Duration of Postoperative Antibiotic Prophylaxis in Facial Fractures
Status:
Terminated
Trial end date:
2012-12-01
Target enrollment:
Participant gender:
Summary
Facial fractures make up a significant proportion of injuries in trauma patients. Treatment
of these fractures often results in standard surgical interventions. While up to the early
1980's perioperative antibiotic prophylaxis in maxillofacial surgery was controversial, its
efficacy is well accepted today. Chole and his team could show that the administration of
antibiotics one hour preoperatively and eight hours after the intervention reduces the
incidence of infectious complications in facial fractures from 42,2% to 8.9%. However there
is still no consensus about the duration of the postoperative administration. In literature
postoperative prophylaxis in facial fractures varies from single-shot 6-7 up to a duration of
7 and even ten days postoperatively 8-10. The use of antibiotics can be associated with
allergic or toxic reactions, adverse effects, drug interactions and increasing bacterial
resistance. In addition some authors assume that a prolonged administration of antibiotics
might increase the risk of infectious complications via superinfection. On the other hand a
short term or single shot administration might not be enough to prevent the onset of an
postoperative infection. Up to date there is no standard to support the administration of
antibiotics after surgical repair of a facial fracture.
The purpose of this prospective, randomized double-blinded trial is to investigate the
utility of antibiotics administered in the postoperative period after surgical revision of
facial fractures.
Hypothesis: a short-term antibiotic prophylaxis of 1 day postoperatively is equally effective
as a long-term administration of 5 days in facial fractures.