Antibiotics not necessary after most sinus surgeries says cl
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Surgeons commonly prescribe prophylactic antibiotics after endoscopic sinus surgery (ESS), a recent study states that the routine use of prophylactic postoperative antibiotics does not improve outcomes post ESS and significantly increases the rate of diarrhea.

Post sinus surgery antibiotics are commonly prescribed yet minimal data exist to support this practice. In the study published by the International Forum of Allergy and Rhinology, researchers aimed to assess the impact of post ESS antibiotics on infection, quality of life (QOL), and endoscopic scores.

This was a randomized, double-blind, placebo-controlled, non-inferiority study comparing ESS amoxicillin-clavulanate versus placebo. Adults with chronic rhinosinusitis (CRS) refractory to suitable medical therapy who underwent ESS were randomized and clinically accompanied by antibiotics or placebo. QOL was assessed at baseline and follow-up with 22-item Sino-Nasal Outcome Test questionnaires and endoscopic Lund-Kennedy scores were analyzed. With repeated measure analysis of variance and analysis of covariance and z tests for proportions, outcomes were analyzed.

Placebo was non-inferior to antibiotic prophylaxis with regard to postoperative SNOT 22 scores. There were no significant differences between the antibiotic and placebo groups in LK score trajectories over time or in postoperative infection rates. The rate of diarrhea was significantly higher in the antibiotic group.

The findings indicate that placebo was non-inferior to prophylactic antibiotics after ESS for CRS with regard to postoperative sinonasal-specific QOL, albeit statistically underpowered. There were no major variations in postoperative endoscopic scores or infection rates, however, in the antibiotic community, the diarrhea rate was substantially higher. These results add to the increasing evidence that regular use of postoperative prophylactic antibiotics does not enhance post-ESS outcomes and significantly increases the diarrhea incidence.