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Antibiotic Prophylaxis for Facial Fractures: Title and subTitle BreakA Prospective, Randomized Clinical Trial FREE

Richard A. Chole, MD, PhD; James Yee, MD
[+] Author Affiliations

Accepted for publication July 2, 1987.

Read before the annual meeting of the American Academy of Otolaryngology, San Antonio, Tex, Sept 16, 1986.

Reprint requests to Department of Otolaryngology–Head and Neck Surgery, University of California at Davis, Otology Laboratory, 1159 Surge III, Davis, CA 95616 (Dr Chole).


Arch Otolaryngol Head Neck Surg. 1987;113(10):1055-1057. doi:10.1001/archotol.1987.01860100033016
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• Although antibiotics are widely used in an attempt to decrease the incidence of infections after facial fractures, no systematic prospective study of their efficacy has been performed. In this study, all adult patients with facial fractures who had not received antibiotics were asked to participate in a clinical trial. There were 101 patients with facial fractures enrolled into the study and randomized prospectively into two groups. One group received no antibiotics. The other group received cefazolin sodium, 1 g intravenously, one hour prior to the surgical procedure, and a similar dose eight hours later. Of the 101 patients enrolled in the study, 79 had mandibular fractures, 18 had zygoma fractures, and four had Le Fort fractures. When all facial fractures were considered, perioperative intravenous cefazolin reduced the incidence of postoperative infections; 42.2% in the no-antibiotic group became infected, and 8.9% in the antibiotic group became infected. On the basis of this study, we conclude that cefazolin, used perioperatively, diminished the incidence of postoperative infections in facial fractures.

(Arch Otolaryngol Head Neck Surg 1987;113:1055-1057)

REFERENCES

Chodak GW, Plaut ME:  Use of systemic antibiotics for prophylaxis in surgery: A critical review . Arch Surg 1977;;112:326-334.
Strong MS:  Wound infection in otolaryngologic surgery and the inexpediency of antibiotic prophylaxis . Laryngoscope 1963;;73:165-184.
Paterson JA, Cardo VA Jr, Stratigos GT:  An examination of antibiotic prophylaxis in oral and maxillofacial surgery . J Oral Maxillofac Surg 1970;;28:753-759.
Becker GD, Parell GJ:  Chemoprophylaxis for surgery of the head and neck . Ann Otol Rhinol Laryngol 1979;;88:183-186.
Johnson JT, Myers EN, Thearle PB, et al:  Antimicrobial prophylaxis for contaminated head and neck surgery . Laryngoscope 1984;;94:46-51.
Eschelman LT:  Prophylactic antibiotics in otolaryngologic surgery: A double-blind study . Trans Am Acad Ophthalmol Otolaryngol 1971;; 75:387-394.
Zallen RD, Curry JT:  A study of antibiotic usage in compound mandibular fractures . J Oral Maxillofac Surg 1975;;33:431-434.
James RB, Fredrickson C, Kent JN:  Prospective study of mandibular fractures . J Oral Maxillofac Surg 1981;;39:275-281.
Kerr NW:  Some observations on infection in maxillofacial fractures . Br J Oral Maxillofac Surg 1966;;4:132-136.
Greenberg RN, James RB, Marier RL, et al:  Microbiologic and antibiotic aspects of infections in the oral and maxillofacial region . J Oral Maxillofac Surg 1979;;37:873-884.
Fee WE, Glenn M, Handen C, et al:  One day vs two days of prophylactic antibiotics in patients undergoing major head and neck surgery . Laryngoscope 1984;;94:612-614.

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Chodak GW, Plaut ME:  Use of systemic antibiotics for prophylaxis in surgery: A critical review . Arch Surg 1977;;112:326-334.
Strong MS:  Wound infection in otolaryngologic surgery and the inexpediency of antibiotic prophylaxis . Laryngoscope 1963;;73:165-184.
Paterson JA, Cardo VA Jr, Stratigos GT:  An examination of antibiotic prophylaxis in oral and maxillofacial surgery . J Oral Maxillofac Surg 1970;;28:753-759.
Becker GD, Parell GJ:  Chemoprophylaxis for surgery of the head and neck . Ann Otol Rhinol Laryngol 1979;;88:183-186.
Johnson JT, Myers EN, Thearle PB, et al:  Antimicrobial prophylaxis for contaminated head and neck surgery . Laryngoscope 1984;;94:46-51.
Eschelman LT:  Prophylactic antibiotics in otolaryngologic surgery: A double-blind study . Trans Am Acad Ophthalmol Otolaryngol 1971;; 75:387-394.
Zallen RD, Curry JT:  A study of antibiotic usage in compound mandibular fractures . J Oral Maxillofac Surg 1975;;33:431-434.
James RB, Fredrickson C, Kent JN:  Prospective study of mandibular fractures . J Oral Maxillofac Surg 1981;;39:275-281.
Kerr NW:  Some observations on infection in maxillofacial fractures . Br J Oral Maxillofac Surg 1966;;4:132-136.
Greenberg RN, James RB, Marier RL, et al:  Microbiologic and antibiotic aspects of infections in the oral and maxillofacial region . J Oral Maxillofac Surg 1979;;37:873-884.
Fee WE, Glenn M, Handen C, et al:  One day vs two days of prophylactic antibiotics in patients undergoing major head and neck surgery . Laryngoscope 1984;;94:612-614.

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