Antibiotic use in mandibular fracture surgery - An international survey and a review of the literature.

Objective: To clarify antibiotic use by oral and maxillofacial surgeons in mandibular fracture patients and evaluate practices based on scientific evidence.

Material and methods: We assessed antibiotic use in simple symphysis and angle mandibular fractures among oral and maxillofacial surgeons in the Nordic countries through an e-survey. In addition, we performed a literature review of antibiotic administration in mandibular fracture surgery.

Results: A total of 41 oral and maxillofacial surgeons who treat mandibular fractures responded to the questionnaire. Timing and duration of antibiotic use varied. The duration of postoperative antibiotic treatment ranged from 1 to 7 days (mean 5.6 days). Respondents' practices were not in concordance with scientific evidence. According to previous studies, restricting antibiotic exposure to a maximum of 24 hours postoperatively was not related to a higher risk of surgical site infections. No articles described a benefit of prolonged postoperative antibiotic therapy.

Conclusions: Antibiotic use in connection with mandibular fracture treatment varied in the Nordic countries and antibiotic practices are not in concordance with the current literature. Restricting antibiotic exposure to a maximum of 24 hours postoperatively should be considered. Clear guidelines for antibiotic prophylaxis as part of the surgical management of mandibular fractures are required.