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Single-dose versus prolonged antibiotic prophylaxis for alveolar bone grafting in cleft patients

  • S. Kluba
    Correspondence
    Correspondence to: Klinik und Poliklinik für Mund-, Kiefer, und Gesichtschirurgie, Universitätsklinikum Tübingen, Osianderstr. 2–8, D-72076 Tübingen, Germany. Tel: +49 7071 2986174. Fax: +49 7071 293481.
    Affiliations
    Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
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  • S. Reinert
    Affiliations
    Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
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  • M. Krimmel
    Affiliations
    Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
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Published:October 21, 2022DOI:https://doi.org/10.1016/j.ijom.2022.10.002

      Abstract

      The increase in antimicrobial resistance requires a critical discussion of antibiotic applications. Postoperative antibiotic prophylaxis is still common for intraoral bone transplantation. However, no guidelines exist for alveolar bone grafting (ABG) in cleft patients. This study compared the infection rate between prolonged and single-dose prophylaxis for this procedure, with the null hypothesis of no difference between the two groups. In total, 109 ABG procedures in 94 cleft patients performed by two surgeons were included. Patients received either prolonged or single-dose antibiotic prophylaxis. The complication rate was compared between the groups. Fifty-nine patients (34 male, 25 female) received prolonged prophylaxis (group 1), while 35 (23 male, 12 female) had just a single dose (group 2). Median age at surgery differed between the two groups, but not significantly (P = 0.72). One relevant surgical site infection was observed among patients with postoperative antibiotic application, while no infections occurred in the single-dose prophylaxis group (1.7% vs. 0%); this difference was not statistically significant (P = 0.84). The duration of hospitalization was longer in group 1. The reduction of antibiotic prophylaxis to a single dose did not increase the infection rate. The results strongly encourage reducing antibiotic prophylaxis for ABG procedures in cleft patients.

      Keywords

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