title: The role of postoperative prophylactic antibiotics in the treatment of facial fractures: a randomised, double-blind, placebo-controlled pilot clinical study. Part 3: Le Fort and zygomatic fractures in 94 patients.
abstract: The aim of this study was to evaluate the difference between the effect of a 5-day and a 1-day postoperative course of antibiotics on the incidence of infection after midfacial fractures. A total of 98 patients with displaced Le Fort or zygomatic fractures that required operation were randomly assigned into 2 groups, both of which were given amoxicillin/clavulanic acid 1.2g intravenously every 8h from the time of admission until 24h postoperatively. The 5-day group was then given amoxicillin/clavulanic acid 625 mg orally 8-hourly for another 4 days. The 1-day group was given placebo orally at the same time points. Patients were followed up 1, 2, 4, 6, and 12 weeks, and 6 months, postoperatively. The development of an infection of the wound was the primary end point. Ninety-four of the 98 patients completed the study. Two of the 45 patients in the 5-day group (4%) and 2/49 in the 1-day group (4%) developed postoperative wound infections. One in each group had a purulent infection, while the others had only wound breakdown. Two patients of the 5-day group and one in the 1-day group developed rashes on the trunk. There were no significant differences in the incidence of infection or side effects between the groups. In midfacial fractures a 1-day course of antibiotics postoperatively is as effective in preventing infective complications as a 5-day regimen.
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland; Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore.
authors.forename: Poh Luon
authors.initials: PL
authors.lastname: Soong
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Benoit
authors.initials: B
authors.lastname: Schaller
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Zix
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Tateyuki
authors.initials: T
authors.lastname: Iizuka
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Mottini
authors.affiliation: Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Switzerland. Electronic address: contact@olivierlieger.ch.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lieger
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005076:Exanthema / Q000209:etiology; D005147:Facial Bones / Q000293:injuries; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D008440:Maxillary Fractures / Q000188:drug therapy / Q000601:surgery*; D008875:Middle Aged; D009917:Orbital Fractures / Q000188:drug therapy / Q000601:surgery; D010865:Pilot Projects; D010919:Placebos; D011182:Postoperative Care; D011446:Prospective Studies; D012887:Skull Fractures / Q000188:drug therapy / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D015051:Zygomatic Fractures / Q000188:drug therapy / Q000601:surgery*
chemical_list: D010919:Placebos; D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Antibiotics; Antimicrobial agents; Infection; Le Fort; Midface fractures; Zygoma; Zygomatic fracture