title: The role of antibiotics in endoscopic sinus surgery.
abstract: OBJECTIVE
  To review and discuss recent literature regarding the use of antibiotics in relation to endoscopic sinus surgery (ESS), including perioperative antibiotics, postoperative antibiotics, and antibiotic usage in the setting of postoperative packing.
  
  
  RESULTS
  Perioperative antibiotics are not recommended by the American Society of Health-System Pharmacists. The necessity of antibiotics following ESS is a heavily debated topic. Most studies show little to no improvement in outcomes. Significant improvement in quality-of-life outcomes and endoscopic scoring appears limited to the early postoperative period using conventional postoperative antibiotics. Prolonged macrolide therapy may improve long-term outcomes. There is no convincing evidence to show the need for antibiotics in the setting of postoperative packing.
  
  
  CONCLUSIONS
  The available evidence regarding antibiotic use in relation to ESS overall fails to demonstrate routine benefit; however, the studies have various limitations. Overall, future, well designed, large-scale prospective studies would be beneficial to direct appropriate antibiotic use, whether systemic or topical, in relation to ESS.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, Orange, California, USA.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Coughlan
authors.forename: Naveen D
authors.initials: ND
authors.lastname: Bhandarkar
authors.forename: Naveen
authors.initials: N
authors.lastname: Bhandarkar
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015897:Comorbidity; D004724:Endoscopy; D006801:Humans; D010256:Paranasal Sinuses / Q000601:surgery*; D059035:Perioperative Period; D011184:Postoperative Period
chemical_list: D000900:Anti-Bacterial Agents