Preoperative antibiotic prophylaxis in orthognathic surgery: a randomized, double-blind, and placebo-controlled clinical study.
OBJECTIVE
This study evaluated the need for antibiotic prophylaxis in orthognathic surgery.


METHODS
Fifty-four patients (age range, 18 to 40 years) underwent bimaxillary orthognatic surgery. After randomization, a placebo (n = 19), 2,200 mg amoxicillin-clavulanic acid (n = 18), or 1,500 mg cefuroxime (n = 17) was administered in a double-blind fashion. During the first month, the postoperative course was observed according to the clinical parameters of infection, total leukocyte count and erythrocyte sedimentation rate (ESR).


RESULTS
Fifteen of 54 patients developed a wound infection. Of these, 10 had received a placebo; 3, cefuroxime; and 2, amoxicillin-clavulanic acid.


CONCLUSIONS
There was a statistically significant (P<.004) increased risk of having an infectious complication after bimaxillary orthognathic surgery without antibiotic prophylaxis. No significant difference in the incidence of infectious complications was found between the 2 medications.
Zijderveld
S A
SA
University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Smeele
L E
LE
Kostense
P J
PJ
Tuinzing
D B
DB
D000293:Adolescent; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002444:Cefuroxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D020380:Needs Assessment; D019340:Osteotomy, Le Fort; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D019980:Amoxicillin-Potassium Clavulanate Combination; D002444:Cefuroxime