AB127. SOH24AB_213. A review of infection rates and the use of prophylactic antibiotics in the management of mandibular fracture: our experience
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AB127. SOH24AB_213. A review of infection rates and the use of prophylactic antibiotics in the management of mandibular fracture: our experience

Eoghan Flynn, Sammy Magdeldin, Eimhin Sheehan, Akinsola Ogunbowale, Mark Wilson

Oral and Maxillofacial Department, University Hospital Limerick, Dooradoyle, Limerick, Ireland

Background: Surgical site infection is a known complication of mandibular fracture repair. Pre, intra and postoperative prophylactic antibiotics are used widely with a large variation in protocol reported. Open reduction internal fixation (ORIF) is the gold standard treatment.

Methods: A literature review was performed regarding antibiotic prophylaxis and mandibular fracture repair. A retrospective study carried out identified 46 adult patients who had ORIF repair of mandibular fracture over a 20-month period at University Hospital Limerick (UHL). Prescription of prophylactic antibiotics regime and subsequent surgical site infection rates were investigated.

Results: The protocol identified in the literature was the use of pre, intra and postoperative antibiotics in patients with ORIF mandibular fracture showing variation in timing, duration and overall regime. Surgical site infections ranged from 3–15%. Postoperative antibiotics ranged from two postoperative doses to 7 days duration. In our centre, initial doses of preoperative antibiotics were favoured until surgery. Intraoperative antibiotics were given in all cases while postoperative antibiotics were given in all cases for at least 5 days. Prophylactic antibiotic use was associated with a surgical site infection rate of 2.2%.

Conclusions: A lack of consensus in the literature exists with no strong evidence either for or against the use of prophylactic antibiotics in mandibular fracture. The antibiotic protocol used in UHL is associated with a low infection rate. Our centre used prolonged prophylaxis in every case despite heterogeneity in the literature regarding its benefit. Further well-designed studies are needed to guide our use of prophylactic antibiotics in fractured mandibles.

Keywords: Prophylactic antibiotics; mandibular fractures; infection rates; open reduction internal fixation (ORIF); antibiotic protocol variation

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab127
Cite this abstract as: Flynn E, Magdeldin S, Sheehan E, Ogunbowale A, Wilson M. AB127. SOH24AB_213. A review of infection rates and the use of prophylactic antibiotics in the management of mandibular fracture: our experience. Mesentery Peritoneum 2024;8:AB127.

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