Perioperative antibiotic prophylaxis in orthognathic surgery: a systematic review and meta-analysis of clinical trials

Department of Oral and Maxillofacial Surgery, University of Hong Kong, Hong Kong, China.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology (Impact Factor: 1.46). 12/2010; 112(1):19-27. DOI: 10.1016/j.tripleo.2010.07.015
Source: PubMed

ABSTRACT The aim of this study was to investigate whether the use of antibiotic prophylaxis in orthognathic surgery can effectively reduce the postoperative infection rate.
Electronic databases were searched and reference lists checked. Full articles meeting the inclusion criteria were retrieved. Study details and outcome data of these reports were statistically analyzed. There was no language limitation.
Five randomized clinical trials were included in the final review process: 4 articles compared the period of prophylactic antibiotic usage, and 1 compared the infection prevention effect of different types of antibiotics with placebo. Although a significantly higher infection rate was found in the placebo group, no significant difference could be found related to infection prevention between short- and long-term antibiotic regimen.
Prophylactic antibiotic regimen is considered to be useful for infection prevention in orthognathic surgery. A single-dose regimen is recommended; application for extended postoperative period is not advocated.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To clarify the use of antibiotics in our hospital and to guide the prophylactic use in future hepatobiliary surgical procedures. Methodology: A retrospective review of patients who underwent hepatobiliary surgery from January 2011 to June 2011 was included. Data were collected, and surgical site infection (SSI) was defined by the criteria of Center for Disease Control and Prevention. Patients were prescribed antibiotics for the clinical diagnosis of hepatobiliary system diseases. Results: 1564 patients were identified, in which 784 patients (50.13%) did not receive preoperative antibiotic prophylaxis. Of these 355 patients with 784 surgical sites received either preoperative or both preoperative and postoperative antibiotic prophylaxis. The SSI rate of the patients who received prophylaxis alone (2.56%, 20 of 780 sites) was not statistically higher than that of the patients who have not received prophylaxis (2.68%, 21 of 784 sites), and the two groups were not statistically correlated (P=0.77). Conclusion: The number of the patients who developed SSI was relatively low, and no reduction in the SSI rate was observed among the patients who have received antibiotic prophylaxis.
    Pakistan Journal of Medical Sciences Online 09/2013; 29(5):1199-202. DOI:10.12669/pjms.295.3344 · 0.10 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Antibiotic therapy before or after orthognathic surgery is commonly recommended by surgeons to minimize the risk of wound infection. This article evaluates the value of Prophylactic antibiotic therapy in order to diminish the incidence of postoperative wound infection after orthognathic surgery. Materials and Methods: Fifty candidates for bimaxillary orthognathic surgery were divided into cases and controls. Cefazolin (1g) was administered intravenously to all participants 30 mins prior to surgery followed by a similar dose 4 hours later. Case-group patients ingested amoxicillin (500 mg) orally for 7 days after surgery. Postoperative wound infection was assessed using clinical features, and the P-value significance was set at P<0.05. Results: Both groups were similar according to gender, age, and operating time. During the follow-up period no infection was observed in either the case or control group. Conclusion: The results of this study suggest that long-term postoperative antibiotic therapy is not essential for the prevention of postoperative infection, and that application of aseptic surgical technique and hygiene instruction after surgery are sufficient.
    10/2014; 26(77):207-10.
  • [Show abstract] [Hide abstract]
    ABSTRACT: There is no consensus on the use of antibiotic prophylaxis in orthognathic surgery to prevent infections. A systematic review of randomized controlled trials investigating the efficacy of antibiotic prophylaxis was performed to make evidence-based recommendations. A search of Embase, Ovid Medline, and Cochrane databases (1966–November 2012) was conducted and the reference lists of articles identified were checked for relevant studies. Eleven studies were eligible and were reviewed independently by the authors using two validated quality assessment scales. Three studies were identified to have a low risk of bias and eight studies a high risk of bias. Most studies compared preoperative and perioperative antibiotic prophylaxis with or without continuous postoperative administration. Methodological flaws in the included studies were no description of inclusion and exclusion criteria and incorrect handling of dropouts and withdrawals. Studies investigating the efficacy of antibiotic prophylaxis are not placebo-controlled and mainly of poor quality. Based on the available evidence, preoperative antibiotic prophylaxis appears to be effective in reducing the postoperative infection rate in orthognathic surgery. However, there is no evidence for the effectiveness of prescribing additional continuous postoperative antibiotics. More trials with a low risk of bias are needed to produce evidence-based recommendations and establish guidelines.
    International Journal of Oral and Maxillofacial Surgery 06/2014; 43(6). DOI:10.1016/j.ijom.2014.01.012 · 1.36 Impact Factor