Are prophylactic antibiotics useful in the management of facial fractures?

BACKGROUND Surgeons operating in the head and neck commonly treat facial fractures; however, the role of prophylactic antibiotics remains controversial. Facial fractures vary in location and severity and can span the range of wound classifications including clean, clean contaminated, contaminated, and dirty/infected. It is clear that actively infected facial fractures should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic use in practice today. In an era of increased antibiotic resistance, as well as greater focus on evidence-based medicine and reducing health care costs, it is important to review the current evidence for the role of prophylactic antibiotics in facial fractures.