Are postoperative prophylactic antibiotics effective for orbital fracture?

Infection is one of the main complications of orbital fracture, either because of the connection to the paranasal sinuses or as a postoperative complication. Despite the advances made in this condition, there is still controversy regarding the role of prophylactic antibiotics.

To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies and generated a summary of findings table using the GRADE approach.

We identified only one systematic review including four studies overall, of which only one was a randomized trial. We concluded that postoperative antibiotic prophylaxis might not decrease the risk of infection in orbital fracture, and probably increases the risk of diarrhea.