amoxicillin-potassium-clavulanate-combination and Mandibular-Fractures

The present study was designed to investigate the difference in the effectiveness of a 3 day postoperative course and a single perioperative dose of antibiotics on the incidence of postoperative infection in the management of maxillofacial trauma patients.. About 183 maxillofacial trauma patients requiring open reduction and internal fixation (ORIF) under general anesthesia were divided based on the type of fracture sustained, i.e., mandibular fractures, Le Fort fractures, and zygomaticomaxillary complex fractures. Patients from each fracture type were randomized into two groups, A and B. All patients were administered amoxicillin/clavulanate 1.2 grams intravenously 8 hours from the time of admission till the patient was taken up for surgery. Once the patients were taken up for surgery, a perioperative dose was administered. No antibiotics beyond this point were given to patients in Group A. Patients in Group B were administered the same antibiotic for 3 postoperative days additionally. Outcomes in terms of purulent discharge from the surgical site, an abscess or any other sign of infection, and wound dehiscence requiring reopening of the surgical site were considered. Patients were reviewed at 1 week, 2 weeks, 1 month, 2 months, and 3 months.. No statistically significant difference was found between the two groups across all three fracture types in terms of postoperative outcomes. However, increased numbers of complications were noted in the patients treated with an intra-oral approach in each fracture type irrespective of group. All complications were managed with local measures.. A single perioperative dose of antibiotics is effective in minimizing postoperative complications following ORIF of maxillofacial fractures and there is no significant benefit in prolonging the course of antibiotics postoperatively with the need for further studies to be conducted considering comminuted, complex fractures and old fractures.. In maxillofacial trauma, fractures frequently communicate with contaminated indigenous flora on the skin surface, oral cavities, or sinus cavities. Surgery is frequently performed using an approach across a contaminated area, even in closed fractures. Postoperative infections can be significantly decreased by using antibiotics in surgical procedures to treat facial fractures.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Humans; Mandibular Fractures; Postoperative Complications; Prospective Studies; Skull Fractures

The aim of this study was to evaluate the difference between a 5-day and a 1-day postoperative course of antibiotic on the incidence of infection after mandibular fractures involving the alveolus. Sixty-two patients with fractures of the mandible involving the dentoalveolar region were randomly assigned to 2 groups, both of which were given amoxicillin/clavulanic acid 1.2 g intravenously every 8 h from admission until 24 h postoperatively. The 5-day group were then given amoxicillin/clavulanic acid 625 mg orally every 8 h for another 4 days. The 1-day group was given an oral placebo at the same intervals. Follow-up appointments were 1, 2, 4, 6, 12 weeks and 6 months postoperatively. Development of an infection was the primary end point. Fifty-nine of the 62 patients completed this study. Six of the 30 patients in the 5-day group (20%) and 6 out of the 29 in the 1-day group (21%) developed local wound infections. Three of the 6 in the 1-day group developed purulent discharge and swelling. One patient in the 5-day group developed a rash on the trunk. There were no significant differences in the incidence of infection or side effects between the groups. In fractures of the mandible involving the alveolus, a 1-day postoperative course of antibiotic is as effective in preventing infective complications as a 5-day regimen.

Topics: Administration, Intravenous; Administration, Oral; Adolescent; Adult; Aged; Alveolar Process; Amoxicillin-Potassium Clavulanate Combination; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Double-Blind Method; Drainage; Exanthema; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Male; Mandibular Fractures; Middle Aged; Pilot Projects; Placebos; Postoperative Care; Povidone-Iodine; Prospective Studies; Surgical Wound Dehiscence; Surgical Wound Infection; Young Adult

We retrospectively studied 708 consecutive patients at the Queen Elizabeth Hospital, Birmingham, to find out whether one of the four antibiotic protocols in use conferred any advantage (or disadvantage) on a patient who had a fractured angle of the mandible, and there was none. However, the time from initial injury until the time of the first dose of antibiotic was important. Clinically, if patients waited more than 72hours after the injury before the first dose of antibiotic was given, they had a three times higher rate of postoperative infection than patients who were given their first dose between 24 and 72hours after the injury. Morbidity was more than five times higher during the postoperative period if the patient had waited for three days before their first dose, compared with those given the first dose within eight hours of injury. The overall rate of malunion or non-union of the fracture was between five and 10 times higher if the patient had waited more than 72hours after injury compared with all the other groups. There was a considerable difference in cost between the intravenous and oral versions of the antibiotics used (Augmentin

Topics: Adolescent; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Female; Humans; Male; Mandibular Fractures; Middle Aged; Retrospective Studies; Surgical Wound Infection; Treatment Outcome

The objective of this study was to retrospectively evaluate and report the associated factors with the diagnosis and management of 24 patients with chronic osteomyelitis of the mandible seen at the authors' institution during the past several years.. Only cases of chronic osteomyelitis of the mandible not associated with antiresorptive medications or radiotherapy to the maxillofacial region were included in the study. After confirmation of the diagnosis, initial clinical and radiologic findings, treatment approach, and outcome were evaluated for each patient. Fourteen male and 10 female patients (average age, 53.75 yr; range, 22 to 83 yr) were included.. The peak incidence of the disease was recorded in the fifth and sixth decades of life. An uneventful healing was observed in 20 patients (83.3%). One of 18 patients (5.5%) who underwent segmental resections developed a secondary infection and was managed with intravenously administered antibiotics. Three of 6 patients (50%) who were treated with marginal resections remained symptomatic after surgery.. Independent of the cause and presentation of the disease, complete resolution of the infection should be the main focus of management in patients with chronic osteomyelitis of the mandible, and findings of this retrospective study indicate that a conservative surgical approach is more likely to result in a less than ideal outcome.

Topics: Administration, Intravenous; Adult; Age Factors; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Anti-Bacterial Agents; beta-Lactams; Chronic Disease; Clindamycin; Doxycycline; Ertapenem; Female; Follow-Up Studies; Fractures, Spontaneous; Humans; Male; Mandibular Diseases; Mandibular Fractures; Middle Aged; Osteomyelitis; Osteosclerosis; Retrospective Studies; Sulbactam; Treatment Outcome; Vancomycin; Young Adult