✨ Reassessing Routine Antibiotic Use in Maxillofacial Trauma Surgery
Maxillofacial trauma surgery frequently involves contaminated wounds, complex anatomy, and prolonged operative time, factors traditionally associated with a higher risk of surgical site infections (SSIs). For this reason, antibiotic prophylaxis has long been prescribed as routine practice. However, growing concerns regarding antimicrobial resistance, unnecessary costs, and unclear clinical benefit have prompted critical re-evaluation of this approach.
A recent systematic review published in Jurnal Rekonstruksi dan Estetik addresses this ongoing debate by examining whether prophylactic antibiotics truly reduce SSI rates in maxillofacial trauma surgery.
📄 Article Title:
Effectiveness of Antibiotic Prophylaxis in Maxillofacial Trauma Surgery: A Systematic Review
🔗 DOI: https://doi.org/10.20473/jre.v10i2.72261
📌 Why This Study Matters
Despite widespread use, recommendations on whether, when, and how long antibiotics should be given in maxillofacial trauma surgery remain inconsistent. Overprescription not only increases healthcare costs but also contributes to the global threat of antimicrobial resistance.
This systematic review provides an evidence-based assessment to support more rational, patient-centered antibiotic use.
🔍 Key Findings from the Review
🔹 Study Design and Methodology
Systematic search conducted using Google Scholar
Selection based on PICO framework
Included observational cohort studies
Study quality assessed using the JBI Critical Appraisal Checklist for Cohort Studies
A total of six studies met the inclusion criteria.
🔹 Do Prophylactic Antibiotics Reduce SSIs?
Five of six studies found no significant reduction in SSI rates with prophylactic antibiotics
Lack of benefit observed regardless of:
Timing (preoperative vs postoperative)
Duration of antibiotic administration
Only one study reported a statistically significant reduction in SSIs with preoperative prophylaxis
Variations in surgical technique, antibiotic regimens, patient characteristics, and study design likely contributed to inconsistent findings.
🔹 Postoperative Antibiotics: More Harm Than Benefit?
The review highlights that postoperative antibiotic regimens:
Do not reduce SSI rates
Increase treatment costs
Contribute to antimicrobial resistance
These findings challenge the routine use of prolonged antibiotics after maxillofacial trauma surgery.
⚠️ Clinical Implications
Rather than universal prophylaxis, the evidence supports a selective, risk-based approach, reserving antibiotics for:
Immunocompromised patients
Grossly contaminated wounds
Extensive soft-tissue injury
Prolonged or complex surgical procedures
Such an approach aligns with modern principles of antibiotic stewardship and evidence-based surgical care.
🎯 Why This Article Is Worth Reading and Citing
Clarifies controversies surrounding antibiotic prophylaxis in maxillofacial trauma
Supports judicious and selective antibiotic use
Reinforces antimicrobial stewardship principles
Relevant for oral and maxillofacial surgeons, plastic surgeons, and trauma teams
Highlights the need for high-quality randomized controlled trials
📚 Published in: Jurnal Rekonstruksi dan Estetik
✍️ Authors: Naufal Agus Isamahendra, Muhammad Tidar Abiyyu, Iswinarno Doso Saputro, Yanuar Ari Pratama
🏥 Institution: Faculty of Medicine, Universitas Airlangga & Dr. Soetomo General Academic Hospital
🔗 Read the full article:
https://doi.org/10.20473/jre.v10i2.72261
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#EvidenceBasedSurgery #MaxillofacialSurgery #PlasticSurgery #ReconstructiveSurgery #TraumaSurgery #InfectionControl #ClinicalResearch #SystematicReview #MedicalPublication
#GlobalHealth #PatientSafety #RationalAntibioticUse #AMR #HealthcareQuality #JRE #JREUnair
