title: Infection rates following perioperative prophylactic antibiotics versus postoperative extended regimen prophylactic antibiotics in surgical management of mandibular fractures.
abstract: OBJECTIVE
  To determine whether or not an extended regimen of prophylactic antibiotics following either open or closed reduction of mandibular fractures is beneficial in lowering the rate of infection in postoperative patients.
  
  
  METHODS
  This study is a retrospective chart review of 150 patients treated operatively for both complicated and uncomplicated mandibular fractures at University of New Mexico Health Sciences Center in Albuquerque, NM, between January 1, 2000 and June 12, 2007. Treatment modalities used were closed reduction with maxillomandibular fixation or open reduction and internal fixation with either wire osteosynthesis or rigid internal fixation. Patients fell into 1 of 2 groups: the first group received antibiotics perioperatively, which consisted of no more than 24 hours of antibiotics in the postoperative period; the second group received extended regimen antibiotics, which consisted of anywhere from 24 hours to 10 days of antibiotics in the postoperative period. Seventy-five patients were included in each group. The type of antibiotic prescribed was at the discretion of the operating surgeon. This study was conducted using an intention-to-treat analysis. Postoperative infection was diagnosed either subjectively or objectively by the clinician evaluating the patient at follow-up appointments.
  
  
  RESULTS
  In the extended antibiotic group, 8 out of 75 subjects (10.67%) developed infection. In the perioperative antibiotic group, 10 out of 75 subjects (13.33%) developed infection. Statistical analysis using chi(2) distribution showed that this difference in proportions was not significant (chi(2) = 0.06, P = 0.8).
  
  
  CONCLUSIONS
  This study found that the use of postoperative prophylactic antibiotics does not have a statistically significant effect on postoperative infection rates in surgical management of complicated or uncomplicated mandibular fractures.
authors.affiliation: University of New Mexico, School of Medicine, Albuquerque, NM 87110, USA. chrlovato@salud.unm.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Lovato
authors.forename: Jon D
authors.initials: JD
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001864:Bone Wires; D002437:Cefazolin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications; D013530:Surgical Wound Infection / Q000209:etiology*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D002437:Cefazolin