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Antibiotikaprofylax vid kirurgiska ingrepp - SBU

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Table 4.14.3 Orthognatic surgery.<br />

Author<br />

Year<br />

Reference<br />

Country<br />

Study<br />

design<br />

Population<br />

characteristics<br />

Intervention<br />

Method<br />

Number indi<strong>vid</strong>uals<br />

Control<br />

Number indi<strong>vid</strong>uals<br />

Results<br />

Withdrawals<br />

Drop outs<br />

Study quality<br />

and relevance<br />

Comments<br />

Baqain<br />

2004<br />

[17]<br />

Jordan<br />

RCT<br />

Pts undergoing orthognathic<br />

surgey. Randomised to<br />

receive short or long term<br />

prophylactic antibiotic.<br />

n=34<br />

I: Iv 1 g amoxicillin + 0.5 g<br />

3 h postoperatively + placebo<br />

per os x 3 x 5 days<br />

Allergic pts: Clindamycin<br />

300 mg iv + 150 mg clindamycin<br />

3 h postoperatively +<br />

placebo x 4 x 5 days, per os<br />

(n=17)<br />

C: Amoxicillin 1 g iv +<br />

0.5 g 3 h postoperatively<br />

+ amoxicillin 0.5 g per os<br />

x 3 x 5 days<br />

Allergic pts: Clindamycin<br />

300 mg iv + 150 mg clindamycin<br />

3 h postoperatively +<br />

150 mg placebo x 4 x 5 days,<br />

per os (n=17)<br />

Score for SSI<br />

I: 406<br />

C: 206<br />

p=0.04<br />

Need of<br />

additional<br />

antibiotics<br />

I: 4/17<br />

C: 2/17<br />

None<br />

Moderate<br />

Power not<br />

estimated. Most<br />

findings not statistically<br />

significant.<br />

Difference in<br />

infection score<br />

Jansisyanont<br />

2008<br />

[21]<br />

Thailand<br />

RCT<br />

Open<br />

study<br />

Pts treated with orthognathic<br />

surgery were<br />

enrolled and 122 pts<br />

participated in the study<br />

and were randomised to<br />

receive one of 4 antibiotic<br />

prophylaxis regimens.<br />

n=137<br />

I1: 1.2 g amoxicillin/clavulanic<br />

acid 30 min. Preoperatively<br />

and every 8 h during operation<br />

and 8 h postoperatively<br />

(n=33)<br />

I2: 2 million units penicillin G<br />

30 min pre-operatively and<br />

every 4 h during operation<br />

and 4 h postoperatively<br />

(n=29)<br />

SSI according<br />

to CDC<br />

I1: 1/33 pts<br />

I2: 0/29 pts<br />

I3: 0/28 pts<br />

I4: 1/32 pts<br />

No sign<br />

difference<br />

between<br />

groups<br />

Moderate<br />

I3: 1.2 g amoxicillin/clavulanic<br />

acid 30 min pre-operatively<br />

and every 8 h during operation<br />

and 8 h postoperatively<br />

+ 625 mg tablets amoxicillin/<br />

clavulanic acid every 8 h for<br />

5 days (n=28)<br />

I4: 2 million units penicillin G<br />

30 min pre-operatively and<br />

every 4h during operation<br />

and 4 h postoperatively +<br />

500 mg tablets amoxicillin/<br />

8 h for 5 days (n=32)<br />

The table continues on the next page<br />

540 antibiotikaprofylax <strong>vid</strong> <strong>kirurgiska</strong> <strong>ingrepp</strong> KAPITEL 4 • den systematiska litteraturöversikten<br />

541

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