title: Comparison of ceftriaxone with penicillin for antibiotic prophylaxis for compound mandible fractures.
abstract: OBJECTIVE
  The purpose of the study was to compare the efficacy and cost of two antibiotic regimens for prophylaxis of compound mandible fractures: 1 gm/day ceftriaxone and 2 million U penicillin G every 4 hours.
  
  
  METHODS
  A prospective study of 90 patients with compound mandible fractures was performed. The patients were randomized to the two antibiotic regimens. The surgical procedures were performed by oral/maxillofacial surgery residents at a large urban training center. Standard treatment consisted of open reduction with either bone plates or wires, with all patients receiving 6 weeks of maxillomandibular fixation. The patients were monitored at 2-week intervals for 8 weeks by two of the authors, who were blinded to which antibiotic regimen the patient was assigned.
  
  
  RESULTS
  Two patients in each group had postoperative infections within the first 2 weeks of treatment. The infections resolved with local wound care, removal of internal fixation devices, and oral antibiotics. After resolution of the infection each patient had a malunion, which was managed without additional complications. The cost difference between the two treatment regimens was approximately $350 per day.
  
  
  CONCLUSIONS
  Ceftriaxone was noted to be an efficacious and cost-effective treatment alternative to penicillin G for compound mandible fracture antibiotic prophylaxis.
authors.affiliation: University of Miami Medical School, Jackson Memorial Hospital, Florida, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Heit
authors.forename: M R
authors.initials: MR
authors.lastname: Stevens
authors.forename: K
authors.initials: K
authors.lastname: Jeffords
mesh_terms: D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000191:economics*; D002443:Ceftriaxone / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D002648:Child; D016527:Drug Costs; D005260:Female; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use*; D011446:Prospective Studies; D016037:Single-Blind Method; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D002511:Cephalosporins; D010406:Penicillins; D002443:Ceftriaxone; D010400:Penicillin G