• Logo
  • SBMUJournals

Role of Prophylactic Antibiotic Administration in Growth of Methicillin Resistant Staphylococcus Aureus in Rhinoplasty

Nader Akbari Dilmaghani, Masoumeh Navidinia, Latif Gachkar, Shima Arastou
40

Views

PDF

Abstract

Background: Septoplasty and septorhinoplasty are common surgical procedures in modern surgical practice. Pre or postoperative antibiotic administration has raised concerns about the possible increase in the antibiotic-resistant species. The aim of this study was to evaluate the role of postoperative antibiotic prophylaxis in increasing Methicillin-Resistant Staphylococcus Aaureus species (MRSA) in patients, who underwent septoplasty or septorhinoplasty in Loghman Hakim Hospital in Tehran, Iran.
Methods: A total of 102 patients, who were planned to undergo septoplasty or septorhinoplasty, participated in this double-blind randomized clinical trial. The patients were divided into the case (n=60, mean age of 28.2 years) and control (n=38, mean age of 28.9 years) groups. Overall, 98 patients participated in the study. The case group received a preoperative injection of cephalothin (1g) and postoperative oral cephalexin regimen (500mg 4 times a day for 7 days). The control group only received a preoperative injection of cephalothin (1g). Vestibular nasal swab cultures were obtained preoperatively and on postoperative day 7. The samples were, then, quickly transferred to the laboratory and cultured on proper media. The results indicated that five MRSA species in the case group and tow MRSA species in the control group were present, postoperatively.
Results: The findings of this study suggest that oral antibiotic prophylaxis may lead to a statically non-significant increase in MRSA infection in patients, who require this treatment.
Conclusion: Further knowledge of the endogenous nasal flora and the microbiology of common pathogens in patients undergoing septorhinoplasty will help reduce the incidence of infectious complications to a greater level.


Keywords

Rhinoplasty, MRSA, Staphylococcus Aureus, Antibiotic

References

Perrotti JA, Castor SA, Perez PC, Zins JE. Antibiotic use in aesthetic surgery: A national survey and literature review. Plastic and Reconstructive Surgery. 2002; 109(5):1685-93. [DOI:10.1097/00006534-200204150-00035] [PMID]

Rajan GP, Fergie N, Fischer U, Romer M, Radivojevic V, Hee GK. Antibiotic prophylaxis in septorhinoplasty? A prospective, randomized study. Plastic and Reconstructive Surgery. 2005; 116(7):1995-8. [DOI:10.1097/01.prs.0000191181.73298.b3] [PMID]

Rechtweg JS, Paolini RV, Belmont MJ, Wax MK. Postoperative antibiotic use of septoplasty: A survey of practice habits of the membership of the American Rhinologic Society. American Journal of Rhinology. 2001; 15:(5):315-20. [DOI:10.1177/194589240101500506] [PMID]

Schwab JA, Pirsig W. Complications of septal surgery. Facial Plastic Surgery. 1997; 13(1):3-14. [DOI:10.1055/s-2008-1064461] [PMID]

Angelos PC, Wang TD. Methicillin‐resistant Staphylococcus aureusinfection in septorhinoplasty. Laryngoscope. 2010; 120(7):1309-11. [DOI:10.1002/lary.20966] [PMID]

Barry AL, Jones RN. Bacterial antibiotic resistance before and after clinical application in the United States. Bulletin of the New York Academy of Medicine. 1987; 63(3):217-30. [PMID] [PMCID]

Leonard D, Thompson D. Unusual septoplasty complication: Streptococcus viridansendocarditis. Ear, Nose & Throat Journal. 1998; 77(10):827-31. [DOI:10.1177/014556139807701009]

Weimert TA, Yoder MG. Antibiotics and nasal surgery. Laryngoscope. 1980; 90(4):667-72. [DOI:10.1288/00005537-198004000-00014]

Yoder M, Weimert T. Antibiotics and topical surgical preparation solution in septal surgery. Otolaryngology-Head and Neck Surgery. 1992; 106(3):243-4. [DOI:10.1177/019459989210600307] [PMID]

Slavin SA, Rees TD, Guy CL, Goldwyn RM. An investigation of bacteremia during rhinoplasty. Plastic and Reconstructive Surgery. 1983; 71(2):196-8. [DOI:10.1097/00006534-198302000-00008] [PMID]

Noble W, Williams R, Jevons MP, Shooter R. Some aspects of nasal carriage of staphylococci. Journal of Clinical Pathology. 1964; 17:79-83. [DOI:10.1136/jcp.17.1.79] [PMID] [PMCID]

Kluytmans J, Van Belkum A, Verbrugh H. Nasal carriage of Staphylococcus aureus: Epidemiology, underlying mechanisms, and associated risks. Clinical Microbiology Reviews. 1997; 10(3):505-20. [DOI:10.1128/CMR.10.3.505] [PMID] [PMCID]

Mahon CR, Lehman DC, Manuselis GJ. Textbook of diagnostic microbiology, 5th edition. London: Elsevier Health Sciences; 2014.

