Skip to main content
SpringerLink
Log in

Perioperative Antibiotikaprophylaxe in der MKG-Chirurgie

Perioperative antibiotic prophylaxis in oral and maxillofacial surgery

  • Leitthema
  • Published:
Der MKG-Chirurg Aims and scope

Zusammenfassung

Der Einsatz eines Antibiotikums als antibiotische Prophylaxe in der Mund-, Kiefer- und Gesichtschirurgie ist abhängig von der Art und der Dauer des Eingriffs sowie den bestehenden lokalen und allgemeinen Infektionsrisiken des Patienten. Ein erhöhtes Infektionsrisiko besteht bei einer Operation durch ein kontaminiertes oder verschmutztes Operationsgebiet, bei patienteneigenen Risikofaktoren und bei operationsbedingten Risiken. Ziel einer antiinfektiven Prophylaxe mit einem systemischen Antibiotikum ist der Schutz des Patienten vor postoperativen Wundinfektionen.

Abstract

The use of antibiotic prophylaxis in oral and maxillofacial surgery depends on the type of surgery, the duration of the operation and the local and systemic infection risks of the patient. A higher risk of infection exists if the operating field is contaminated or infected and if there are more patient-specific and surgery-specific risk factors. The aim of antibiotic prophylaxis with a systemic antibiotic is protection of the patient from postoperative wound infections.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Adalarasan S, Mohan A, Pasupathy S (2010) Prophylactic antibiotics in maxillofacial fractures: a requisite? J Craniofac Surg 21:1009–1011

    Article  PubMed  CAS  Google Scholar 

  2. Ataoglu H, Oz GY, Candirli C, Kiziloglu D (2008) Routine antibiotic prophylaxis is not necessary during operations to remove third molars. Br J Oral Maxillofac Surg 46:133–135

    Article  PubMed  Google Scholar 

  3. Bassetti M, Righi E, Astilean A et al (2014) Antimicrobial prophylaxis in minor and major surgery. Minerva Anestesiol (Epub ahead of print)

  4. Bratzler DW, Houck PM (2005) Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg 189:395–404

    Article  PubMed  Google Scholar 

  5. Cruse PJ, Foord R (1980) The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 60:27–40

    PubMed  CAS  Google Scholar 

  6. Culver DH, Horan TC, Gaynes RP et al (1991) Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 91:152S–157S

    Article  PubMed  CAS  Google Scholar 

  7. Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (2012) S2k-Leitlinie „Zahnärztlich-chirurgische Sanierung vor Herzklappenersatz“, AWMF-Register Nr. 007/096. http://www.awmf.org/leitlinien/detail/ll/007-096.html

  8. Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (2010) S3-Leitlinie „Implantat-Versorgung zur oralen Rehabilitation im Zusammenhang mit Kopf-Hals-Bestrahlung“, AWMF-Register Nr. 007/089, geplante Aktualisierung bis 31.12.2015. http://www.awmf.org/leitlinien/detail/ll/007-089.html

  9. Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (2012) S2k-Leitlinie „Operative Entfernung von Weisheitszähnen“, AWMF-Register Nr. 007/003. http://www.awmf.org/leitlinien/detail/ll/007-003.html

  10. Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (2009) S2-Leitlinie „Wurzelspitzenresektion“ (02/2009, AWMF-Register Nr. 007/007, geplante Aktualisierung bis 31.12.2014. http://www.awmf.org/leitlinien/detail/ll/007-007.html

  11. Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie (2012) S3-Leitlinie „Bisphosphonat-assoziierte Kiefernekrosen (BP-ONJ) und andere Medikamenten-assoziierte Kiefernekrosen“, AWMF-Register Nr. 007/091. http://www.awmf.org/leitlinien/detail/ll/007-091.html

  12. Dowell S, Oates TW, Robinson M (2007) Implant success in people with type 2 diabetes mellitus with varying glycemic control: a pilot study. J Am Dent Assoc 138:355–361, quiz 397–358

    Article  PubMed  CAS  Google Scholar 

  13. Enzler MJ, Berbari E, Osmon DR (2011) Antimicrobial prophylaxis in adults. Mayo Clin Proc 86:686–701

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  14. Esposito M, Grusovin MG, Worthington HV (2013) Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database Syst Rev 7:CD004152

