The role of antibiotics in endoscopic sinus surgery

Area of Science:

• Otolaryngology
• Pharmacology
• Infectious Disease

Background:

• Endoscopic sinus surgery (ESS) is a common procedure for chronic rhinosinusitis.
• The role of antibiotic prophylaxis and treatment in ESS remains a subject of ongoing debate.
• Current guidelines and evidence require critical evaluation for optimal patient care.

Purpose of the Study:

• To review and synthesize recent literature on antibiotic use in relation to endoscopic sinus surgery (ESS).
• To evaluate the efficacy of perioperative, postoperative, and packing-associated antibiotic regimens.
• To identify areas for future research in antibiotic management for ESS.

Main Methods:

• Systematic literature review of studies on antibiotic use in ESS.
• Analysis of evidence regarding perioperative antibiotic prophylaxis.
• Assessment of outcomes associated with postoperative antibiotic therapy and antibiotic-impregnated packing.

Main Results:

• Perioperative antibiotics are not recommended by major health-system pharmacy organizations.
• Most studies indicate limited or no significant improvement in outcomes with routine postoperative antibiotics following ESS.
• Evidence suggests potential benefits for quality-of-life and endoscopic scores in the early postoperative period with conventional antibiotics, and possible long-term advantages with prolonged macrolide therapy.
• No convincing evidence supports the need for antibiotics when using postoperative packing.

Conclusions:

• The current evidence does not support the routine use of antibiotics in relation to ESS.
• Existing studies have limitations, highlighting the need for high-quality research.
• Well-designed, large-scale prospective studies are essential to guide appropriate systemic and topical antibiotic use in ESS.