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Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?

INTRODUCTION: The current mainstream practice in otolaryngology departments relating to the use of prophylactic antibiotics in epistaxis patients requiring nasal packing is highly variable. This is due primarily to the lack of any validated guidelines. As such, we introduced a new treatment algorith...

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Autores principales: Biggs, TC, Nightingale, K, Patel, NN, Salib, RJ
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Surgeons 2013
Materias:
ENT
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964636/
https://www.ncbi.nlm.nih.gov/pubmed/23317726
http://dx.doi.org/10.1308/003588413X13511609954734
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author Biggs, TC
Nightingale, K
Patel, NN
Salib, RJ
author_facet Biggs, TC
Nightingale, K
Patel, NN
Salib, RJ
author_sort Biggs, TC
collection PubMed
description INTRODUCTION: The current mainstream practice in otolaryngology departments relating to the use of prophylactic antibiotics in epistaxis patients requiring nasal packing is highly variable. This is due primarily to the lack of any validated guidelines. As such, we introduced a new treatment algorithm resulting in significant reduction of use in the systemic antibiotics, with emphasis instead on the use of topical antibiotics. The results were validated through a complete audit cycle. METHODS: A total of 57 patients undergoing nasal packing for spontaneous epistaxis were studied. Reaudit occurred after the implementation of new guidelines. Telephone surveys were conducted six weeks after hospital discharge, assessing infective nasal symptoms as well as rebleeding and readmission rates. RESULTS: Systemic antibiotic prescribing in anterior nasal packing fell by 58.2% between audit cycles with no statistically significant associated increase in infective nasal symptoms, rebleeding or readmission rates six weeks following hospital discharge. CONCLUSIONS: Systemic prophylactic antibiotics are unnecessary in the majority of epistaxis patients with nasal packs. The use of topical antibiotics such as Naseptin(®) may be more appropriate, cheaper and as effective. Implementation of this treatment algorithm will help standardise systemic antibiotic usage in epistaxis patients with nasal packing and should reduce costs associated with unnecessary use of such medication.
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spelling pubmed-39646362014-07-17 Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs? Biggs, TC Nightingale, K Patel, NN Salib, RJ Ann R Coll Surg Engl ENT INTRODUCTION: The current mainstream practice in otolaryngology departments relating to the use of prophylactic antibiotics in epistaxis patients requiring nasal packing is highly variable. This is due primarily to the lack of any validated guidelines. As such, we introduced a new treatment algorithm resulting in significant reduction of use in the systemic antibiotics, with emphasis instead on the use of topical antibiotics. The results were validated through a complete audit cycle. METHODS: A total of 57 patients undergoing nasal packing for spontaneous epistaxis were studied. Reaudit occurred after the implementation of new guidelines. Telephone surveys were conducted six weeks after hospital discharge, assessing infective nasal symptoms as well as rebleeding and readmission rates. RESULTS: Systemic antibiotic prescribing in anterior nasal packing fell by 58.2% between audit cycles with no statistically significant associated increase in infective nasal symptoms, rebleeding or readmission rates six weeks following hospital discharge. CONCLUSIONS: Systemic prophylactic antibiotics are unnecessary in the majority of epistaxis patients with nasal packs. The use of topical antibiotics such as Naseptin(®) may be more appropriate, cheaper and as effective. Implementation of this treatment algorithm will help standardise systemic antibiotic usage in epistaxis patients with nasal packing and should reduce costs associated with unnecessary use of such medication. Royal College of Surgeons 2013-01 2013-01 /pmc/articles/PMC3964636/ /pubmed/23317726 http://dx.doi.org/10.1308/003588413X13511609954734 Text en Copyright © 2013 Royal College of Surgeons http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle ENT
Biggs, TC
Nightingale, K
Patel, NN
Salib, RJ
Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
title Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
title_full Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
title_fullStr Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
title_full_unstemmed Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
title_short Should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
title_sort should prophylactic antibiotics be used routinely in epistaxis patients with nasal packs?
topic ENT
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964636/
https://www.ncbi.nlm.nih.gov/pubmed/23317726
http://dx.doi.org/10.1308/003588413X13511609954734
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