Is single-shot antibiotic prophylaxis really enough for standard OMF-surgeries?

OBJECTIVES: Antibiotic resistance and the development of multidrug-resistant pathogens are on the rise worldwide. This is mainly due to inappropriate or excessive use of antibiotics. There is a lack of evidence-based guidelines and studies for the administration of antibiotics in OMF surgery. In this study, a new shortened antibiotic prophylaxis regimen for six standard OMFS procedures (Fracture repair, plate removal, orthognathic surgery, TUROP, ND and bone augmentation) was introduced and evaluated for clinical outcomes and feasibility. MATERIALS AND METHODS: 856 patients were enrolled in this study. They were monitored for postoperative complications such as dehiscence, fistula, signs of clinical infection, and laboratory markers of inflammation. Subgroup analyses were performed for clinically relevant procedure categories, including fractures, plate removal, and orthognathic surgery. RESULTS: After risk adjustment, reduced-duration antibiotic prophylaxis was not associated with adverse postoperative outcomes. Furthermore, a more restrictive administration as a single shot was associated with a shorter length of hospital stay (from 5.83 (± 7.92) to 4.32 (± 4.88) days (p = > 0.001)). CONCLUSIONS: A single dose of antibiotics was found to be sufficient for the oral and maxillofacial procedures evaluated. Implementation of a new policy of reduced antibiotic prophylaxis coincided with a shorter length of hospital stay. CLINICAL RELEVANCE: This study supports the growing body of evidence suggesting that shorter, procedure-tailored antibiotic regimens can be safe and effective, potentially reducing antimicrobial resistance and adverse drug effects without compromising surgical outcomes.