Antibiotic prophylaxis in orthognathic surgery: A 1-day versus 5-day regimen

Abstract

Purpose: The effect on infection rates of 1-day and 5-day administration of prophylactic antibiotics in orthognathic surgical procedures was compared. Patients and Methods: A prospective, randomized, double-blind clinical trial using placebo was conducted. Thirty patients were distributed equally between two groups. Each group received penicillin G, two million units intravenously, immediately preoperatively, and one million units intravenously every 3 hours intraoperatively and once postoperatively 3 hours after the last intraoperative dose. Group 1 then received penicillin G, one million units intravenously, every 6 hours for eight doses, followed by penicillin V suspension 300 mg orally every 6 hours for eight doses. Group 2 received placebo in a similar dosing schedule. The wounds were inspected on a regular schedule and evaluated for infection according to criteria established by the Centers for Disease Control. Results: One of 15 patients in group 1 (6.7%) and 9 of 15 patients (60%) in group 2 became infected. The overall infection rate was 33.3%. There was a statistically significant difference in rates of infection between the two groups ( P < .01). Conclusion: Antibiotic prophylaxis for orthognathic surgical procedures should continue beyond the immediate postoperative period. Five days of antibiotic administration appears to provide adequate coverage.