Preoperative antibiotic prophylaxis in orthognathic surgery: A randomized,double-blind, and placebo-controlled clinical study

Purpose: This study evaluated the need for antibiotic prophylaxis in orthog nathic surgery. Patients and Methods: Fifty-four patients (age range, 18 to 40 years) under went bimaxillary orthognatic surgery. After randomization, a placebo (n = 1 9), 2,200 mg amoxicillin-clavulanic acid (n = 18), or 1,500 mg cefuroxime ( n = 17) was administered in a double-blind fashion. During the first month, the postoperative course was observed according to the clinical parameters of infection, total leukocyte count and erythrocyte sedimentation rate (ES R). Results: Fifteen of 54 patients developed a wound infection. Of these, 10 h ad received a placebo; 3, cefuroxime; and 2, amoxicillin-clavulanic acid. Conclusions: There was a statistically significant (P <.004) increased risk of having an infectious complication after bimaxillary orthognathic surger y without antibiotic prophylaxis. No significant difference in the incidenc e of infectious complications was found between the 2 medications.