Antibiotic duration and postoperative infection rates in mandibular fractures

Although the use of preoperative antibiotics has been proven effective, the value of postoperative antibiotics in the setting of mandibular fracture remains in question as does the appropriate duration of therapy.

A retrospective study of all patients 18 years and older who presented with mandibular fractures to St Louis University Hospital between December 2001 and July 2006 was conducted. Collected variables included age, injury severity score, fracture type and location, preoperative antibiotic administration, antibiotic type, duration of antibiotic course, and postoperative infection. Infections were statistically compared with each.

Of 253 identified patients, 197 qualified for study inclusion. A total of 9 postoperative infections were documented. When comparing individuals with postoperative infection to those without, age was the only significant difference between infected and uninfected groups, with older patients more likely to acquire infection. Injury severity score, fracture type, duration of antibiotic course, and antibiotic type were not significantly different.

Our findings suggest that patient factors make a greater contribution to postoperative infection when compared with iatrogenic factors in the treatment of mandibular fractures. We found no evidence to support prolonged postoperative antibiotic therapy. Our findings bring into question the need for postoperative antibiotics for the treatment of mandibular fractures.