COMPARISON OF CEFTRIAXONE WITH PENICILLIN FOR ANTIBIOTIC-PROPHYLAXIS FOR COMPOUND MANDIBLE FRACTURES

Purpose. The purpose of the study was to compare the efficacy and cost of two antibiotic regimens for prophylaxis of I compound mandible fra ctures: 1 gm/day ceftriaxone and 2 million U penicillin G every 4 hour s. Design. A prospective study of 90 patients with compound mandible f ractures was performed. The patients were randomized to the two antibi otic regimens. The surgical procedures were performed by oral/maxillof acial surgery residents at a large urban training center. Standard tre atment consisted of open reduction with either bone plates or wires, w ith all patients receiving 6 weeks of maxillomandibular fixation. The patients were monitored at 2-week intervals for 8 weeks by two of the authors, who were blinded to which antibiotic regimen the patient was assigned. Results. Two patients in each group had postoperative infect ions within the first 2 weeks of treatment. The infections resolved wi th local wound care, removal of internal fixation devices, and oral an tibiotics. After resolution of the infection each patient had a maluni on, which was managed without additional complications. The cost diffe rence between the two treatment regimens was approximately $350 per da y. Conclusion. Ceftriaxone was noted to be an efficacious and cost-eff ective treatment alternative to penicillin G for compound mandible fra cture antibiotic prophylaxis.