Antibiotics and Mandibular Fracture Update

Abstract

1.Gutta R, Tracy K, Johnson C, et al: Outcomes of mandible fracture treatment at an academic tertiary hospital: A 5-year analysis. J Oral Maxillofac Surg 72:550, 2014. http://www.joms.org/article/S0278-2391(13)01192-0/abstract. Epub 2014 January 7The use of antibiotics did not decrease the incidence of infections in patients treated with open reduction and internal fixation for mandibular fractures.2.Mottini M, Wolf R, Soong PL, et al: The role of postoperative antibiotics in facial fractures: Comparing the efficacy of a 1-day versus a prolonged regimen. J Trauma Acute Care Surg 76:720, 2014. http://journals.lww.com/jtrauma/pages/articleviewer.aspx?year=2014&issue=03000&article=00021&type=abstractIn this retrospective study, the use of prolonged postoperative antibiotics in uncomplicated mandibular and midfacial fractures had no important benefit in decreasing the incidence of infections.3.Schaller B, Soong PL, Zix J, et al: The role of postoperative prophylactic antibiotics in the treatment of facial fractures: A randomized, double-blind, placebo-controlled pilot clinical study. Part 2: Mandibular fractures in 59 patients. Br J Oral Maxillofac Surg 51:803, 2013. http://www.bjoms.com/article/S0266-4356(13)00401-4/abstract. Epub 2013 September 3In fractures of the mandible involving the alveolus (compound fractures), a 1-day postoperative course of antibiotic was as effective in preventing infective complications as a 5-day regimen.4.Singh RP, Carter LM, Whitfield PH: Antimicrobial prophylaxis in open reduction and internal fixation of compound mandibular fractures: A collaborative regional audit of outcome. Br J Oral Maxillofac Surg 51:444, 2013. http://www.bjoms.com/article/S0266-4356(12)00599-2/abstract. Epub 2013 January 28Their data suggest that a short perioperative antimicrobial prophylaxis with a maximum of 2 postoperative doses after open reduction and internal fixation of mandibular fractures is adequate.5.Hindawi YH, Oakley GM, Kinsella CR Jr, et al: Antibiotic duration and postoperative infection rates in mandibular fractures. J Craniofac Surg 22:1375, 2011. http://journals.lww.com/jcraniofacialsurgery/pages/articleviewer.aspx?year=2011&issue=07000&article=00045&type=abstractWhen comparing patients with postoperative infection after treatment of mandibular fracture with those without, age was the only relevant difference between infected and uninfected groups, with older patients more likely to acquire infection. They found no evidence to support prolonged postoperative antibiotic therapy.6.Adalarasan S, Mohan A, Pasupathy S: Prophylactic antibiotics in maxillofacial fractures: A requisite?. J Craniofac Surg 21:1009, 2010. http://journals.lww.com/jcraniofacialsurgery/pages/articleviewer.aspx?year=2010&issue=07000&article=00015&type=abstractThis study suggests that prophylactic antibiotic therapy might not alter the incidence of surgical wound infection.7.Lovato C, Wagner JD: Infection rates following perioperative prophylactic antibiotics versus postoperative extended regimen prophylactic antibiotics in surgical management of mandibular fractures. J Oral Maxillofac Surg 67:827, 2009. http://www.joms.org/article/S0278-2391(08)01202-0/abstractThis study found that the use of postoperative prophylactic antibiotics does not have a statistically relevant effect on postoperative infection rates in surgical management of complicated or uncomplicated mandibular fractures.8.Miles BA, Potter JK, Ellis E III: The efficacy of postoperative antibiotic regimens in the open treatment of mandibular fractures: A prospective randomized trial. J Oral Maxillofac Surg 64:576, 2006. http://www.joms.org/article/S0278-2391(06)00005-X/abstractThis study could not prove any statistically relevant benefit to the administration of postoperative antibiotics in patients undergoing open reduction and internal fixation of mandibular fractures.9.Furr AM, Schweinfurth JM, May WL: Factors associated with long-term complications after repair of mandibular fractures. Laryngoscope 116:427, 2006. http://onlinelibrary.wiley.com/doi/10.1097/01.MLG.0000194844.87268.ED/abstract;jsessionid=F6ECAC5FBF19776AB97D4D1538F2CD95.f03t02In this series, antibiotic therapy appeared to have no impact on the development of postoperative complications.10.Abubaker AO, Rollert MK: Postoperative antibiotic prophylaxis in mandibular fractures: A preliminary randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg 59:1415, 2001. http://www.joms.org/article/S0278-2391(01)41650-8/abstractThe use of postoperative oral antibiotics in uncomplicated fractures of the mandible had no benefit in decreasing the incidence of infections.