Faculty Collaboration Database

Antibiotic Duration and Outcome Complications for Surgical Site Infection Prevention in Traumatic Mandible Fracture. J Surg Res 2020 Mar;247:524-529

Date

11/02/2019

Pubmed ID

31668431

DOI

10.1016/j.jss.2019.09.050

Scopus ID

2-s2.0-85074440328 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: The appropriate duration of antibiotic therapy for surgical site infection (SSI) prevention in traumatic mandibular fracture repair is unknown, and practices vary significantly. The objective of this study was to characterize antibiotic duration and outcomes after surgical repair of traumatic mandibular fracture.

METHODS: A single-center, retrospective analysis of all adult patients who underwent surgical fixation of a mandible fracture between January 2014 and December 2016 was performed. Operative service was categorized between otolaryngology (ear, nose, and throat surgery), plastic and reconstructive surgery, and oral and maxillofacial services. Primary outcomes were SSI and operative complications (including osteomyelitis, nonunion, malocclusion, and hardware infections). Differences in antibiotic prescription pattern were analyzed using analysis of variance test and Pearson chi-squared test.

RESULTS: A total of 75 patients were included in the study with 33 (44.0%), 26 (34.7%), and 16 (21.3%) managed by plastic and reconstructive surgery, ear, nose, and throat surgery, and oral and maxillofacial services, respectively. Median age was 30.0 y. Median injury severity score was 4.0. There was no significant difference in hospital length of stay (P = 0.44), intensive care unit length of stay (P = 0.53), or postoperative complications (P = 0.15). None of our patients developed an SSI or postantibiotics complications. Although the total inpatient duration of antibiotics was not significantly different among services (P = 0.37), there were significant differences in outpatient duration of antibiotics (P = 0.007) and total duration of antibiotics (P = 0.003).

CONCLUSIONS: Duration of antibiotics is not associated with postoperative SSI or antibiotics-related complications. The wide variation in prescribing practices and lack of any clear benefit for prolonged antibiotics provides an opportunity to explore the benefits of a standardized short course of antibiotics.

LEVEL OF EVIDENCE: Therapeutic study, III.

Author List

Zein Eddine SB, Cooper-Johnson K, Ericksen F, Brookes CC, Peppard WJ, Revolinski SL, Carver TW

Authors

Thomas W. Carver MD Associate Professor in the Surgery department at Medical College of Wisconsin
William J. Peppard PharmD Trauma/Surgical Critical Care Pharmacist in the Pharmacy department at Froedtert Hospital
Sara L. Revolinski PharmD Adjunct Assistant Professor in the School of Pharmacy Administration department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Anti-Bacterial Agents
Antibiotic Prophylaxis
Drug Administration Schedule
Female
Fracture Fixation
Humans
Injury Severity Score
Male
Mandible
Mandibular Fractures
Mandibular Injuries
Middle Aged
Practice Guidelines as Topic
Registries
Retrospective Studies
Surgical Wound Infection
Time Factors
Treatment Outcome
Young Adult