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Are Intravenous Antibiotics Really Necessary?

Craig S. Derkay, MD; Barry E. Hirsch, MD; Jonas T. Johnson, MD; Robin L. Wagner

Arch Otolaryngol Head Neck Surg. 1989;115(4):439-441.

Abstract
• The use of antimicrobial prophylaxis in the presence of posterior nasal packing for the treatment of posterior epistaxis remains controversial. Twenty patients were prospectively randomized into this placebo-controlled, double-masked pilot study to receive either placebo or cefazolin sodium. Antibiotic-impregnated posterior gauze packing was employed in all patients. No infectious complications were noted in either group. The packings from the patients in the placebo group were foul smelling and heavily colonized with gram-negative bacteria while the packings from the antibiotic group were odor-free and lightly colonized with gram-positive organisms. This preliminary study suggests the usefulness of antimicrobial prophylaxis for preventing complications from posterior nasal packing, although a larger sample size will be needed to decrease the type II (β) error.

(Arch Otolaryngol 1989;115:439-441)

Author Affiliations
From the Department of Otolaryngology, University of Pittsburgh School of Medicine, and the Eye and Ear Hospital of Pittsburgh.

Footnotes
Accepted for publication Sept 9, 1988.

Presented at the Second Annual Mid-Atlantic Resident Research Symposium, Bethesda, Md, May 7, 1988.

Reprint requests to Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye and Ear Hospital, Suite 500, 203 Lothrop St, Pittsburgh, PA 15213 (Dr Johnson).

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