A randomized prospective study of oral versus intravenous antibiotic prophylaxis against postoperative infection after sagittal split ramus osteotomyof the mandible

Background: We investigated whether oral levofloxacin was as effective as i ntravenous cefazolin sodium for preventing postoperative infections in pati ents undergoing sagittal split ramus osteotomy of the mandible. Methods: Fo rty-four patients were randomized to treatment with levofloxacin or cefazol in sodium. Levofloxacin (100 mg t.d.s.) was administered orally, and cefazo lin sodium (1 g b.i.d.) by intravenous infusion. Both drugs were given unti l 5 days postoperatively. The concentrations of levofloxacin in the mandibu lar bone marrow and serum were measured. Results: The mean levofloxacin con centration 4 h and 53.7 min after administration was 1.086 mug/ml in serum and 1.328 mug/ml in the mandibular bone marrow. The efficacy rate of levofl oxacin was 95% and that of cefazolin sodium was 85.7%, with no significant difference between the two drugs (p = 0.322). Conclusion: Oral administrati on of levofloxacin is a simple, cost-effective and safe alternative to intr avenous antibiotic prophylaxis after mandibular surgery. Copyright (C) 2000 S. Karger AG, Basel.