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01-08-2019 | Oral and Maxillofacial Surgery | Review

A systematic review of latest evidence for antibiotic prophylaxis and therapy in oral and maxillofacial surgery

Authors: Sebastian Blatt, Bilal Al-Nawas

Published in: Infection | Issue 4/2019

Abstract

Purpose

Especially in oral and maxillofacial surgery, where procedures involving the aero-digestive tract considered clean contaminated, surgical site infections (SSI) represent a severe health care burden. To improve implementation and methodological standard, an upgrade of the existing S1 guideline to a consensus-guided S3 guideline was initiated by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V., AWMF, register number 067/009) and 25 collaborating medical societies.

Methods

A systematic literature search based on the Scottish Intercollegiate GL Network (SIGN)-search string for the guideline “Antibiotic prophylaxis in surgery” from 2014 was performed and equivalent exclusion/inclusion criteria were applied. An additional hand search provided latest evidence.

Results

In total, 80 clinical trials, retrospective studies, reviews, and meta-analysis were analyzed. For orthognathic surgery, prolonged antibiotic regimen may reduce risk for SSI but there is lack of evidence for the effects of short- vs. long-term therapy. For maxillofacial traumatology, antibiotic prophylaxis might reduce SSI but prolonged postoperative dosing shows no benefit. For clean-contaminated oncological interventions, anti-infectious therapy for 24 h only can reduce SSI; patients may not benefit from prolonged regimen. In contrast, for dentoalveolar procedures such as implantology or third molar removal, literature reveals ambivalent results.

Conclusion

In summary, consensus process of the planned S3 guideline is much in need to transfer the indecisive results for antibiotic prophylaxis in dentoalveolar surgery in clinical praxis and encourage adherence to guidelines.

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Title: A systematic review of latest evidence for antibiotic prophylaxis and therapy in oral and maxillofacial surgery
Authors: Sebastian Blatt
Bilal Al-Nawas
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Oral and Maxillofacial Surgery
Ampicillin
Antibiotic
Amoxicillin
Clindamycin
Oral and Maxillofacial Surgery
Cefazolin
Published in: Infection / Issue 4/2019
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-019-01303-8

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Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A systematic review of latest evidence for antibiotic prophylaxis and therapy in oral and maxillofacial surgery

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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