Abstract
Purpose. The purpose of the study was to compare the efficacy and cost of two antibiotic regimens for prophylaxis of compound mandible fractures: 1 gm/day ceftriaxone and 2 million U penicillin G every 4 hours. Design. A prospective study of 90 patients with compound mandible fractures was performed. The patients were randomized to the two antibiotic regimens. The surgical procedures were performed by oral/maxillofacial surgery residents at a large urban training center. Standard treatment consisted of open reduction with either bone plates or wires, with all patients receiving 6 weeks of maxillomandibular fixation. The patients were monitored at 2-week intervals for 8 weeks by two of the authors, who were blinded to which antibiotic regimen the patient was assigned. Results. Two patients in each group had postoperative infections within the first 2 weeks of treatment. The infections resolved with local wound care, removal of internal fixation devices, and oral antibiotics. After resolution of the infection each patient had a malunion, which was managed without additional complications. The cost difference between the two treatment regimens was approximately $350 per day. Conclusion. Ceftriaxone was noted to be an efficacious and cost-effective treatment alternative to penicillin G for compound mandible fracture antibiotic prophylaxis.
Published Version
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