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

Published online by Cambridge University Press:  04 January 2012

C Pepper ,
S Lo  and
A Toma
C Pepper*
Affiliation:
ENT Department, St George's Hospital, London, UK
S Lo
Affiliation:
ENT Department, St George's Hospital, London, UK
A Toma
Affiliation:
ENT Department, St George's Hospital, London, UK
*
Address for correspondence: Mr C Pepper, ENT Department, Frimley Park Hospital, Portsmouth Rd, Frimley GU16 7UJ, UK E-mail: drpepper@doctors.org.uk
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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.

Keywords

EpistaxisComplicationsInfectionAntibiotics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 3 , March 2012 , pp. 257 - 259
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented at the South West ENT Academic Meeting (SWEAM), 19 June 2009, Bath, UK

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