A Systematic Review of Prophylactic Antibiotics in the Surgical Treatment of Maxillofacial Fractures

Andreasen, Jens O.; Jensen, Simon S.; Schwartz, Ole; Hillerup, Yören

doi:10.1016/j.joms.2006.02.032

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 64, Issue 11 , Pages 1664-1668, November 2006

A Systematic Review of Prophylactic Antibiotics in the Surgical Treatment of Maxillofacial Fractures

Jens O. Andreasen, DDS, Odont Drhc
- Consultant, Department of Oral and Maxillofacial Surgery, University Hospital (Rigshospitalet), Copenhagen, Denmark.
- Address correspondence and reprint requests to Dr Andreasen: Department of Oral and Maxillofacial Surgery, University Hospital (Rigshospitalet), Blegdamsvej 9, DK-2100 Copenhagen, Denmark
Simon S. Jensen, DDS
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University Hospital (Glostrup), Copenhagen, Denmark; and the Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland.
Ole Schwartz, DDS, LDS
- Department Chairman, Department of Oral and Maxillofacial Surgery, University Hospital (Rigshospitalet), Copenhagen, Denmark.
Yören Hillerup, DDS, Dr Odont
- Professor, Department of Oral and Maxillofacial Surgery, University Hospital (Rigshospitalet), Copenhagen, Denmark.

Purpose

A systematic review was performed to find evidence for prophylactic administration of antibiotics in relation to treatment of maxillofacial fractures.

Methods

Four studies were retrieved that fulfilled most of the requirements of being randomized controlled clinical trials.

Results

An analysis of these studies showed a 3-fold decrease in the infection rate of mandibular fractures in the antibiotic treated groups compared with the control groups. A variety of antibiotics had been used with an apparently uniform effect. A “1-shot” regimen or a 1-day treatment course had a similar or perhaps even better effect than 7 days of treatment. No infections were related to condylar, maxillary, or zygoma fractures.

Conclusion

A 1-shot or 1-day administration of prophylactic antibiotics seem to be the best documented to reduce infections in the management of mandibular fractures not involving the condylar region.