Are postoperative antibiotics required after orthognathic surgery?

The aim of this study was to investigate and compare the frequency of surgical site infection (SSI) between orthognathic patients who received only intraoperative antibiotics and patients who received intraoperative antibiotics plus postoperative antibiotics. A retrospective study was performed of patients treated by a single surgeon over the years 2006-2012 and 2016-2019. The primary predictor variable was antibiotic exposure. The control group received no postoperative prophylactic antibiotics. The study group received postoperative antibiotics. Both groups received prophylactic intraoperative antibiotics and performed postoperative chlorhexidine rinses. The primary outcome was SSI frequency. Univariate, bivariate, and multiple logistic regression analyses were performed; statistical significance was set at P ≤ 0.05. The sample comprised 333 patients. Their mean age was 30.7 ± 11.8 years. The study group included 129 patients (38.7%); the control group included 204 patients (61.3%). The frequency of SSI was 17.1% in the study group and 26.5% in the control group (P = 0.048). In the multivariable logistic regression, only alcohol consumption was significantly associated with an increased risk of SSI (odds ratio 2.46, 95% confidence interval 1.36-4.44; P = 0.003). In patients undergoing orthognathic surgery, postoperative antibiotic exposure in addition to intraoperative prophylaxis approached but was not statistically significant for a decreased risk of SSI (P = 0.067).