Abstract
No clear index is available for prophylactic antimicrobial administration during oral and maxillofacial surgery. Moreover, the correct use is little understood. Therefore, the antimicrobials used for oral and maxillofacial surgery are often empirically chosen based on the characteristics of the medical facility or the experience of the surgeon. In our department, we have recommended the prophylactic use of a first-generation cephalosporin rather than a second-generation cephalosporin since July 2011. Our first-generation cephalosporin recommendation is the result of a study conducted by the infection control team (ICT) in our hospital. To confirm whether or not this change represents appropriate use of antimicrobials, we determined the incidence of surgical site infections (SSIs) in malignant tumor cases (n=140), in which SSI occurs most frequently (4.7%) among all cases (n=1,160), and prophylactic antimicrobials were administered between January 2009 and December 2013. In this study, 3 SSI cases were found in the cefazolin (CEZ) group (4.8%), and 3 SSI cases in the cefotiam (CTM) group (4.1%). Because the incidence of SSIs in the CEZ and CTM groups did not differ, we showed that a first-generation cephalosporin can prevent SSIs during oral and maxillofacial surgery similar to a second-generation cephalosporin. The prophylactic antimicrobial dosing period and change to internal use antimicrobial, as well as other SSI risk factors, require investigation.
