Impact of long-term vs. short-term and single day vs. single dose of antibiotic prophylaxis in reducing infection rates after orthognathic surgery: a systematic review and meta-analysis.

IF 2.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Medicina Oral Patologia Oral Y Cirugia Bucal Pub Date : 2024-05-01 DOI:10.4317/medoral.26368
X Tang, K Wen, Y Yang
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Abstract

Background: This review was designed to examine the effect of long-term (≥2 days) vs. short-term (1 day) and single-day vs. single preoperative doses of antibiotic prophylaxis on surgical site infection (SSI) rates after orthognathic surgery.

Material and methods: PubMed, Web of Science, Embase, and Scopus were searched for randomized controlled trials (RCTs) without any date or language restriction till 1st September 2023. SSI rates were pooled to generate risk ratio (RR).

Results: Eight RCTs comparing long-term vs. short-term and three RCTs comparing single day vs. single preoperative dose of antibiotic prophylaxis were included. Meta-analysis showed that the use of long-term antibiotic prophylaxis significantly reduced the risk of SSI after orthognathic surgery as compared to short-term antibiotics [RR:0.42 (95% CI: 0.23, 0.76) I2=0%]. Meta-analysis also noted that patients receiving a single day of antibiotic prophylaxis had significantly reduced risk of SSI as compared to those receiving only a preoperative single dose of antibiotics [RR:0.28 (95%: 0.09, 0.82) I2=0%].

Conclusions: Evidence from a limited number of RCTs with moderate to high risk of bias shows that two to seven days of long-term antibiotic prophylaxis reduces the risk of SSI as compared to single-day antibiotic therapy. Also, a single day of antibiotics may be more beneficial than a single pre-operative dose of antibiotic.

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长期与短期、单日与单剂量抗生素预防对降低正颌外科手术后感染率的影响:系统回顾和荟萃分析。
背景:本综述旨在研究长期(≥2 天)与短期(1 天)、单日与单次术前抗生素预防对正颌外科手术后手术部位感染(SSI)率的影响:在PubMed、Web of Science、Embase和Scopus上搜索截至2023年9月1日的随机对照试验(RCT),无任何日期或语言限制。对 SSI 发生率进行汇总,得出风险比 (RR):结果:共纳入了 8 项比较长期与短期抗生素预防的随机对照试验和 3 项比较单日与单次术前抗生素预防的随机对照试验。Meta 分析表明,与短期抗生素相比,使用长期抗生素预防可显著降低正颌手术后的 SSI 风险[RR:0.42 (95% CI: 0.23, 0.76) I2=0%]。Meta分析还指出,与仅接受术前单剂抗生素治疗的患者相比,接受单日抗生素预防治疗的患者发生SSI的风险显著降低[RR:0.28 (95% CI:0.09, 0.82) I2=0%]:来自数量有限且存在中度至高度偏倚风险的研究性试验的证据显示,与单日抗生素治疗相比,2 至 7 天的长期抗生素预防可降低 SSI 风险。此外,单日抗生素治疗可能比术前单剂抗生素治疗更有益。
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来源期刊
Medicina Oral Patologia Oral Y Cirugia Bucal
Medicina Oral Patologia Oral Y Cirugia Bucal DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.60
自引率
0.00%
发文量
52
审稿时长
3-8 weeks
期刊介绍: 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology
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