The efficiency of extended postoperative antibiotic prophylaxis in orthognathic surgery: A prospective, randomized, double-blind, placebo-controlled clinical trial

• Published in: Journal of cranio-maxillo-facial surgery 2019-02, Vol.47 (2), p.228-232
• Main Authors: Ghantous, Yasmine, Araidy, Sharif, Yaffe, Victoria, Mirochnik, Roman, El-raziq, Murad Abdol, El-naaj, Imad Abu
• Format: Article
• Language: English
• Subjects: Administration, Intravenous; Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination - administration & dosage; Amoxicillin-Potassium Clavulanate Combination - therapeutic use; Antibiotic Prophylaxis; C-Reactive Protein - analysis; CRP; Double-Blind Method; Erythema; Female; Humans; Male; Orthognathic Surgical Procedures - adverse effects; Orthognathic Surgical Procedures - methods; Perioperative antibiotics; Postoperative fever; Postoperative infection; Prospective Studies; Surgical Wound Infection - prevention & control; Young Adult
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2018.11.017

Postoperative antibiotics are commonly administered in orthognathic surgery, despite the fact that there is no consensus regarding their efficacy. The objective of this study was to investigate the effectiveness of postoperative antibiotics in orthognathic surgery by conducting a prospective, randomized, double-blind, placebo-controlled trial. Patients were randomly allocated into one of two study groups: the intervention group (treated with 1 g of intravenous (IV) amoxicillin-clavulanate TID) or the placebo group (treated with 50 mL of IV 0.9% NaCl TID). The infection rate was assessed using clinical and laboratory parameters. The intervention group included 38 patients, with 40 patients in the placebo group. Baseline and surgical characteristics were comparable between both groups. Mean postoperative C-reactive protein (CRP) and temperature were similar for both groups. Serous discharge was observed in two patients (both in the placebo group), and one of them required surgical intervention. Overall, infection rate was similar in both groups (p-value > 0.1). To conclude, administration of postoperative antibiotics in healthy, young patients undergoing orthognathic surgery did not show a significant advantage in reducing surgical infection rate.