Armin S, Fallah F, Navidinia M, Vosoghian S. Prevalence of blaOXA-1 and blaDHA-1 AmpC β-Lactamase-Producing and Methicillin-Resistant Staphylococcus aureus in Iran. Archives of Pediatric Infectious Diseases. 2017; 5(4):e36778.

Clinical & Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-second informational supplements. Clinical & Laboratory Standards Institute. 2013; 31(3):70-88.

Mäkitie A. Postoperative infection following nasal septoplasty. Acta Oto-Laryngologica. 2000; 120(543):165-6. [DOI:10.1080/000164800454297]

Silk KL, Ali MB, Cohen BJ, Summersgill JT, Raff MJ. Absence of bacteremia during nasal septoplasty. Archives of Otolaryngology-Head and Neck Surgery. 1991; 117:54-5. [DOI:10.1001/archotol.1991.01870130060016]

Caniello M, Passerotti GH, Goto EY, Voegels RL, Butugan O. Antibiotics in septoplasty: Is it necessary? Brazilian Journal of Otorhinolaryngology. 2005; 71:734-8. [DOI:10.1016/S1808-8694(15)31241-6]

Lawson W, Kessler S, Biller HF. Unusual and fatal complications of rhinoplasty. Otolaryngology-Head and Neck Surgery. 1983; 109(3):164-9. [DOI:10.1001/archotol.1983.00800170030008]

Fairbanks D. Complications of nasal packing. Otolaryngology-Head and Neck Surgery. 1986; 94(3):412-5. [DOI:10.1177/019459988609400337] [PMID]

Hull HF, Mann JM, Sands CJ, Gregg SH, Kaufman PW. Toxic shock syndrome related to nasal packing. Archives of Otolaryngology-Head and Neck Surgery. 1983; 109(9):624-6. [DOI:10.1001/archotol.1983.00800230060015] [PMID]

Taasan V, Wynne JW, Cassisi N, Block AJ. The effect of nasal packing on sleep‐disordered breathing and nocturnal oxygen desaturation. Laryngoscope. 1981; 91(7):1163-72. [DOI:10.1288/00005537-198107000-00015] [PMID]

Philpott C, Sharma A, McKiernan D. Does methicillin-resistant Staphylococcus aureushave a significant role in the peri-operative course of patients undergoing rhinological surgery? The Journal of Laryngology and Otology. 2009; 123(2):191-4. [DOI:10.1017/S0022215108002855] [PMID]

Elie‐Turenne MC, Fernandes H, Mediavilla JR, Rosenthal M, Mathema B, Singh A, et al. Prevalence and characteristics of Staphylococcus aureuscolonization among healthcare professionals in an urban teaching hospital. Infection Control and Hospital Epidemiology. 2010; 31(6):574-80. [DOI:10.1086/652525] [PMID]

Sharma A, Philpott C, Pope L, McKiernan D. Methicillin resistant Staphylococcus aureus: Is it a problem for nasal surgery? The Journal of Laryngology and Otology. 2007; 121(5):415-8. [DOI:10.1017/S0022215106002763] [PMID]

Kuehnert MJ, Kruszon-Moran D, Hill HA, McQuillan G, McAllister SK, Fosheim G, et al. Prevalence of Staphylococcus aureusnasal colonization in the United States, 2001-2002. The Journal of Infectious Diseases. 2006; 193(2):172-9. [DOI:10.1086/499632] [PMID]

Lucet JC, Chevret S, Durand-Zaleski I, Chastang C, Regnier B. Prevalence and risk factors for carriage of methicillin-resistant Staphylococcus aureusat admission to the intensive care unit: results of a multicenter study. Archives of Internal Medicine. 2003; 163(2):181-8. [DOI:10.1001/archinte.163.2.181] [PMID]

Lucet JC, Grenet K, Armand-Lefevre L, Harnal M, Bouvet E, Regnier B, et al. High prevalence of carriage of methicillin-resistant Staphylococcus aureusat hospital admission in elderly patients: Implications for infection control strategies. Infection Control and Hospital Epidemiology. 2005; 26(2):121-6. [DOI:10.1086/502514] [PMID]

Kaygusuz I, Kizirgil A, Karlidag T, Yalçin S, Keles E, Yakupogullari Y, et al. Bacteriemia in septoplasty and septorhinoplasty surgery. Rhinology. 2003; 41(2):76-9.

Ricci G, D’Ascanio L. Antibiotics in septoplasty: Evidence or habit? American Journal of Rhinology & Allergy. 2012; 26(3):194-6. [DOI:10.2500/ajra.2012.26.3755] [PMID]

Georgiou I, Farber N, Mendes D, Winkler E. The role of antibiotics in rhinoplasty and septoplasty: A literature review. Rhinology. 2008; 46(4):267-70. [PMID]




DOI: https://doi.org/10.32598/ijmtfm.v9i3.25228