Postoperative antibiotic prophylaxis in mandibular fractures: A preliminary randomized, double-blind, and placebo-controlled clinical study

Abubaker, A. Omar; Rollert, M.K

doi:10.1053/joms.2001.28272

Cited by 103 publications

(106 citation statements)

References 16 publications

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“…Combination of an infection of the medullary bone adjacent to the fracture site, coupled with stripping of the periosteum and muscle while performing an open reduction, certainly compromises the blood flow to the fracture site and provides a local environment that is at an increased risk for a bone infection. In a preliminary study by Abubaker AO et al, has shown that the use of postoperative antibiotics in uncomplicated fractures of the mandible had no benefit in reducing the incidence of infection [8].…”

Section: Discussionmentioning

confidence: 99%

Time lapse from the occurrence of trauma to the definitive management of mandibular fractures: a retrospective study

Mahajan¹,

Datarkar²,

Borle³

2009

J. Maxillofac. Oral Surg.

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Section: Discussionmentioning

confidence: 99%

Time lapse from the occurrence of trauma to the definitive management of mandibular fractures: a retrospective study

Mahajan¹,

Datarkar²,

Borle³

2009

J. Maxillofac. Oral Surg.

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“…As fraturas mandibulares de corpo, sínfise, parassínfise e ângulo mandibular, localizadas em regiões de presença de elementos dentários são consideradas abertas e potencialmente contaminadas, devido à comunicação direta com a cavidade bucal e flora endógena 2,3,10,12,15 . Ainda, fraturas de côndilo, ramo e processo coronoide são consideradas fechadas, envolvidas por um envelope de tecido mole que as protege da contaminação bacteriana 1,16 .…”

Section: Discussionunclassified

“…Fraturas localizadas em regiões com a presença de elementos dentários são consideradas contaminadas devido à proximidade da fratura com os tecidos periodontais e maior exposição à microbiota oral 1,2 . Portanto, as regiões de corpo, sínfise, parassínfise e ângulo mandibular apresentam maior incidência de infecção pós-operatória [3][4][5] . Ainda, o tratamento por meio de redução aberta e fixação interna estável apresenta um índice de infecção pós-operatória até quatro vezes maior do que o tratamento fechado 2,6 .…”

Section: Introductionunclassified

“…O estudo de Chole, Yee 9 foi o primeiro a avaliar a utilização de profilaxia antibiótica em cirurgias para tratamento de fraturas mandibulares, iniciando seu protocolo previamente ao acesso cirúrgico e mantendo no período pós-operatório, e observou uma redução do índice de infecção de 43% para 11%. A utilização de profilaxia antibiótica em cirurgias de fraturas mandibulares é efetiva na redução dos índices de infecção pós-operatória, entretanto, não existe consenso quanto à duração deste tratamento 3,4,6,10,11 .…”

Section: Introductionunclassified

“…A utilização de antibiótico por um período maior do que o necessário representa o erro mais comum do uso da profilaxia antibiótica 2,3 . Esta situação pode ocasionar um aumento nos índices de infecção, visto que nenhum antibiótico é capaz de eliminar todos os tipos de bactérias e seu uso inadequado pode desequilibrar a microbiota e aumentar a susceptibilidade às infecções oportunistas 2,4,8,12 .…”

Section: Introductionunclassified

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Comparação do índice de infecção pós-operatória em fraturas mandibulares lineares com o uso de profilaxia antibiótica

Moura

Trivellato

Figueiredo

et al. 2017

Rev. odontol. UNESP

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Evaluation of Prolonged vs Short Courses of Antibiotic Prophylaxis Following Ear, Nose, Throat, and Oral and Maxillofacial Surgery

Oppelaar

Zijtveld

Kuipers

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Antibiotic prophylaxis is widely used after surgical procedures operating on the mucosal tissues of the aerodigestive tract, but the optimal duration of these prophylactic therapies is often unclear. OBJECTIVE To compare short-course antibiotic prophylaxis (Յ24 hours) vs extended-course antibiotic prophylaxis (Ն72 hours) after ear, nose, throat, and oral and maxillofacial surgery. DATA SOURCES AND STUDY SELECTION Literature searches of PubMed were completed in October 2017 and included prospective trials that compared antibiotic prophylaxis courses of 24 hours or less vs 72 hours or more after ear, nose, throat, and oral and maxillofacial surgery. Some studies were also handpicked from reference lists of studies found with the initial search terms. All analysis was performed between September 2017 and October 2018. DATA EXTRACTION AND SYNTHESIS All review stages were conducted in consensus by 2 reviewers. Data extraction and study quality assessment were performed with the Cochrane data extraction form and the Cochrane risk of bias tool. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for reporting. The fixed-effects Mantel-Haenszel method was used for meta-analysis. MAIN OUTCOMES AND MEASURES Relative risk (RR) of surgical site infections, microbial origins of surgical site infections, adverse events, duration of hospital stay, and treatment costs. RESULTS Included in the meta-analysis were 21 articles with a cumulative 1974 patients. In patients receiving 24 hours or shorter vs 72 hours or longer antibiotic prophylaxis regimens, no significant difference was found in the occurrence of postoperative infections in the pooled population (RR, 0.90; 95% CI, 0.67-1.19), or in the ear, nose, throat (RR, 0.89; 95% CI, 0.54-1.45), and oral and maxillofacial populations (RR, 0.88; 95% CI, 0.63-1.21), separately. No heterogeneity was observed overall or in the subgroups. Patients receiving extended-course antibiotic prophylaxis were significantly more likely to develop adverse events unrelated to the surgical site (RR, 2.40; 95% CI, 1.20-3.54). CONCLUSIONS AND RELEVANCE No difference was found in the occurrence of postoperative infections between short-course and extended-course antibiotic prophylaxis after ear, nose, throat, and oral and maxillofacial surgery. Therefore, a short course of antibiotic prophylaxis is recommended unless documented conditions are present that would be best treated with an extended course. Using short-course antibiotics could avoid additional adverse events, antibiotic resistance development, and higher hospital costs. Future research should focus on identifying risk groups that might benefit from prolonged prophylaxis.

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Postoperative antibiotic prophylaxis in mandibular fractures: A preliminary randomized, double-blind, and placebo-controlled clinical study

Cited by 103 publications

References 16 publications

Time lapse from the occurrence of trauma to the definitive management of mandibular fractures: a retrospective study

Time lapse from the occurrence of trauma to the definitive management of mandibular fractures: a retrospective study

Comparação do índice de infecção pós-operatória em fraturas mandibulares lineares com o uso de profilaxia antibiótica

Evaluation of Prolonged vs Short Courses of Antibiotic Prophylaxis Following Ear, Nose, Throat, and Oral and Maxillofacial Surgery

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