Antibiotic Prophylaxis in Maxillofacial Surgery and Evidence-Based Practice: A Systematic Review

Area of Science:

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

Background:

• Antibiotic prophylaxis aims to prevent surgical site infections (SSIs) by administering antibiotics before, during, or after procedures.
• The efficacy of prophylactic antibiotics in oral and maxillofacial surgery remains a subject of ongoing investigation.

Purpose of the Study:

• To systematically review current literature on the influence of preoperative, perioperative, or postoperative antibiotic prophylaxis on patient outcomes in oral and maxillofacial surgeries.
• To evaluate the overall benefit and specific indications for antibiotic prophylaxis in this surgical domain.

Main Methods:

• Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Comprehensive literature search across PubMed, Scopus, and Web of Science up to May 2025.
• Inclusion of randomized controlled trials (RCTs) and cohort studies focusing on various maxillofacial procedures.

Main Results:

• Thirteen studies were included, covering dental implants, surgical tooth extraction, maxillofacial trauma, orthognathic surgery, and drug allergy.
• Prophylactic antibiotics demonstrated limited overall benefit in maxillofacial surgery.
• Selective advantages were noted in complex or high-risk cases, but routine use was not consistently justified.

Conclusions:

• The routine administration of prophylactic antibiotics in oral and maxillofacial surgery is not consistently supported by current evidence.
• Judicious application of antibiotics is recommended, tailored to specific patient and procedural risk factors.
• Further high-quality research is necessary to refine guidelines for antibiotic prophylaxis in this field.