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Related Experiment Videos

Antibiotic Prophylaxis in Orbital Fractures.

Benjamin Reiss1, Lamise Rajjoub1, Tamer Mansour1

  • 1Department of Ophthalmology, The George Washington University, Washington D.C., USA.

The Open Ophthalmology Journal
|April 13, 2017
PubMed
Summary

Prophylactic antibiotics are widely used for orbital fractures, but this study found no orbital infections in patients, regardless of antibiotic use. Shorter courses and avoiding broad-spectrum agents are recommended to prevent antibiotic resistance.

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Area of Science:

  • Ophthalmology
  • Trauma Surgery
  • Infectious Disease

Background:

  • Orbital fractures are common injuries.
  • Prophylactic antibiotic use is a standard practice for patients with orbital fractures to prevent infection.
  • The efficacy and necessity of routine antibiotic prophylaxis remain subjects of debate.

Purpose of the Study:

  • To evaluate the effectiveness of prophylactic antibiotics in preventing orbital infections in patients with orbital fractures.
  • To analyze antibiotic prescribing patterns and their outcomes in this patient population.

Main Methods:

  • Retrospective cohort study.
  • Inclusion of all patients diagnosed with orbital fracture at a single institution between 2008 and 2014.
  • Tracking the development of orbital infection as the primary outcome measure.
Keywords:
Amoxicillin-clavulanateAntibiotic prophylaxisCephalexinOrbital fracturePost-traumatic orbital cellulitis

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Main Results:

  • 172 patients with orbital fractures were analyzed; no orbital infections were documented.
  • 12% of patients received no prophylactic antibiotics, and 1% received a single preoperative dose.
  • Antibiotic courses of 5-7 days showed no increased infection rates compared to 10-14 day courses. The Number Needed to Treat (NNT) ranged from 75, and the Number Needed to Harm (NNH) was 198.

Conclusions:

  • The widespread use of prophylactic antibiotics for orbital fractures may lead to overmedication and antibiotic resistance.
  • Coordination between trauma and specialist teams is crucial for optimizing antibiotic use.
  • Shorter antibiotic courses and avoidance of broad-spectrum agents are recommended if prophylaxis is deemed necessary. Further research is warranted.