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

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 antibioticresistant species. The aim of this study was to evaluate the role of postoperative antibiotic prophylaxis in increasing MethicillinResistant 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 doubleblind 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 nonsignificant 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.