Comparative evaluation of short-term versus long-term post-operative antibiotic prophylaxis after mandibular fractures
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20150387Keywords:
Mandibular fractures, Post-operative infection, Post-operative antibiotic prophylaxisAbstract
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.
References
Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg. 1990;48(9):926-32.
Schaefer EH th, Caterson EJ. Antibiotic selection for open reduction internal fixation of mandible fractures. J Craniofac Surg. 2013;24(1):85-8.
Martis C, Karabouta I. Infection after orthognathic surgery, with and without preventive antibiotics. Int J Oral Surg. 1984;13(6):490-4.
Chole RA, Yee J. Antibiotic prophylaxis for facial fractures. A prospective, randomized clinical trial. Arch Otolaryngol Head Neck Surg. 1987;113(10):1055-7.
Hotz G, Novotny-Lenhard J, Kinzig M, Soergel F. Single-dose antibiotic prophylaxis in maxillofacial surgery. Chemotherapy. 1994;40(1):65-9.
Zallen RD, Curry JT. A study of antibiotic usage in compound mandibular fractures. J Oral Surg. 1975;33(6):431-4.
Gerlach KL, Pape HD. Studies on preventive antibiotics in the surgical treatment of mandibular fractures. Dtsch Z Mund Kiefer Gesichtschir. 1988;12(6):497-500.
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control. 1999;27(2):97-132.
Lamphier J, Ziccardi V, Ruvo A, Janel M. Complications of mandibular fractures in an urban teaching center. J Oral Maxillofac Surg. 2003;61(7):745-9.
Iizuka T, Lindqvist C, Hallikainen D, Paukku P. Infection after rigid internal fixation of mandibular fractures: a clinical and radiologic study. J Oral Maxillofac Surg. 1991;49(6):585-93.
Dhariwal DK, Gibbons AJ, Murphy M, Llewelyn J, Gregory MC. A 2 year review of the treatment and complications of mandibular angle fractures. J R Army Med Corps. 2002;148(2):115-7.
Ellis E 3rd. Outcomes of patients with teeth in the line of mandibular angle fractures treated with stable internal fixation. J Oral Maxillofac Surg. 2002;60(8):863-5.
Stone IE, Dodson TB, Bays RA. Risk factors for infection following operative treatment of mandibular fractures: a multivariate analysis. Plast Reconstr Surg. 1993;91(1):64-8.
