Background: Prophylactic antimicrobial therapy during nasal surgery is common among surgeons worldwide, although the effectiveness of this practice is controversial. The authors reviewed the literature to evaluate the value of antibiotic prophylaxis.
Methods: A MEDLINE search was preformed using the key terms septoplasty, rhinoplasty, infections and antibiotics. The authors identified eleven studies written in English or German that addressed the effectiveness of prophylactic antibiotics, infection rate and bacteremia during nasal surgery. Due to the small number of studies statistical re-analysis was discarded.
Results: The articles demonstrated an overall very low incidence of bacteremia or infection. The studies failed to demonstrate a difference between patients who received antibiotic prophylaxis during nasal surgery and patients who did not; with the only exception being cases of complicated revision rhinoplasties.
Conclusion: Our review suggests that the infection rate after elective nasal surgery is very low, making routine antibiotic prophylaxis redundant. Preventive systemic antibiotics are indicated in complicated revision rhinoplasties, prolonged placement of nasal packs and for patients who are susceptible to infections.