Perepa Anisha, Sinha Ramen, Agarwal Anmol, Khan Tahseen Ali
1Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India.
Plot No 204, Sripuram Colony, Malakpet, Hyderabad, India.
J Maxillofac Oral Surg. 2018 Mar;17(1):19-23. doi: 10.1007/s12663-016-0964-9. Epub 2016 Sep 10.
The purpose of this study is to determine the necessity and/or effectiveness of antibiotics in cases with maxillofacial trauma and emphasise the administration of antibiotics in maxillofacial fractures indicated for open reduction and rigid internal fixation (ORIF).
This study is a single blind, prospective, randomized clinical trial composed of subjects who presented with non-comminuted, linear fractures of the mandible and were treated by ORIF via an intraoral approach. One hundred and forty-four subjects (2011-2015) who belonged to the above entities were randomly categorized into 2 groups of 72 each, on lottery method. Patients in Group A were administered a 5 day course of antibiotic (1 day IV antibiotics followed by 4 days oral) while patients in Group B received a 1 day course of IV antibiotic (1 dose post op). Both the groups were followed up on the 1st day, 3rd day, 1st week, 1st month, 3rd month post operatively and were evaluated for pain, swelling, infection, fever, spontaneous wound dehiscence, purulent discharge and any other adverse effects.
Post operative infection when measured clinically and radiographically was comparatively higher in Group B. Out of 72 patients in both the groups, 5 patients each in Group A and Group B reported with wound dehiscence, 9 patients in both groups developed pyrexia.
Though the post operative infection was slightly more in Group B compared to Group A, 1 day antibiotic regimen was found to be equally effective when compared to 5 day regimen and helps in reducing the after effects, superinfection and antibiotic resistance. It has better patient compliance and is cost effective.
本研究旨在确定抗生素在颌面部创伤病例中的必要性和/或有效性，并强调在需要切开复位内固定术（ORIF）的颌面部骨折中使用抗生素。
本研究为单盲、前瞻性、随机临床试验，研究对象为下颌骨非粉碎性线性骨折并通过口内入路接受ORIF治疗的患者。采用抽签法将2011年至2015年符合上述条件的144名患者随机分为两组，每组72人。A组患者接受为期5天的抗生素治疗（1天静脉注射抗生素，随后4天口服），而B组患者接受为期1天的静脉注射抗生素治疗（术后1剂）。两组患者均在术后第1天、第3天、第1周、第1个月、第3个月进行随访，并对疼痛、肿胀、感染、发热、伤口自发裂开、脓性分泌物及其他不良反应进行评估。
临床和影像学测量显示，B组术后感染率相对较高。两组72例患者中，A组和B组各有5例患者出现伤口裂开，两组各有9例患者出现发热。
虽然B组术后感染率略高于A组，但与5天治疗方案相比，1天抗生素治疗方案同样有效，有助于减少后遗症、二重感染和抗生素耐药性。它具有更好的患者依从性且具有成本效益。
