Antibiotic prevalence and infection rates in mandibular fractures-A systematic review

Abstract

Managing traumatic mandibular fractures in oral and maxillofacial surgery is challenging, with infection rates, healing time, and reoperation risks being key concerns. The effectiveness of antibiotic prophylaxis in reducing post-trauma infections and the optimal regimen remain debated. This study aims to provide evidence-based insights to inform clinical practice and guide future research. A comprehensive search in PICO question format with Medical Subject Headings terms was done in PubMed, Cochrane, and Google Scholar databases. Randomized controlled trials, prospective studies, and retrospective studies without age or time restrictions and published in English language were selected. Twelve studies qualified for the review after quality assessment. Data regarding the study’s origin, design, mean age and gender of the patients, site and rate of infection, infected patients and type of reduction, antibiotic regimen type, days of follow-up, complication after treatment, and any medication other than antibiotics were extracted. Studies on 4508 patients have shown mixed results on antibiotic prophylaxis for mandibular fractures. Open reduction without antibiotics had the highest infection rates. No difference was found between 1-day and 5-day antibiotic regimens. Overall infection rates ranged from 4.4% to 18.8% with an average of 12.25% in the antibiotic-associated group. Cephalosporin administration was associated with decreased incidence of infections among the studies. This study concludes that, antibiotics are beneficial, particularly for open reduction cases where patient factors such as poor oral hygiene and injury severity remain crucial.