TY - JOUR
T1 - An examination of antibiotic administration in septorhinoplasty
T2 - A systematic review and meta-analysis
AU - Benites, Cristina
AU - Awan, Muhammad Usman
AU - Patel, Heli
AU - Pandit, Saket
AU - Shifchik, Anastassia
AU - Harmon, Skylar
AU - Malisetyan, Tatevik
AU - Angel, Samuel
AU - Goldrich, David
AU - Demory, Michelle L.
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2024/7
Y1 - 2024/7
N2 - Purpose: Septoplasty and rhinoplasty are common otolaryngological procedures, often combined as septorhinoplasty (SRP), offering aesthetic and functional benefits. These surgeries are believed to potentially risk postoperative infections due to natural bacterial flora in the nares. This study evaluates the effectiveness of prophylactic antibiotics in reducing post-surgical infection complications. Materials and methods: A systematic review was conducted using PubMed, Cochrane, and Web of Science, adhering to PRISMA guidelines, focusing on antibiotic use in septoplasty, rhinoplasty, and SRP. The study included randomized control trials, single/double-blind studies, retrospective chart reviews, and prospective cohort studies, excluding pediatric, non-human research, or studies with inaccessible data. Postoperative infection rates were analyzed utilizing R software as a form of Statistic. Results: From 697 articles, 15 studies were chosen for meta-analysis, involving 2225 patients, with 1274 receiving prophylactic antibiotics and 951 as controls. The meta-analysis indicated an odds ratio of 0.65 (95 % CI: [0.23, 1.89]), showing no significant protective effect of prophylactic antibiotics. Discussion: The study found no significant infection rate reduction with prophylactic antibiotic use. Notable were inconsistencies in study designs, antibiotic administration timing, and varied surgical practices. Antibiotic use risks were considered. Study limitations include potential biases and the retrospective nature of many studies. Conclusions: This review and meta-analysis found no substantial evidence supporting prophylactic antibiotics' effectiveness in reducing postoperative infection rates in septoplasty, rhinoplasty, and SRP, indicating a need to reevaluate practices and develop evidence-based guidelines. Future research should focus on comprehensive, randomized control studies, covering both preoperative and postoperative stages.
AB - Purpose: Septoplasty and rhinoplasty are common otolaryngological procedures, often combined as septorhinoplasty (SRP), offering aesthetic and functional benefits. These surgeries are believed to potentially risk postoperative infections due to natural bacterial flora in the nares. This study evaluates the effectiveness of prophylactic antibiotics in reducing post-surgical infection complications. Materials and methods: A systematic review was conducted using PubMed, Cochrane, and Web of Science, adhering to PRISMA guidelines, focusing on antibiotic use in septoplasty, rhinoplasty, and SRP. The study included randomized control trials, single/double-blind studies, retrospective chart reviews, and prospective cohort studies, excluding pediatric, non-human research, or studies with inaccessible data. Postoperative infection rates were analyzed utilizing R software as a form of Statistic. Results: From 697 articles, 15 studies were chosen for meta-analysis, involving 2225 patients, with 1274 receiving prophylactic antibiotics and 951 as controls. The meta-analysis indicated an odds ratio of 0.65 (95 % CI: [0.23, 1.89]), showing no significant protective effect of prophylactic antibiotics. Discussion: The study found no significant infection rate reduction with prophylactic antibiotic use. Notable were inconsistencies in study designs, antibiotic administration timing, and varied surgical practices. Antibiotic use risks were considered. Study limitations include potential biases and the retrospective nature of many studies. Conclusions: This review and meta-analysis found no substantial evidence supporting prophylactic antibiotics' effectiveness in reducing postoperative infection rates in septoplasty, rhinoplasty, and SRP, indicating a need to reevaluate practices and develop evidence-based guidelines. Future research should focus on comprehensive, randomized control studies, covering both preoperative and postoperative stages.
KW - Antibiotic
KW - Antibiotic resistance
KW - Flora
KW - Healthcare
KW - Postoperative
KW - Preoperative
KW - Prophylactic
KW - Rhinoplasty
KW - Septoplasty
KW - Septorhinoplasty
KW - SRP
KW - Surgery
KW - Surgical
UR - https://www.scopus.com/pages/publications/85191339583
UR - https://www.scopus.com/pages/publications/85191339583#tab=citedBy
U2 - 10.1016/j.amjoto.2024.104333
DO - 10.1016/j.amjoto.2024.104333
M3 - Review article
C2 - 38677149
AN - SCOPUS:85191339583
SN - 0196-0709
VL - 45
JO - American Journal of Otolaryngology - Head and Neck Medicine and Surgery
JF - American Journal of Otolaryngology - Head and Neck Medicine and Surgery
IS - 4
M1 - 104333
ER -