Antibiotic prophylaxis in orthognathic surgery: A complex systematic review

Area of Science:

• Oral and Maxillofacial Surgery
• Infectious Disease Prevention
• Evidence-Based Medicine

Background:

• Antibiotics are crucial for preventing postoperative infections in orthognathic surgery.
• Current guidelines lack consensus on optimal antibiotic choice, dosage, and duration.
• This highlights a significant gap in evidence-based practice.

Purpose of the Study:

• To systematically review the existing literature on antibiotic prophylaxis in orthognathic surgery.
• To assess the effectiveness of antibiotics in reducing postoperative infections.
• To identify optimal antibiotic regimens for this surgical population.

Main Methods:

• A complex systematic review was conducted.
• Searches included Medline, Cochrane Library, EMBASE, PubMed, and HTA publications.
• Systematic reviews were assessed using AMSTAR, and primary studies using GRADE.

Main Results:

• 6 systematic reviews and 36 primary studies were initially identified.
• Only 14 primary studies underwent full-text review and risk of bias assessment.
• Limited high-quality studies and heterogeneity precluded statistical analysis.

Conclusions:

• Most studies on antibiotic prophylaxis in orthognathic surgery are of poor quality.
• Significant scientific uncertainty persists regarding the preferred antibiotic and optimal administration duration.
• Further high-quality research is needed to establish evidence-based guidelines.