    PubMed  Google Scholar 

  15. Fenton DA, Piecuch JF (2012) Perioperative strategies for third molar surgery. Atlas Oral Maxillofac Surg Clin North Am 20:225–232

    Article  PubMed  Google Scholar 

  16. Furr AM, Schweinfurth JM, May WL (2006) Factors associated with long-term complications after repair of mandibular fractures. Laryngoscope 116:427–430

    Article  PubMed  Google Scholar 

  17. Grötz K.A. KT (2006) Zahnärztliche Betreuung von Patienten unter/nach Bisphosphonat-Medikation. Dtsch Zahnärztl Z 60

  18. Gutta R, Tracy K, Johnson C et al (2014) Outcomes of mandible fracture treatment at an academic tertiary hospital: a 5-year analysis. J Oral Maxillofac Surg 72:550–558

    Article  PubMed  Google Scholar 

  19. Habib G, Hoen B, Tornos P et al (2009) Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the prevention, diagnosis, and treatment of infective endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for infection and cancer. Eur Heart J 30:2369–2413

    Article  PubMed  Google Scholar 

  20. Hansen E, Belden K, Silibovsky R et al (2014) Perioperative antibiotics. J Orthop Res 32(Suppl 1):S31–S59

    Article  PubMed  Google Scholar 

  21. Hansen S, Sohr D, Piening B et al (2013) Antibiotic usage in German hospitals: results of the second national prevalence study. J Antimicrob Chemother 68:2934–2939

    Article  PubMed  CAS  Google Scholar 

  22. Harrop JS, Styliaras JC, Ooi YC et al (2012) Contributing factors to surgical site infections. J Am Acad Orthop Surg 20:94–101

    Article  PubMed  Google Scholar 

  23. Johnson JT, Wagner RL (1987) Infection following uncontaminated head and neck surgery. Arch Otolaryngol Head Neck Surg 113:368–369

    Article  PubMed  CAS  Google Scholar 

  24. Kamizono K, Sakuraba M, Nagamatsu S et al (2014) Statistical analysis of surgical site infection after head and neck reconstructive surgery. Ann Surg Oncol 21(5):1700–1705

    Article  PubMed  Google Scholar 

  25. Korol E, Johnston K, Waser N et al (2013) A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One 8:e83743

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kujath P, Bouchard R, Scheele J, Esnaashari H (2006) Current perioperative antibiotic prophylaxis. Chirurg 77:490, 492–498

    Article  PubMed  CAS  Google Scholar 

  27. Lauder A, Jalisi S, Spiegel J et al (2010) Antibiotic prophylaxis in the management of complex midface and frontal sinus trauma. Laryngoscope 120:1940–1945

    Article  PubMed  Google Scholar 

  28. Lindeboom JA, Baas EM, Kroon FH (2003) Prophylactic single-dose administration of 600 mg clindamycin versus 4-time administration of 600 mg clindamycin in orthognathic surgery: a prospective randomized study in bilateral mandibular sagittal ramus osteotomies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 95:145–149

    Article  PubMed  Google Scholar 

  29. Lindeboom JA, Tuk JG, Kroon FH, Akker HP van den (2005) A randomized prospective controlled trial of antibiotic prophylaxis in intraoral bone grafting procedures: single-dose clindamycin versus 24-hour clindamycin prophylaxis. Mund Kiefer Gesichtschir 9:384–388

    Article  PubMed  Google Scholar 

  30. Lovato C, Wagner JD (2009) Infection rates following perioperative prophylactic antibiotics versus postoperative extended regimen prophylactic antibiotics in surgical management of mandibular fractures. J Oral Maxillofac Surg 67:827–832

    Article  PubMed  Google Scholar 

  31. Man LX, Beswick DM, Johnson JT (2011) Antibiotic prophylaxis in uncontaminated neck dissection. Laryngoscope 121:1473–1477

    Article  PubMed  Google Scholar 

  32. Monaco G, Tavernese L, Agostini R, Marchetti C (2009) Evaluation of antibiotic prophylaxis in reducing postoperative infection after mandibular third molar extraction in young patients. J Oral Maxillofac Surg 67:1467–1472

    Article  PubMed  Google Scholar 

  33. Montefusco V, Gay F, Spina F et al (2008) Antibiotic prophylaxis before dental procedures may reduce the incidence of osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphonates. Leuk Lymphoma 49:2156–2162

