SHOULD PROPHYLACTIC ANTIBIOTICS BE USED IN THE MANAGEMENT OF CEREBROSPINAL-FLUID RHINORRHEA FOLLOWING ENDOSCOPIC SINUS SURGERY - A REVIEW OF THE LITERATURE

This review article investigates whether prophylactic antibiotics shou ld be used in the management of cerebrospinal fluid rhinorrhoea follow ing endoscopic sinus surgery. A medline database was used to retrieve all English articles from 1970 to the present, cross-indexing cerebros pinal rhinorrhoea, antibiotics and endoscopic sinus surgery. All relev ant articles retrieved were reviewed together with their bibliographie s. The use of prophylactic antibiotics is neither recommended nor cond emned by evidence of efficacy. However, their use is cautioned against by evidence of a subsequent change in nasopharyngeal flora to potenti ally more invasive organisms. The review concludes that, at present, i t is usually justifiable to withhold prophylactic antibiotics and to o bserve for the symptoms and signs of meningitis instituting antibiotic therapy when this complication develops.