Preoperative Prophylactic Antibiotics in Mandibular Fractures and Surgical Site Infection

Area of Science:

• Oral and Maxillofacial Surgery
• Infectious Disease Prevention
• Surgical Site Infection (SSI) Research

Background:

• Mandibular fractures exhibit the highest postsurgical site infection rates among facial fractures.
• Postoperative antibiotics show no proven benefit in reducing surgical site infections (SSIs) regardless of duration.
• Conflicting data exists regarding the efficacy of prophylactic preoperative antibiotics for reducing SSIs.

Purpose of the Study:

• To compare SSI rates in patients undergoing mandibular fracture repair.
• To evaluate the impact of preoperative prophylactic antibiotics versus perioperative or no antibiotics on SSI rates.

Main Methods:

• Retrospective cohort review of adult patients undergoing mandibular fracture repair (2014-2019).
• Comparison of SSI rates between two groups: those receiving >1 dose of preoperative antibiotics and those receiving 0-1 dose of perioperative antibiotics.
• Primary outcome: rate of surgical site infection (SSI).

Main Results:

• 183 patients received >1 dose of preoperative antibiotics; 35 received 0-1 dose of perioperative antibiotics.
• SSI rate in the preoperative antibiotic group was 29.3%.
• SSI rate in the perioperative/no antibiotic group was 25.0%; no significant difference was observed.

Conclusions:

• Extended preoperative prophylactic antibiotic regimens do not reduce SSIs after mandibular fracture repair.
• Current evidence does not support the use of multiple preoperative antibiotic doses beyond a single perioperative dose for mandibular fracture repair.
• Further research may clarify optimal antibiotic strategies for preventing SSIs in these procedures.