The purpose of this study was to perform a systematic literature review to determine the role of prophylactic systemic antibiotics with nasal packing in the prevention of toxic shock syndrome and local nasal infections.

This was conducted in several medical literature databases by following the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Only English publications and human studies were randomized control trials, quasi-randomized control trials, controlled clinical trials, retrospective studies, and case series.

Six studies, with 990 patients, met the inclusion criteria for the review and were included. Primary outcomes were signs and symptoms of nasal or sinus infections in patients who underwent nasal packing for epistaxis or septoplasty. There was no statistical difference in purulent drainage in patients who had septoplasty treated with or without antibiotics.

There is a lack of literature that reviewed the need for prophylactic systemic antibiotics with nasal packing. The available literature does not significantly benefit the use of antibiotics with nasal packing, but the studies were underpowered to detect such a difference. One must consider the associated risks of prophylactic antibiotics to the patient and when deciding to prescribe prophylactic antibiotics.