Comparative evaluation of short-term versus long-term post-operative antibiotic prophylaxis after mandibular fractures

Mahesh Goel, Shruti Kirti, J. Singh, Rajiv Tawar, Arun Kumar


Background: No consensus is present among the clinicians regarding the use of post-operative antibiotics after the open reduction and internal fixation. This study evaluates the efficacy of short-term (48 hrs) versus long-term (5 days) post-operative antibiotics in preventing infection rates after the open reduction and internal fixation in mandible fractures.

Methods: A total of 80 patients of dentate mandibular fractures were divided randomly in 2 groups; Group 1 received post-operative intravenous antibiotics (amoxicillin+clavulanate 1.2 g+ metronidazole 0.5 g/100 cc) TDS for 48 hrs post-operatively Group 2 received same course for 5 post-operative days and patient were monitored for the signs of infection according to the centers for disease control and prevention criteria, rise in white blood cells counts and C-reactive protein (CRP) levels. Side effects were recorded in both groups.

Results: Out of 39 patients in Group 1 two patients showed rise in CRP levels and single patient developed abscess, whereas in Group 2 wound dehiscence was noted in 2 patients and both had prolonged rise in CRP levels at the 5th day.

Conclusions: No significant difference in post-operative infection rates was seen between two groups which suggests short-term post-operative antibiotic treatment is equally efficacious as long-term treatment.


Mandibular fractures, Post-operative infection, Post-operative antibiotic prophylaxis

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