Effectiveness of Postoperative Antibiotics in Orthognathic Surgery: A Meta-Analysis

Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Saveetha University, Chennai, India.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons (Impact Factor: 1.43). 05/2011; 69(10):2650-6. DOI: 10.1016/j.joms.2011.02.060
Source: PubMed


To conduct a systematic review of published clinical trials on the effectiveness of extended postoperative antibiotics in orthognathic surgery.
Electronic databases were searched for randomized clinical trials. Data from relevant articles were extracted and assessed. The primary outcome variable was surgical site infection. Extracted data were analyzed using a meta-analytical program with a random effects model.
In total 532 patients were assessed in 8 clinical trials. Wound infection occurred in 30 of 268 patients in the short-term prophylaxis group (frequency, 11.2%) and in 10 of 264 patients in the extended-term group (frequency, 3.8%). Extended antibiotic therapy was more effective in decreasing the risk of postoperative wound infection (odds ratio, 3.2; number needed to treat, 13.5).
Extended postoperative antibiotic treatment does have a place in decreasing the risk of postoperative wound infection in orthognathic surgery. More trials are needed to standardize a proper regimen.

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    • "On average, 13.5 patients had to be treated with antibiotics to prevent one case of wound infection (NNT = 13.5) [13]. Tan et al. compared intravenous versus oral application of postoperative antibiotics in a randomized clinical trial with 42 patients and found no statistically significant difference in the infection rate [14]. "
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    ABSTRACT: Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.
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    No preview · Article · Mar 2012 · Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons

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