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July 1986

Toxic Shock Syndrome After Nasal Surgery

Arch Otolaryngol Head Neck Surg. 1986;112(7):784. doi:10.1001/archotol.1986.03780070096021

To the Editor.—I am writing concerning the article about toxic shock syndrome (TSS) after nasal surgery in the March 1986 Archives.1 Jacobson and Kasworm make the statement that "topical or systemic antibiotics did not have a demonstrable protective effect [on preventing toxic shock following nasal surgery]." They use in support of this statement three cases, which they report in their article1; four cases reported previously2-5; and a survey of ear, nose, and throat surgeons in Utah concerning cases from 1980 to 1983 that involved 18 190 surgeries without incidence of TSS. Although the statement may be true that systemic antibiotics do not have a demonstrable protective effect on the prevention of TSS, their article did not provide any evidence to this end, and the cases and survey that they quote show that no patient who received appropriate perioperative prophylactic antibiotics6 contracted TSS and that no

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