The role of postoperative administration of antibiotics in prevention of infection after open reduction of mandibular compound fractures: A randomized double-blind placebo controlled pilot clinical study
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Abstract
Purpose: This study determines the effectiveness and/or necessity of applying postoperative antibiotics in the treatment of mandible fractures. Materials and Methods: This is a randomized, double-blind clinical study using a placebo control. 65 patients diagnosed with mandibular fractures underwent open reduction and internal fixation surgery. The patients were randomly divided into 2 groups: antibiotic group (38 patients) and placebo group (27 patients), based on whether or not they received postoperative antibiotics. Both groups received preoperative as well as intraoperative antibiotics on the day of surgery. The antibiotic group was postoperatively given clindamycin 600 mg IV every 8 hours for 5-7 days. The placebo group received placebo using the same schedule for the same duration as the antibiotic group. Follow-up examination was performed at discharge, 2 and 3 weeks, postoperatively. Results: A total number of 65 patients participated in this study; 50 (76.9%) males and 15 (23.1%) females. The evidence of surgical site infection was noted in 24 out of 65 patients within 3 weeks post-operation totally, 13 out of 38 patients in the antibiotic group (34.3%) and 11 out of 27 patients in the placebo group (40.7%) had evidence of surgical site infections. No statistically significant difference in the incidence of infection was noted between the groups (p<.368). Conclusion: This study could not statistically prove any beneficial effect for post-operative administration of antibiotics in patients undergoing open reduction and internal fixation of mandibular fractures.
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[4] Zallen RD, Curry JT. A Study of antibiotic usage in compound mandibular fractures. J Oral Surg1975; 33:431–4.
[5] Courtney DJ, Thomas S, Whitfield PH. Isolated orbital blowout fractures: survey and review. Br JOral Maxillofac Surg 2000; 38: 496–504.
[6] Folkesta dL,Granström G. A Prospective Study Of Orbital fracture sequelae after change of surgical routines. J Oral Maxillofac Surg 2003; 61:1038–44.
[7] Abubaker AO, Rollert MK. Postoperative antibiotic prophylaxis in mandibular fractures: a preliminary randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg 2001;59: 1415–9.
[8] Brunicardi C, Andersen DK, Billiar TR, et al: Schwartz’s Principles of Surgery. Ed 8. Columbus:Mc Graw Hill, 2005.
[9] Barrera J, Batuello S: Mandibular Body Fractures.Emedicine.com. Accessed August, 2005.
[10] Edward H. Schaefer IV, Edward J. Caterson: Antibiotic selection for open reduction internal fixationf mandible fractures; J Craniofac Surg 2013;24:85-88.
[11] U.S. National Research Council of Medical Sciences,Ad Hoc Committee of the Committee of Trauma, Division of Medical sciences, National Academy of Sciences-National Research Council.Postoperative wound infections; the influence of
ul-travioletirradiation of the operating room andvarious other factors. Ann Surg 160:1, 1964 (suppl2).
[12] Paradisi F, Corti G: Which prophylactic regimen for which surgical procedure? Am J Surg 164: 25,1992 (suppl 1).
[13] Peterson LJ: Principles of antibiotic therapy, in Tobazian RG, Goldberg MH (eds): Oral and Maxillofacial Infections (ed 3). Philadelphia, PA, Saunders,1994, pp 160-197.
[14] Zallen RD, Curry JT:A study of antibiotic usage in compound mandibular fractures. J Oral Surg 33:431, 1975.
[15] Chole RA, Yee J: Antibiotic prophylaxis for facial fractures. Arch Otolaryngol Head Neck Surg 113:1055, 1987.
[16] Abubaker AO, Rollert MK. Postoperative antibiotic prophylaxis in mandibular fractures: a preliminary randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg 2001;59:1415–9.
[17] Miles BA, Potter JK, Ellis 3rd E. The efficacy of postoperative antibiotic regimens in the open treatment of mandibular fractures: a prospective randomized trial. J Oral Maxillofac Surg 2006; 64:576–82.
[18]Wittman Dietmar H, Schein Moshe (1996); Let us shorten antibiotic prophylaxis and therapy in sursurgery.Am J Surg 172 (suppl. 6A): 26s-32s.
[2] Patzakis M: The use of antibiotics in open fractures.Surg Clin North Am 55:6, 1975.
[3] Patzakis MJ, Ivler D: Antibiotics and bacteriology consideration in open fractures. South Med J 70:1,1977.
[4] Zallen RD, Curry JT. A Study of antibiotic usage in compound mandibular fractures. J Oral Surg1975; 33:431–4.
[5] Courtney DJ, Thomas S, Whitfield PH. Isolated orbital blowout fractures: survey and review. Br JOral Maxillofac Surg 2000; 38: 496–504.
[6] Folkesta dL,Granström G. A Prospective Study Of Orbital fracture sequelae after change of surgical routines. J Oral Maxillofac Surg 2003; 61:1038–44.
[7] Abubaker AO, Rollert MK. Postoperative antibiotic prophylaxis in mandibular fractures: a preliminary randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg 2001;59: 1415–9.
[8] Brunicardi C, Andersen DK, Billiar TR, et al: Schwartz’s Principles of Surgery. Ed 8. Columbus:Mc Graw Hill, 2005.
[9] Barrera J, Batuello S: Mandibular Body Fractures.Emedicine.com. Accessed August, 2005.
[10] Edward H. Schaefer IV, Edward J. Caterson: Antibiotic selection for open reduction internal fixationf mandible fractures; J Craniofac Surg 2013;24:85-88.
[11] U.S. National Research Council of Medical Sciences,Ad Hoc Committee of the Committee of Trauma, Division of Medical sciences, National Academy of Sciences-National Research Council.Postoperative wound infections; the influence of
ul-travioletirradiation of the operating room andvarious other factors. Ann Surg 160:1, 1964 (suppl2).
[12] Paradisi F, Corti G: Which prophylactic regimen for which surgical procedure? Am J Surg 164: 25,1992 (suppl 1).
[13] Peterson LJ: Principles of antibiotic therapy, in Tobazian RG, Goldberg MH (eds): Oral and Maxillofacial Infections (ed 3). Philadelphia, PA, Saunders,1994, pp 160-197.
[14] Zallen RD, Curry JT:A study of antibiotic usage in compound mandibular fractures. J Oral Surg 33:431, 1975.
[15] Chole RA, Yee J: Antibiotic prophylaxis for facial fractures. Arch Otolaryngol Head Neck Surg 113:1055, 1987.
[16] Abubaker AO, Rollert MK. Postoperative antibiotic prophylaxis in mandibular fractures: a preliminary randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg 2001;59:1415–9.
[17] Miles BA, Potter JK, Ellis 3rd E. The efficacy of postoperative antibiotic regimens in the open treatment of mandibular fractures: a prospective randomized trial. J Oral Maxillofac Surg 2006; 64:576–82.
[18]Wittman Dietmar H, Schein Moshe (1996); Let us shorten antibiotic prophylaxis and therapy in sursurgery.Am J Surg 172 (suppl. 6A): 26s-32s.
| Files | ||
| Issue | Vol 5, No 3 (Summer 2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Mandible fractures Open reduction internal fixation (ORIF) Antibiotic Antibiotic resistance Infection. | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Momeni M, Mortazavi M, Najarnobari M. The role of postoperative administration of antibiotics in prevention of infection after open reduction of mandibular compound fractures: A randomized double-blind placebo controlled pilot clinical study. J Craniomaxillofac Res. 2018;5(3):112-118.
