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Br J Oral Maxillofac Surg. 2014 Apr;52(4):329-33. doi: 10.1016/j.bjoms.2014.01.010. Epub 2014 Mar 3.

The role of postoperative prophylactic antibiotics in the treatment of facial fractures: a randomised, double-blind, placebo-controlled pilot clinical study. Part 3: Le Fort and zygomatic fractures in 94 patients.

Author information

1
Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore.
2
Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
3
Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland. Electronic address: contact@olivierlieger.ch.

Abstract

The aim of this study was to evaluate the difference between the effect of a 5-day and a 1-day postoperative course of antibiotics on the incidence of infection after midfacial fractures. A total of 98 patients with displaced Le Fort or zygomatic fractures that required operation were randomly assigned into 2 groups, both of which were given amoxicillin/clavulanic acid 1.2g intravenously every 8h from the time of admission until 24h postoperatively. The 5-day group was then given amoxicillin/clavulanic acid 625 mg orally 8-hourly for another 4 days. The 1-day group was given placebo orally at the same time points. Patients were followed up 1, 2, 4, 6, and 12 weeks, and 6 months, postoperatively. The development of an infection of the wound was the primary end point. Ninety-four of the 98 patients completed the study. Two of the 45 patients in the 5-day group (4%) and 2/49 in the 1-day group (4%) developed postoperative wound infections. One in each group had a purulent infection, while the others had only wound breakdown. Two patients of the 5-day group and one in the 1-day group developed rashes on the trunk. There were no significant differences in the incidence of infection or side effects between the groups. In midfacial fractures a 1-day course of antibiotics postoperatively is as effective in preventing infective complications as a 5-day regimen.

KEYWORDS:

Antibiotics; Antimicrobial agents; Infection; Le Fort; Midface fractures; Zygoma; Zygomatic fracture

PMID:
24602602
DOI:
10.1016/j.bjoms.2014.01.010
[Indexed for MEDLINE]

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