Cefuroxime as a prophylactic preoperative antibiotic in septoplasty. A double blind randomized placebo controlled study

Abstract

BACKGROUND: Prophylactic antibiotics are often used in septoplasty. However, the number of controlled studies, especially randomized double blind placebo controlled studies on the effect of antibiotics in septum surgery, is very low. The PURPOSE OF THE PRESENT STUDY was to investigate if intravenous cefuroxime given as preoperative antimicrobial prophylaxis 30 minutes prior to surgery diminishes the risk of infection after septoplasty during the first postoperative month among patients with normal immune function. METHODS: This study was a double-blind placebo controlled randomized study and patients were randomized to either an antibiotic prophylaxis-group or placebo-group. RESULTS: In the antibiotic-group, the infection rate was 2.2% (2/92) and in the placebo-group 8.3% (8/96), which is not statistically different. All three deep incisional SSI (septal abscess) occurred in the placebo-group. The preoperative crusting or purulent secretion, or Staphylococcus aureus in the bacterial swab increased the risk of postoperative infection significantly. CONCLUSIONS: We recommend the use of one dose of 1500 mg intravenous cefuroxime prior to septoplasty in patients having crusts or purulent secretion in the nasal cavities or if the operation is expected to be prolonged.

One dose of preoperative, intravenous, prophylactic antibiotics significantly lowers postoperative infection rate in septoplasty—a study of 772 operations

“…The overall infection rate of 3.8% was similar to previous reports, [3][4][5][6][7][8] but in the non-antibiotic group, the rate was high; 6.1%. In the comparison over time, infection rates, and especially the amount of potentially dangerous deep SSIs, reduced with increased use of prophylactic antibiotics, [3][4][5]9 advocating the use of prophylaxis.…”

“…Form of anaesthesia does not explain the SSI reduction over time, as GA was more frequent in 2015-2018 than in the previous studies. 3,5,9 The reason for this finding is unclear. The most common reason for GA in our institution is patient's request.…”

“…than in the placebo group. 3 Our current aim was to assess the trend of the use of prophylactic antibiotics and how different regimens affect the infection rate in a real-world setting.…”

“…Reported infection rates vary considerably (0.5%-12%). [3][4][5][6][7][8][9] The World Health Organization (WHO) guidelines generally recommend antibiotic prophylaxis in clean-contaminated surgeries such as septoplasty. 1 The administration should occur prior to, but no earlier than 120 min before incision.…”

“…Although septoplasty is one of the most common otorhinolaryngologic surgeries, there are no generally accepted recommendations on the use of prophylactic antibiotics. Reported infection rates vary considerably (0.5%–12%) 3–9 . The World Health Organization (WHO) guidelines generally recommend antibiotic prophylaxis in clean‐contaminated surgeries such as septoplasty 1 .…”