A randomized prospective study of oral levofloxacin vs intravenous flomoxef prophylaxis in postoperative infection after endoscopic sinus surgery.
OBJECTIVE
The clinical efficacy and cost effectiveness of oral antimicrobial prophylaxis with levofloxacin (LVFX) on endoscopic sinus surgery (ESS) was evaluated.


METHODS
Ninety-three patients undergoing ESS were prospectively enrolled in the present study. The patients were randomly divided into 2 groups, LVFX and flomoxef (FMOX). Two hundred milligrams of LVFX was orally given 2 hours before the start of surgery and 6 hours after the end of surgery, which was followed by the administration of 200 mg every 12 hours for 2 days. One gram of FMOX was dissolved in 100 ml of physiological saline and given intravenously at the induction of anesthesia and 6 hours after the end of surgery, followed by infusion twice daily for 2 days.


RESULTS
There were no statistically significant differences between 2 groups in terms of age, sex, systemic complications, surgical procedures, the duration of the operation, the length of hospitalization, the amount of blood loss, body temperature, or the number of white blood cells or C-reactive protein. Although no statistical significance was observed in the bacterial resistance between the two antibiotics, LVFX seems to show a low rate of resistance pattern change as compared to FMOX. The present study demonstrated that no patients treated with LVFX or FMOX were afflicted with postsurgical infection.


CONCLUSIONS
Oral administration of LVFX is a simple, cost-effective and safe alternative to intravenous prophylaxis in ESS based on clinical efficacy and bacteriological study.
Inoshita
Ayako
A
Department of Otorhinolaryngology, Juntendo University School of Medicine, Tokyo, Japan.
Yokoi
Hidenori
H
Matsumoto
Fumihiko
F
Yao
Toru
T
Kawano
Kenji
K
Furukawa
Masayuki
M
Ikeda
Katsuhisa
K
D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000517:prevention & control; D002511:Cephalosporins / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004724:Endoscopy; D006801:Humans; D007262:Infusions, Intravenous; D064704:Levofloxacin; D015242:Ofloxacin / Q000627:therapeutic use*; D010256:Paranasal Sinuses / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012220:Rhinitis / Q000601:surgery; D012852:Sinusitis / Q000601:surgery
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D064704:Levofloxacin; D015242:Ofloxacin; C045693:flomoxef