Prophylactic Antibiotics for Facial Fractures

Abstract

At the September 1986 meeting of the American Academy of Otolaryngology—Head and Neck Surgery in San Antonio, Tex, Dr Richard A. Chole of Sacramento, Calif, reported the results of a prospective randomized trial of prophylactic antibiotics in the treatment of facial fractures. The antibiotic regimen consisted of 1 g of cefazolin administered intravenously one hour prior to the surgical procedure and again eight hours later. One hundred and one patients were randomly selected. In the entire group, there were 79 mandible fractures, 18 zygoma fractures, and four Le Fort fractures. Perioperative cefazolin therapy appeared to significantly reduce the incidence of infection: 40.9% in the nonantibiotic group vs 8.8% in the antibiotic-treated group (<i>P</i>&lt;.005). On closer inspection, it was seen that all infections occurred in patients with mandibular fractures, and most of these infections occurred in those patients whose fractures required open reduction. Among patients with mandible fractures requiring open