EFFECTIVENESS OF ANTIBIOTIC PROPHYLAXIS IN MAXILLOFACIAL TRAUMA SURGERY: A SYSTEMATIC REVIEW
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Highlights:
- Antibiotic prophylaxis does not significantly decrease surgical site infection rates in maxillofacial trauma surgery.
- Post-operative antibiotic regimens are not recommended as they increase costs without reducing infection rates.
Abstract
Introduction: The effectiveness of antibiotic prophylaxis in maxillofacial trauma surgery remains a subject of debate, with varying recommendations regarding its necessity and duration. This systematic review aims to evaluate the impact of prophylactic antibiotics on the incidence of surgical site infections (SSIs) in maxillofacial trauma patients.
Methods: A systematic literature search was conducted using Google Scholar, following predefined inclusion and exclusion criteria based on the PICO framework. Studies included observational cohort studies comparing the use of prophylactic antibiotics to either no antibiotics or different regimens of antibiotic administration. The quality of the selected studies was assessed using the JBI Critical Appraisal Checklist for Cohort Studies.
Results: Six studies met the inclusion criteria, with five reporting no significant reduction in SSIs with prophylactic antibiotic use, regardless of the timing or duration of administration. Only one study found a statistically significant decrease in SSIs with preoperative antibiotic prophylaxis. Variations in study design, antibiotic regimens, surgical techniques, and patient populations may have influenced the inconsistent findings.
Conclusion: The findings suggest that routine antibiotic prophylaxis in maxillofacial trauma surgery may not be universally beneficial and should be reconsidered in favor of a more selective, patient-specific approach. Given the increasing concerns regarding antimicrobial resistance, prophylactic antibiotics should be reserved for high-risk patients where a clear benefit can be demonstrated. Further research, particularly well-designed randomized controlled trials, is necessary to establish standardized guidelines and optimize perioperative infection control strategies.
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