assessed using clinical examination and a questionnaire.

RESULTS:

Fourteen of the 149 patients experienced otalgia, most commonly following posterior nasal packing. No patient in either group had evidence of any infective complication.

CONCLUSION:

We do not recommend the routine prescription of prophylactic antibiotics for patients undergoing nasal packing for spontaneous epistaxis.

PMID:
22214602
[PubMed - indexed for MEDLINE]
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