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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
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.
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.
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.
