amoxicillin-potassium-clavulanate-combination and Epistaxis

There is limited evidence supporting the usage of prophylactic antibiotics in the setting of nasal packing for epistaxis. It is unclear what current antiobiotic usage patterns are by otolaryngologists.. Characterize the antibiotic prescribing practices employed by otolaryngologists in the management of epistaxis patients treated with packing as well as the underlying rationale. Explore the impact of experience, geography, and academic affiliation on treatment decisions.. An anonymous survey of antibiotic prescribing patterns for patients with epistaxis requiring nasal packing was distributed to all physician members of the American Rhinologic Society. Responses to each question were descriptively summarized including 95% confidence intervals and were linked to demographics using Fisher's exact tests.. Antibiotic use in patients with epistaxis controlled with nondissolvable packing is common. Treatment patterns are influenced by geography, years in practice, and practice type.. 4.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Epistaxis; Humans; Sinusitis

Orbital blowout fractures are nearly always caused by acute trauma. Non-traumatic cases of orbital blowout fractures have only been rarely described. In this case study, we discuss an orbital blowout fracture directly caused by nose blowing. The patient developed unilateral eye swelling and orbital emphysema. It is important for the clinician to investigate all suspected orbital blowout fractures with imaging and full ophthalmological examination regardless of a trauma history. Most cases of orbital emphysema resolve spontaneously, however one must always exclude compression of the central retinal artery. This may present as acute loss of vision and/or ophthalmoplegia.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Barotrauma; beta-Lactamase Inhibitors; Epistaxis; Female; Humans; Nose; Orbital Fractures; Patient Education as Topic; Referral and Consultation; Tomography, X-Ray Computed; Treatment Outcome

There is wide variation in UK prescribing practice regarding prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published cases of infective complications in such patients.. This prospective study examined 149 consecutive patients admitted to a tertiary otorhinolaryngology centre with spontaneous epistaxis, who underwent nasal packing, over a six-month period. In the first three-month period, 78 patients were routinely prescribed prophylactic antibiotics; in the second three months, 71 patients were not routinely prescribed antibiotics. Exclusion criteria included antibiotics prescribed for unrelated pathology and post-operative epistaxis. Signs and symptoms of acute otitis media, sinusitis and toxic shock syndrome were assessed using clinical examination and a questionnaire.. Fourteen of the 149 patients experienced otalgia, most commonly following posterior nasal packing. No patient in either group had evidence of any infective complication.. We do not recommend the routine prescription of prophylactic antibiotics for patients undergoing nasal packing for spontaneous epistaxis.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Earache; Epistaxis; Hemostatic Techniques; Humans; Nasal Mucosa; Outcome Assessment, Health Care; Practice Patterns, Physicians'; Prospective Studies; Risk Factors; Tampons, Surgical; United Kingdom

This pilot study did not show an advantage of the routine use of prophylactic antibiotics for spontaneous epistaxis treated by nasal packing.. The purpose of this study was to investigate the value of the use of prophylactic antibiotics in spontaneous epistaxis cases treated with anterior nasal packing.. Over a period of 6 months, all cases of epistaxis managed with anterior nasal packing were studied prospectively. After pack removal, swabs from the packed and the non-packed sides of the nasal cavity were cultured to detect any difference in the bacterial growth pattern between the two sides. All these cases were clinically evaluated to detect any infection secondary to the anterior nasal packing.. We did not observe infection in any of the cases before or after removal of the anterior nasal pack. The bacterial growth profile of packed and non-packed sides of the nose did not differ significantly.

Topics: Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacteriological Techniques; Colony Count, Microbial; Epistaxis; Guideline Adherence; Humans; Nasal Mucosa; Pilot Projects; Prospective Studies; Tampons, Surgical