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A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Antibiotic use in nasal bone fracture: a nationwide population-based cohort study in Korea
Yeo Reum Jeon1, Ji Hyuk Jung1, Joon Ho Song1
1Department of Plastic and Reconstructive Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Insights
Antibiotic use in nasal fracture surgery varies widely in Korea, with over half of patients receiving prescriptions. General anesthesia increased antibiotic odds, highlighting a need for evidence-based guidelines in nasal bone fracture treatment.
Area of Science:
- Otorhinolaryngology
- Surgical Infection Prevention
- Pharmacology
Background:
- Prophylactic antibiotic use is common in craniofacial surgery.
- Consensus on antibiotic prophylaxis for closed nasal fracture reduction is lacking, leading to varied prescribing.
- This study examines prophylactic antibiotic use in Korean nasal bone fracture surgeries.
Purpose of the Study:
- To investigate the current status of prophylactic antibiotic prescription patterns.
- To identify factors influencing perioperative antibiotic use in closed nasal fracture reductions.
- To inform future evidence-based guidelines for antimicrobial prescribing.
Main Methods:
- Retrospective cohort study using Korean National Health Insurance Service data (2005-2015).
- Analysis of medical records for patients undergoing closed reduction of nasal bone fractures.
- Multivariate logistic regression to evaluate factors affecting antibiotic prescription.
Main Results:
- Over half (51.4%) of 3,678 patients received perioperative antibiotics.
- General anesthesia significantly increased the odds of antibiotic use (OR=1.59).
- Second-generation cephalosporins were most common; lincomycin derivatives and aminoglycosides were not used.
Conclusions:
- Significant variability exists in perioperative antibiotic prescribing for nasal bone surgeries.
- The findings underscore the need for evidence-based guidance on antimicrobial use.
- Future research should focus on developing clear prescribing recommendations.
Background:
Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea.
Methods:
This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis.
Results:
A total of 3,678 patients (mean± standard deviation of age, 28.7± 14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed.
Conclusion:
The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.
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Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...