Extended Antibiotic Prophylaxis Not Associated With Improved Outcomes Following Open Reduction of Mandible Fractures

Area of Science:

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

Background:

• Current guidelines advise against extended antibiotic prophylaxis for mandible fractures, yet it is frequently used.
• The study investigates the clinical utility of extended antibiotic use in managing mandible fractures.

Purpose of the Study:

• To evaluate the association between extended preoperative or postoperative antibiotic prophylaxis and 90-day adverse events following open reduction and internal fixation (ORIF) of closed mandible fractures.

Main Methods:

• A national administrative database identified patients undergoing ORIF for closed mandible fractures.
• Patients were stratified by antibiotic exposure: extended preoperative, extended postoperative, or no extended prophylaxis.
• Multivariable logistic regression analyzed 90-day outcomes including surgical site infections, osteomyelitis, and overall complications, controlling for confounders.

Main Results:

• Extended preoperative antibiotics were used in 9.4%, extended postoperative in 26.2%, and no extended prophylaxis in 64.4% of 16,110 patients.
• A slight reduction in debridement rates was observed with postoperative antibiotics (0.5% vs. 1.1%; P=0.003).
• Neither extended preoperative nor postoperative antibiotic prophylaxis demonstrated an association with reduced overall postoperative complications.

Conclusions:

• Extended outpatient antibiotic prophylaxis following ORIF for closed mandible fractures is not linked to improved patient outcomes.
• The findings challenge the routine use of extended antibiotic prophylaxis in this patient population.