    Article  PubMed  CAS  Google Scholar 

  34. Nichols RL (2001) Preventing surgical site infections: a surgeon’s perspective. Emerg Infect Dis 7:220–224

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  35. Ogihara H, Takeuchi K, Majima Y (2009) Risk factors of postoperative infection in head and neck surgery. Auris Nasus Larynx 36:457–460

    Article  PubMed  Google Scholar 

  36. Oomens MA, Verlinden CR, Goey Y, Forouzanfar T (2014) Prescribing antibiotic prophylaxis in orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 43(6):725–731

    Article  PubMed  CAS  Google Scholar 

  37. Pestel G, Closhen D, Zimmermann A et al (2013) Aspects of perioperative care in patients with diabetes. Anaesthesist 62:9–19

    Article  PubMed  CAS  Google Scholar 

  38. Powell CA, Mealey BL, Deas DE et al (2005) Post-surgical infections: prevalence associated with various periodontal surgical procedures. J Periodontol 76:329–333

    Article  PubMed  Google Scholar 

  39. Reutter F, Reuter DA, Hilgarth H et al (2014) Perioperative antibiotic prophylaxis. Anaesthesist 63:73–86

    Article  PubMed  CAS  Google Scholar 

  40. Schwartz AB, Larson EL (2007) Antibiotic prophylaxis and postoperative complications after tooth extraction and implant placement: a review of the literature. J Dent 35:881–888

    Article  PubMed  CAS  Google Scholar 

  41. Sharaf B, Jandali-Rifai M, Susarla SM, Dodson TB (2011) Do perioperative antibiotics decrease implant failure? J Oral Maxillofac Surg 69:2345–2350

    Article  PubMed  Google Scholar 

  42. Tan SK, Lo J, Zwahlen RA (2011) Are postoperative intravenous antibiotics necessary after bimaxillary orthognathic surgery? A prospective, randomized, double-blind, placebo-controlled clinical trial. Int J Oral Maxillofac Surg 40:1363–1368

    Article  PubMed  CAS  Google Scholar 

  43. Tawil G, Younan R, Azar P, Sleilati G (2008) Conventional and advanced implant treatment in the type II diabetic patient: surgical protocol and long-term clinical results. Int J Oral Maxillofac Implants 23:744–752

    PubMed  Google Scholar 

  44. Turkyilmaz I (2010) One-year clinical outcome of dental implants placed in patients with type 2 diabetes mellitus: a case series. Implant Dent 19:323–329

    Article  PubMed  Google Scholar 

  45. Walraven C van, Musselman R (2013) The Surgical Site Infection Risk Score (SSIRS): a model to predict the risk of surgical site infections. PLoS One 8:e67167

    Article  PubMed  PubMed Central  Google Scholar 

  46. Wacha H, Hoyme U, Isenmann R et al (2010) Perioperative Antibiotika-Prophylaxe. Empfehlungen einer Expertenkommission der Paul-Ehrlich-Gesellschaft für Chemotherapie e. V. Chemother J 19:70–84

    Google Scholar 

  47. Zelenitsky SA, Ariano RE, Harding GK, Silverman RE (2002) Antibiotic pharmacodynamics in surgical prophylaxis: an association between intraoperative antibiotic concentrations and efficacy. Antimicrob Agents Chemother 46:3026–3030

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  48. Zhang L, Liu BC, Zhang XY et al (2012) Prevention and treatment of surgical site infection in HIV-infected patients. BMC Infect Dis 12:115

    Article  PubMed  PubMed Central  Google Scholar 

  49. Zijderveld SA, Smeele LE, Kostense PJ, Tuinzing DB (1999) Preoperative antibiotic prophylaxis in orthognathic surgery: a randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg 57:1403–1406, discussion 1406–1407

    Article  PubMed  CAS  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Karbach und B. Al-Nawas geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Plastische Operationen, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Augustusplatz 2, 55131, Mainz, Deutschland

    J. Karbach & B. Al-Nawas

Authors
  1. J. Karbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Al-Nawas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Karbach.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karbach, J., Al-Nawas, B. Perioperative Antibiotikaprophylaxe in der MKG-Chirurgie. MKG-Chirurg 7, 261–267 (2014). https://doi.org/10.1007/s12285-013-0415-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12285-013-0415-2

Schlüsselwörter

Keywords

Search

Navigation