KBB-Forum 2007 , Cilt 6, Sayı 1


Celil GÖÇER, MD1; Engin DURSUN, MD1; Aydın ACAR, MD1; Mustafa ÖZMAN, MD1; Muharrem DAĞLI, MD1; Neriman BALABAN, MD2; Adil ERYILMAZ, MD1
1Ankara Numune Training and Research Hospital, 3rd Otorhinolaryngology Clinic, Ankara, Turkey
2Ankara Numune Training and Research Hospital, Clinic of Microbiology Ankara, Turkey
Aim of the study was to compare two different antimicrobial prophylaxis (AMP) regimens and obtain objective data about effectiveness of these regimens in nasal septal surgery (NSS) patients. One hundred-eight patients were randomized into 2 groups. Group one consisted 48 and the other 60 patients. Forty-eight patients in the 1st group were administered ampicillin/sulbactam 375 mg twice a day p.o. five days postoperatively and 60 patients in the 2nd group were administered a single dose of cefazolin 1gr/iv preoperatively. In both groups nitrofurazone ointment soaked extrafor packing material was applied after septoplasty. Preoperative and postoperative nasal flora was determined by microscopy and cultures. Preoperative and postoperative cultures of 1st group revealed Staphylococcus aureus in 20.8% (10/48) and 14.6% (7/48), and potential pathogenic bacteria (PPB) in 4.2% (2/48) and 14.6% (7/48), respectively. Preoperative and postoperative cultures of 2nd group revealed Staphylococcus aureus in 16.7% (10/60) and 18.3% (11/60), and PPB in 5% (3/60) and 20% (12/60). In analysis of growth rates of bacteria statistically insignificant pre and post-operative counts were found (p=0.216>0.05) in the 1st group, but significant (p=0.015<0.05) in 2nd group. One and two of the patients showed localized infection signs in 1st and 2nd group, respectivelyMicrobiologically postoperative five-day orally given AMP is superior but clinically there is no difference. According to clinicall follow-up both AMP regimes are similarly effective. Compliance of patients to medical prescriptions should be taken in attention, therefore single dose preoperative iv AMP is more attractive to ensure patients adherence. Keywords : Septal deviation, nasal septal surgery, septoplasty, antimicrobial prophylaxis, nasal packing