Do Antibiotics Prevent Infectious Complications in Critically Injured Patients With Blunt Nonoperative Midfacial...

Area of Science:

• Trauma Surgery
• Critical Care Medicine
• Infectious Diseases

Background:

• Existing literature suggests antibiotics are unnecessary for nonoperative facial fractures.
• Critically injured patients with facial fractures face higher risks of sinusitis and ventilator-associated pneumonia (VAP).
• Previous studies have not specifically addressed antibiotic use in this high-risk group.

Purpose of the Study:

• To investigate whether antibiotics decrease infectious complications in critically injured patients with nonoperative blunt midfacial trauma.
• To evaluate the impact of antibiotic administration on sinusitis, pneumonia, and other infections in this specific patient cohort.

Main Methods:

• Retrospective cohort study of critically injured adults with nonoperative midfacial fractures treated at a Level 1 trauma center (2012-2020).
• Exclusion criteria included operative repair of any facial fracture.
• Antibiotic use was the predictor variable; infectious complications (sinusitis, VAP, other pneumonia) were the primary outcome.

Main Results:

• 307 patients were included; 74.6% received antibiotics.
• Overall infectious complications occurred in 13.6% of patients.
• Antibiotic use was not associated with a significant reduction in infectious complications (unadjusted RR=0.85, adjusted OR=0.74).

Conclusions:

• In critically injured patients with nonoperative midfacial fractures, antibiotic administration did not lower the rate of infectious complications.
• These findings suggest that a more judicious approach to antibiotic use is appropriate for this patient group.
• Further research may clarify optimal antibiotic strategies for preventing infections in trauma patients with facial fractures.