The effect of antibiotic ointment on nasal packings: Is it effective in reducing postoperative nasal bacterial loads?

Nasal packing is a widely used procedure in various types of nasal surgery and the management of nasal bleeding. The purpose of this study was to evaluate a simple procedure of applying antibiotic ointment to the surface of the packing during the packing procedure. Six patients who were undergoing septomeatoplasty were enrolled in this study. All patients received postoperative antibiotics by mouth (cephalexin 500mg 4 times daily for 7 days). In addition, all patients received bilateral nasal packing with Merocele. On one randomly chosen side, ointment containing neomycin sulfate 5mgplusbacitracin zinc 12.5mg was applied on the surface of the packing prior to use. On the control side of the same patient, Vaseline ointment was used instead. The packs were removed 3 days later and a 1cm3 piece of the packing was taken from the middle section. The samples were sent for bacteriological analysis. Tryptic soy broth was added to the samples and they were evenly dispersed on blood agar plates. After incubating overnight, colony formation was observed and recorded. The data from each group were compared using the Wilcoxon signed rank test. Among the control nasal packing side, Pseudomonas putida and Staphylococcus epidermidis were the bacteria most commonly cultured. The mean±SD number of colony-forming units for the removed nasal packing (n=6) on the neomycin side and the control side of the same patient were 70±105 units and 165±166 units, respectively. In addition to the systemic administration of antibiotics, a significant reduction in bacterial load was achieved if a topical neomycin antibiotic ointment was applied to the nasal packing prior to use. We suggest that this simple application of topical neomycin on the nasal packing surface should be used whenever nasal packing is needed.