Soong, P.L., Schaller, B., Zix, J., Iizuka, T., Mottini, M., Lieger, O.

The aim of this study was to evaluate the difference between the effect of a five-day and a one-day postoperative course of antibiotics on the incidence of infection after midfacial fractures. A total of 98 patients with displaced Le Fort or zygomatic fractures that required operation were randomly assigned into two groups, both of which were given amoxicillin/clavulanic acid 1.2g intravenously every eight hours from the time of admission until 24h postoperatively. The five-day group was then given amoxicillin/clavulanic acid 625mg orally eight-hourly for another four days. The one-day group was given placebo orally at the same time points. Patients were followed up one, two, four, six, and 12 weeks, and six months, postoperatively. The development of an infection of the wound was the primary end point. Ninety-four of the 98 patients completed the study. Two of the 45 patients in the five-day group (4%) and 2/49 in the one-day group (4%) developed postoperative wound infections. One in each group had a purulent infection, while the others had only wound breakdown. Two patients of the five-day group and one in the one-day group developed rashes on the trunk. There were no significant differences in the incidence of infection or side effects between the groups. In midfacial fractures, a one-day course of antibiotics postoperatively is as effective in preventing infective complications as a five-day regimen.

British Journal of Oral and Maxillofacial Surgery. 2014; 52 (4): 329-333.