A randomized prospective study of oral versus intravenous antibiotic prophylaxis against postoperative infection after sagittal split ramus osteotomy of the mandible.
BACKGROUND
We investigated whether oral levofloxacin was as effective as intravenous cefazolin sodium for preventing postoperative infections in patients undergoing sagittal split ramus osteotomy of the mandible.


METHODS
Forty-four patients were randomized to treatment with levofloxacin or cefazolin sodium. Levofloxacin (100 mg t.d.s.) was administered orally, and cefazolin sodium (1 g b.i.d.) by intravenous infusion. Both drugs were given until 5 days postoperatively. The concentrations of levofloxacin in the mandibular bone marrow and serum were measured.


RESULTS
The mean levofloxacin concentration 4 h and 53.7 min after administration was 1.086 microg/ml in serum and 1.328 microg/ml in the mandibular bone marrow. The efficacy rate of levofloxacin was 95% and that of cefazolin sodium was 85.7%, with no significant difference between the two drugs (p = 0.322).


CONCLUSIONS
Oral administration of levofloxacin is a simple, cost-effective and safe alternative to intravenous antibiotic prophylaxis after mandibular surgery.
Yoda
T
T
Second Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan. yoda.os2@dent.tmd.ac.jp
Sakai
E
E
Harada
K
K
Mori
M
M
Sakamoto
I
I
Enomoto
S
S
D000284:Administration, Oral; D000328:Adult; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000188:drug therapy; D006801:Humans; D007275:Injections, Intravenous; D064704:Levofloxacin; D008297:Male; D008334:Mandible / Q000378:metabolism / Q000601:surgery*; D015242:Ofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019647:Oral Surgical Procedures; D010027:Osteotomy; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
D064704:Levofloxacin; D015242:Ofloxacin; D002437:Cefazolin