ANTIMICROBIAL PROPHYLAXIS IN NASOSEPTAL SURGERY

¹Ankara Numune Training and Research Hospital, 3^rd 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 1^st group were administered ampicillin/sulbactam 375 mg twice a day p.o. five days postoperatively and 60 patients in the 2^nd 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 1^st 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 2^nd 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 1^st group, but significant (p=0.015<0.05) in 2^nd group. One and two of the patients showed localized infection signs in 1^st and 2^nd 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