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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: [email protected]
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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

References

1Biswas, D, Wilson, H, Mal, R. Use of systemic antibiotics with anterior nasal packing in England, UK. Clin Otolaryngol 2006;31:566–7CrossRefGoogle ScholarPubMed
2Thompson, AC, Crowther, JA. Effect of nasal packing on Eustachian tube function. J Laryngol Otol 1991;105:539–40CrossRefGoogle ScholarPubMed
3McGarry, GW. Epistaxis. In: Gleeson, M, ed. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery, 7th edn.London: Hodder Arnold, 2008;2:1596–606CrossRefGoogle Scholar
4Daudia, A, Jaiswal, V, Jones, NS. Guidelines for the management of idiopathic epistaxis in adults: how we do it. Clin Otolaryngol 2008;33:618–20CrossRefGoogle ScholarPubMed
5Browning, GG. Clinical Otology and Audiology, 2nd edn.Oxford: Butterworth Heinmann, 1998Google Scholar
6McCurdy, JA. Effects of nasal packing on Eustachian tube function. Arch Otolaryngol 1977;103:521–3CrossRefGoogle ScholarPubMed
7Nahass, RG, Gocke, DJ. Toxic shock syndrome associated with use of nasal tampon. Am J Med 1988;84:629–31CrossRefGoogle ScholarPubMed
8Ogawa, TK, Bergeron, RT, Whitaker, CW, Miles, JW, Rumbaugh, CL. Air-fluid levels in the sphenoid sinus in epistaxis and nasal packing. Radiology 1976;118:351–4CrossRefGoogle ScholarPubMed
9Orlandi, RR, Lanza, DC. Is nasal packing necessary following endoscopic sinus surgery? Laryngoscope 2004;114:1541–4CrossRefGoogle ScholarPubMed