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 orthognathic surgery. Patients and Methods: Fifty-four patients (age range, 18 to 40 years) underwent bimaxillary orthognatic surgery. After randomization, a placebo (n = 19), 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 (ESR). Results: Fifteen of 54 patients developed a wound infection. Of these, 10 had 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 surgery without antibiotic prophylaxis. No significant difference in the incidence of infectious complications was found between the 2 medications.