A systematic review of prophylactic antibiotics in the surgical treatment of maxillofacial fractures.

PURPOSE A systematic review was performed to find evidence for prophylactic administration of antibiotics in relation to treatment of maxillofacial fractures. METHODS Four studies were retrieved that fulfilled most of the requirements of being randomized controlled clinical trials. RESULTS An analysis of these studies showed a 3-fold decrease in the infection rate of mandibular fractures in the antibiotic treated groups compared with the control groups. A variety of antibiotics had been used with an apparently uniform effect. A "1-shot" regimen or a 1-day treatment course had a similar or perhaps even better effect than 7 days of treatment. No infections were related to condylar, maxillary, or zygoma fractures. CONCLUSION A 1-shot or 1-day administration of prophylactic antibiotics seem to be the best documented to reduce infections in the management of mandibular fractures not involving the condylar region.