This retrospective cohort study attempted to understand the benefits of prophylactic antibiotics with nasal packing. 275 cases of nasal packing secondary to epistaxis in the Emergency Room were reviewed. Both absorbable and non absorbable packing were used. The majority of patients that received absorbable nasal packing did not receive prophylactic antibiotics while 73% of patients with non absorbable nasal packing were treated prophylactically. No cases of toxic shock syndrome were reported among any of the patients. One case of sinusitis was reported in the group that received non absorbable packing with prophylactic antibiotics, while no cases of sinusitis were reported in the group of patients that received non absorbable packing without prophylactic antibiotics. No cases of sinusitis were reported in the group that received absorbable packing with prophylaxis, while one case reported in the group that did not receive prophylaxis with absorbable packing. The authors conclude that there is no clear advantage to treating patients prophylactically when they undergo nasal packing for epistaxis control.