Prophylactic antibiotics in septoplasty with intranasal septal splints: A comparative analysis.

OBJECTIVES: Postoperative antibiotic therapy is a common practice following septoplasty with intra-septal splints placement (ISS), even though there is a lack of evidence to support it. We sought to investigate the role of antibiotic therapy in septal surgeries with the placement of ISS.

DESIGN: A retrospective comparative study was conducted using the electronic charts of adult patients who underwent septoplasty with the placement of ISS with or without turbinate reduction. Nasal cultures were taken routinely during surgery as part of the department's protocol for monitoring infectious diseases. The ISS were also routinely examined for the presence of bacteria after their removal on the eighth day following surgery.

SETTING: A large otolaryngology department in a tertiary medical center.

PARTICIPANTS: Adult patients who underwent septoplasty in our institution.

MAIN OUTCOME MEASURES: We analyzed all post-operative infections to search for risk factors in the cohort.

RESULTS: Post-operative infection rates following septoplasty with ISS were low at 6%, which is consistent with previously published rates. Infection rates were significantly higher in patients who were not treated with antibiotics (OR = 8.2, 95%CI: 1.63-41.1; p = .01, φ = 0.04). Diabetes was associated with an increased risk of postoperative infection regardless of prophylactic antibiotic therapy (OR = 5.2, 95%CI: 1.15-23.5; p = .032, φ = .04). The detection of Klebsiella pneumonia before surgery was associated with an increased rate of postoperative infection (OR = 16.6, 95%CI: 3.02-91.54; p = .001, φ = 0.12).

CONCLUSIONS: Patients undergoing septoplasty with the placement of ISS are at increased risk of gram-negative bacterial colonisation, and development of postoperative nasal infection. A single preoperative dose of IV antibiotic therapy should be considered a potential prophylactic option for septoplasty with ISS.